Lynda Kizer

Contact Lynda at Lynda Kizer & Associates, Inc., 7585 S. Prescott St., Littleton, CO 80120. Phone 303-794-6642, fax 303-794-1395, or e-mail: lyndakizer@worldnet.att.net

We have all heard "People make the difference!" until we're probably sick of the phrase. However, in my twenty years dealing with the dental profession, I have seen the truth in that statement. The successful fee-for-service practices seem to attract and keep committed employees who in turn, retain loyal patients who trust the quality of the dentist. This of course translates into better case acceptance.

The market trends today have made it increasingly difficult to recruit people into our support jobs. This makes it even more important to keep the talented people we have in place. Patient retention is also getting more difficult due to the changing insurance game and professional marketing groups attracting patients to their fold. Therefore, we must be sure that we are doing all we can to attract and retain the best talent in the marketplace.

I decided to determine if there were common denominators as to why good people stayed on in a practice. Does money have the most influence on career choices, or are there other primary factors? I called successful practices (both small and group practices) and received permission to do confidential interviews with staff members who had been employed with them for five years or more.

Forty-seven staff members, including business assistants, clinical assistants and hygienists, agreed to participate in my research. Some of the practices were large group practices, some very small and some were mid-sized. All were predominately fee-for-service and in the top percentile financially. The length of employment ranged from five years to thirty-seven years, with the average being fourteen years.

I asked the same questions of all interviewees and had each of them rank fifteen factors that were absolutely essential to joining, staying with, or leaving a practice. Other questions also included if they had ever considered leaving in the past, why they decided to stay and if another employer had recruited them. The last question asked them to identify what they had brought of value to the practice.

The following factors for retaining the most talented people are listed by order of perceived importance:

#1 An Employer I Admire; Company Values (tied for first place)

Staff members defined this as: quality technical skills; ethical, moral standards, behavior and honesty; doing the best they can for every patient -- the patient is #1; the employee is treated with respect; Doctor is compassionate, and has a life "in balance." The Boy Scout Virtues were mentioned as a code to live by for employee and patient retention.

#2 Freedom and Autonomy

This was particularly important to hygienists interviewed. The respondents saw this as showing trust and respect for them. It prevents burn-out by allowing creative thinking and the opportunity to do their very best.

#3 Salary

Several respondents commented that this could move to number one when recruiting new employees, especially young and inexperienced people. It moved down in priority as they realized the importance of other things that gave job satisfaction. However, the salary must be fair and within market standards.

#4 Benefits and Profit Sharing

Vacation, sick leave, medical insurance and profit sharing or retirement benefits were mentioned not only as incentives to take the job, but also as a prevention in leaving to take another position. Profit sharing or retirement became more important to the employees employed more than ten years.

#5 Well-Managed

This issue was listed as important in reducing daily stress and keeping other talented team members in place. If management does not act to replace team members that are "C" employees, it will cause the "A" employees to consider leaving.

#6 Exciting Challenges; Offering Additional Training and Development (tied for 6^th place)

These help to create loyalty to the practice and to improved job satisfaction.

I asked each respondent if they could think of anything else that might help a dentist attract and keep talented people. A very large percentage talked about how common courtesies and appreciation increased their loyalty and commitment to the practice. They mentioned the doctor saying "Good morning" and "Thank you for being here today" as very important to them. They mentioned the doctor showing genuine interest and concern in their personal lives -- not involvement, but caring. They shared their appreciation of surprise gifts that fit their life style, which showed that the doctor had taken the time to match the gift to the receiver. They talked about being treated as an equal and important team member, and an open interest in their ideas for change or improvement. They appreciated flexibility, when possible, in hours and schedules.

The last topic we covered was their value to the practice. Nearly all responded that they had built relationships with the patients that created loyalty to the practice. Also, relationships build trust and therefore improved patient acceptance of recommended treatment. Many of the respondents saw themselves as taking more responsibility in area management and training of newer team members, which in turn relieved the doctor from some management duties and tasks.

Looking at what the employees have told us, here are some aggressive actions to take to grow and keep the talent you have in place: Look at yourself and the values of the practice. Make sure that they reflect honest ethical behavior, both with the patients and employees. Your personal integrity should be evident in all of your actions and decisions.

Give your best people clear expectations and training and then give them the freedom to do their best. Pay what it takes and differentiate sharply based on performance. Be sure that your benefit package is designed to keep talented people in your practice.

Look at all your management systems and be sure they are designed to give results that keep the office flowing smoothly and profitably. If you have poor performers, move them out or get them out of critical positions.

You may wonder, "Where do I begin?" It is critical to understand your starting point. You need a straightforward diagnosis. You might consider some professional outside help. But, if you agree that keeping talented people contributes to your overall profitability and success, it will be worth the time and effort to make the necessary changes.

"The most important thing we do is hire great people. I am surprised by the number of CEOs who don't see that this is like Michael Jordan and the Bulls: indivisible from our success."

-Dick Vague, CEO, Bank One