Dental Practice Heroes
Where dentists learn how to cut clinical days while increasing profits - without sacrificing patient care, cutting corners, or cranking volume. We teach you how to grow a scalable practice through communication, leadership, and effective management.
Hosted by Dr. Paul Etchison, author of two books on dental practice management, dental coach, and owner of a $6M collections group practice in the south suburbs of Chicago, we provide actionable advice for practice owners who want to intentionally create more time to enjoy their families, wealth, and deep personal fulfillment.
If you want to build a scalable practice framework that no longer stresses, drains, or relies on you for every little thing, we will teach you how and share stories of other dentists who have done it!
Dental Practice Heroes
Handling Raise Requests and Wages
Nobody looks forward to raise discussions, but a few easy strategies can make them more productive and less awkward. This episode explores the right way (and the wrong way) to approach these conversations, including strategies to handle raise requests fairly and navigate challenges like wage compression. We share key lessons from our past mistakes, tips for setting clear performance and compensation expectations with your team, and why one-on-ones are crucial to this process.
Tune in to learn how to turn raise requests into growth opportunities for your practice and team!
Topics discussed in this episode:
- How raise conversations impact the workplace
- Benefits of a pay grade system
- Strategies to assess raise eligibility
- Maintaining fairness and transparency
- Balancing team morale with operational costs
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Take Control of Your Practice and Your Life
I help dentists create thriving practices that make more money, require less of their time, and empower their teams to run the office seamlessly—so they can focus on what matters most.
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How do you handle money conversations with your team? Are you prepared to face them head on or do you try to avoid them altogether? Sometimes, if you're like me, you get completely blindsided. One time I had an employee come in and reach into her purse and whip out a big stack of papers and she wanted to share with me the data on inflation over the past 20 years. And she wanted to share with me the data on inflation over the past 20 years, how the cost of living increases and how the dental industry, as far as wages, hasn't really kept up, to which I didn't reply the best I just said. You know you can just put that away. I don't really care to see that Not my best moment. So today I am joined by my DPH coaches, dr Steve and Dr Henry, and we're going to discuss how you can confidently navigate, raise requests and avoid awkward conversations, especially when you need to say no. These insights will make your one-on-ones more productive and turn them into opportunities for growth for both your practice and for your employees. It's time to step up and take control of these conversations. So stick around and find out how you are listening to Dental Practice Heroes, where we help you create and scale your dental practice so that you are no longer tied to the chair.
Speaker 1:I'm Dr Paul Etcheson, author of two books on dental practice management, dental coach and owner of a $6 million group practice in the suburbs of Chicago. I want to teach you how to grow and systematize your dental practice so you can spend less time practicing and more time enjoying a life that you love. Let's get started. Hey everybody, welcome back to Dental Practice Heroes. I'm joined by my coaches today, dr Stephen Markowitz and Dr Henry Ernst, and we were just having a conversation earlier about doing one-on-ones, which we recommend everybody do, but owners. We always have this hesitancy because we say, well, I don't want to do the one-on-one because then it turns into a raised conversation and I think, more or less, if you're not doing one-on-ones very often at a regular cadence, it can turn into that. But I just thought today it would be great to provide some guidance on what do we do with these conversations and what's the right thing to do and what's the wrong thing to do. So I'll just, I'll go with you, steve. What do you think?
Speaker 2:I remember the first time anyone ever asked me for a raise, it was this dental assistant. She had worked at the office. She worked for my dad for a long time. She was a great assistant and everyone hated her. But I didn't know. I just thought that if someone asked for a raise, I was probably like three months into practice ownership. I thought, if someone asked for a raise, you just that's what you do, you give it to them. So I gave her. I gave she asked for a raise, even though I knew everyone hated her. I leave for the day. I come back. I got people. Everyone pissed at me. Three people ended up leaving and I'm like, oh, everyone pissed at me. Three people ended up leaving and I'm like, oh, my goodness, I thought I was doing something nice. How did everyone know? Because everyone talks, everybody talks.
Speaker 3:They do Not in your dental practice, but in every other dental practice in the country.
Speaker 2:Yes, they talk. So there has to be reasons for raises. There needs to be an understanding of when raises are, why they happen and how someone can work towards getting more. We want to create a culture of growth and opportunity, but it can't just be for reasons unknown, or even because I like someone more. It just can't be. There needs to be something tangible for that person to understand what they have to do, what they're working towards and how they can get more.
Speaker 1:So, in retrospect, what do you wish you would have did? How do you wish you would have handled that?
Speaker 2:Well, first of all, I love that experience, not because it's a funny story you get to share on this podcast. It taught me so much. I think, from messing up and those failures, you're able to say I got to do something different. And that was probably a punch in the face, one of those stories that sticks with you of like I need to do something different. I wish in that moment that I had just, instead of saying yes, here's $2, I would have said let's work together, let me understand a little bit more, let me ask questions of what this person is doing, what they want, where they want to go, and then let's together create a plan to help them get there and then have everyone else around them seeing how much more this person's doing, that this raise wasn't given. This raise was deserved and everyone would feel a lot better about it. What do you think, henry?
Speaker 3:So I think it's important to implement something called a pay grade system, and I'm not a plagiarizer. Dr Glenn Vo taught me this years ago and he does lectures on it. It's pretty good. So, basically, what you have is for any position, there should be a pay grade system. You've got entry level, you've got moderate and you've got advanced. So for entry level, it should have a pay scale. Whatever that scale is right $15 to $19 for I don't know. First entry level, front desk, and then it has bullet points. These are the skills that you have at this entry level position, same thing for moderate, same thing for advanced. It has all the bullet points.
Speaker 3:So if somebody ever comes to you and asks you for a raise, you can refer to that sheet and show them. Well, let's see what skills do you do? Right, if you're for a dental assistant, or do you make temps? No, I don't. Well, maybe we need to learn this skill, become proficient at it, and then maybe we'll consider you for a raise. So it's like I get this with a lot of clients People ask for raises just because the earth ran around the sun another time. It's not right. Right, you have to give more value to the business to earn a raise. So, for all the offices that implement a pay grade system, then everybody knows what's expected to them. It's kind of like the accountability chart we talked about a few podcasts ago. Everybody needs to know.
Speaker 3:The other thing that you mentioned in the beginning, paul, is one-on-ones. I think it's really important to do the one-on-ones. We try to do it once a quarter with our team, and I do it. I let the team leads do it with the people in their department, and they ask four questions, which I mentioned before. It's what's working in the practice, what's not, what do we need to do more of, what do we need to do less of? So you're getting feedback from them also, so you can kind of say oh shit, we need to do more of this, we need to do less of this as a practice. So those are my feelings. As far as the pay grade system, I think it's important. Plus, though, having the one-on-ones. I think it's important when the doctor does the one-on-ones. I think that's where you get the people asking for raises.
Speaker 1:And maybe when you're having a team lead do it, it's more of an authentic conversation. Yeah, I like when the leads do it, because then they ask the lead for the raise and then the lead just comes to ask me and I just go no, no, no, no, yep, that's true. You know. What's funny is that I think about this in my career and I've always been doing a lot of one-on-ones with my team and a lot of our sharing the wealth has come from our bonus systems. But I've got to think in my 13 years now, 12 years of practice ownership, almost 13, I've only been asked for a raise, I want to say six or seven times, you know, and I don't know what to take of that. And I would say at the beginning my whole thing was like it's once a year or once every 18 months, let's just just enough, so that they didn't have to ask for it. I think these past few years I've been asked quite a bit a few times and I've had to come up with an assistant where it was like I want a raise and it was like well, let's look at your training sheet, because she was relatively new. I was like, hey, you don't have these things done yet, Like you don't get any raise until you even get through this, like 90 days, you know.
Speaker 1:So I think that's an easy conversation, but I think it runs into my hesitancy with the pay scale. The pay different things is that it's too easy to jump and there's not enough based. All those intangible things that make people amazing the way that they talk to patients, the way that they talk about additional treatment, the way they step up and grab more responsibilities and take charge. How do you put that on like a pay raise sheet? How do you even quantify that? That's my struggle. So I'll just share with the listeners For me. I don't necessarily think I've got a great system by any means, but one thing I've noticed in the past few years is that entry level has become a lot closer to the more longer term team members and that's just a product of just this wage compression. That's happening because the entry level wage and we're so desperate for people and I'd love to hear a better solution. I love what you guys are sharing. I'm gonna pass it back to you, steve.
Speaker 2:Yeah, how does corporate like corporate America does it as they get a promotion? And the promotion may not come because they do different tasks. They may, but there's a system to, there's an HR system to how someone gets to the next level. Or there's a time of year where we're going to have compensation discussions. We are a business too. I think that as dental businesses, we should have structure and understanding of how people get more. But I think it starts with, for the dental owner, for the runner, the CEO, the operator of the business, you need to first make sure you're within normal range for that job description.
Speaker 2:I would get on salarycom and payscalecom and maybe pay for some of those services to be like all right, what is a dental hygienist? What is a dental assistant? What is a treatment coordinator in my area? Make what are the ranges? I want to make sure that I'm on the higher end of that range so I can attract and retain talent. And then I want to check that every 6, 12, 18 months because right now, especially, this is crazy how quickly things are changing and there may be a time where I think I'm in the higher range and I may not be and I need to adjust because I don't want my teams to feel like I'm not compensating them at the higher end of the market.
Speaker 2:And that's when they start to feel a lack of appreciation because they look on Craigslist or Indeed or whatever it is and they say like oh, down the street they're paying $2 an hour more. I'm like I didn't even know. I need to be educated enough in what the economic environment is and what these ranges are, and then we can build upon that and provide direction to how people get raises. For me that's we need to have one-on-ones monthly, we need to have yearly compensation discussions and then if someone is off cycle and just crushing it, they can get a promotion or a raise because their role is changing, not because they've changed some tasks throughout in the office on a daily basis.
Speaker 1:Yeah, I think that we got to get away from this whole idea of just every year, because I think when somebody comes and asks you for a raise, it's not only like we're looking at this person, like I really appreciate you, I want to give you a raise, but there's always a part in the back of my mind of thinking about where's that going to put this person relative to everybody else on the team and is this small raise going to backfire where they all talk? And now I just, instead of giving out a $2 raise, I'm giving out like $24 an hour in payroll because I've got so many team members and it's a struggle. But I love the idea of talking about what do you bring this office? What is new? Not just a cost of living increase, but just like what do you want to do to earn this raise? I'll pass it back to you, henry.
Speaker 3:Yeah, I think we knew we were going to be in trouble during COVID, when our employees would go to lunch through the drive-thru at Burger King and they would see a big sign that said like starting at $20 an hour or whatever ridiculous they were paying, and they were like entry-level dental assistants were like, dude, that's more money than I make in a professional dental office, you know. So we had to pivot. It's been a challenge. It's not as easy as it ever was. I think what's important is like we talked about with bonus systems in prior episode is you have to get credit for what you're doing. We talked about with bonus systems in prior episode is you have to get credit for what you're doing. So in my office you could be having a regular bonus. You could be having a quarterly bonus. I need to show you on a quarterly basis how much you average per hour. It could be four or five dollars more than what you think it is. So I have to get credit for that.
Speaker 3:And I can't agree anymore with you, paul. It's probably one of my biggest pet peeves is people that just think, because another year went by, that I should get a raise. Do we get a raise every single year for every procedure? We do no, right. I mean, sometimes we can raise it, but in general, that's not how the world works. You have to earn it. Nothing is given to you in this world, and that's what you want out of your team. You want them to work hard and you want them to be rewarded for it, but nothing should just be given.
Speaker 2:I think that also helps as we become more transparent with the health of the business. So if we can share what health looks like and I know, henry, you were saying 25% payroll cost If we can share what that looks like with the team, they'll know how much flexibility that the business has. A lot of dental business owners are afraid to share things and what happens is the employees think that you produced $7,000 today and you're walking home with $7,000 in your pocket and it's not their fault. They just don't know it and it's not their fault, they just don't know. So, sharing your perspective and having them understand like I would love all of every single one of my employees to have a million dollars, but I know if I did that, I would never be able to open the door again. So I need to share that perspective with them of where we're at as a business and how we can create more value so that they can get more too.
Speaker 3:I think that it's all about clarity. The way that I would do it sometimes is show them hey, this is our payroll costs, right, this is what I can do. It's not an endless stream of money. The more that we do, the more flexible I can be. I love saying it that way to the team. So, hey, you got somebody who's got that crown. They got another one right next door. Why don't we ask them if they can do want to do that extra one? You got mom in the chair and she's about to leave. Why don't we ask her hey, is there anybody else in the family? I get booked on the schedule. These little things help a lot, and the more you kind of be transparent with your team, the more they'll be willing to do things like that, like they already should.
Speaker 2:Yeah, I agree, it's really easy to give when your cup is full. Yeah, if your cup isn't, you can't, and your team doesn't doesn't know that. So I love that, henry.
Speaker 1:Yeah, it's one thing that I've always my team has always known like. We do bonus, Everything is based off of. We're going to keep our payroll under 30%. That's what we do in my office. I say industry standard is 22 to 30. You guys are worth the top end of the scale. I am comfortable with that, but I mean a lot of things happened these past years where it was wages went up a lot and it's a struggle. I think it's something we all struggle with and I don't think there's a right answer. But I think the best answer is to constantly, always just be communicating, and I think it fixes so many other things. So if you're interested in working with a coach and you're ready to take your practice to the next level, please reach out to us at dentalpracticeheroescom. You can work with Steve or Henry or myself and we'll get you on a free discovery call and we'll talk to you about what's possible and I know if you're ready for results, you will get them. So thank you so much for listening. We'll talk to you next time.
