Where Are the Hygienists? Tackling the Dental Staffing Deficit

If you go and spend time at your local dental events, hygiene events, assistant events, and you start to network, you will be astounded at how you can preload your workforce. If even if you say to somebody, hey, Jenny, I just met you two minutes ago. I really like you. I think you'd be a good fit for our team. We're not high right now. Maybe you're not looking right now, but here's my business card, right? When you're looking, you give us a call. Welcome to the Phil Klein Dental Podcast. So unless you've been hiding under a rock for the last four or five years, I think most of us know that we are in the midst of a serious staffing crisis in dentistry. Hiring a hygienist and an assistant can be a challenging task. And if you need someone right away, it can be a real problem for your practice. So what can we do as dental practice owners, dentists, and chief hygiene officers to make sure we have the right team? retain the people that we have, and when we need to hire someone, we hire the best person as quickly as possible. To give us insight and talk about solutions to this real crisis affecting our profession is our guest, Melissa Turner. Melissa is a practicing registered dental hygienist. She is a sought-after consultant and speaker. She partners with companies of all sizes on brand strategy and product growth, leveraging her unique insights from her experience in the boardroom and as a clinician. We'll be getting to our guests in a second, but first, for many years now, we've recognized that buffering local anesthetics can reduce injection pain, speed up onset, and decrease the overall volume of anesthesia needed. However, the process of buffering has always been complex, time-consuming, and expensive, until now. Introducing BufferPro. a single-use, sterile, self-contained capsule that delivers 0.1 mils of sodium bicarbonate into a dental anesthetic cartridge, raising the solution's pH to near physiologic levels. No measuring, no mixing, and no hassle. Join the growing number of dentists introducing BufferPro into their practices. To learn more, visit septodontusa.com. Melissa, it's great to have you on the show. Thanks for having me, Phil. So, in your expert opinion, Do you see the staffing shortage as something that is here to stay? Or are we looking at a cyclical challenge where current staffing issues will resolve on their own, like let's say in the near future, the next six months to 18 months? Well, my gut wants me to say that it's going to change. But in all the research that I've done in the past year on staffing in the United States, it's going to stay this way. It's not just a trend. It's going to stay at least for five, 10 years. So are we talking about staffing problems related to dental hygienists or is this also related to dentists and their assistants? I think strictly it's going to be hygienists and it's also going to continue with the assistants as well because we've had a staffing shortage of them for five years now at least. So it's just going to continue. It's going to be interesting too, Phil, because now that we're seeing the rise of DSOs, the rise of group practices, Now that more and more dentists are female and also more and more dentists aren't necessarily owning their own single traditional practice, I think we're going to start to have to have these conversations about staffing shortages for dentists as well. So there are certainly a couple of components that are feeding into this crisis, the staffing crisis. Of course, one was COVID. Hygienists were on the front line of the aerosol situation. They wore PPE for protection. Some of the officers bought machinery that helped filter out the aerosol. But in general, the danger level perceived by the hygienists, rightfully so, by the press and the craze that was going on during the COVID crisis resulted in many hygienists to leave their career. And I don't think many of them are coming back. When you add that on to the fact that what I hear, 25% of the matriculating class of hygiene school do not finish. One out of four hygienists don't graduate. So when you're combining these two things together, we're looking at an obvious situation where there's a lot less hygienists available than there were before COVID. So it seems to me it's a difficult problem to resolve. And I think COVID has still left a lasting scar on the... profession. Do you agree? It's a permanent scar. It's certainly not ever going to resolve in my opinion, because if you look at the, you know, if you step back and look at even the psychological aspect that COVID had on all of us, it took us down personal and professional lives. It took us down really to the bottom of Maslow's hierarchy. You know, we're, we are still kind of in survival mode. I would say we're coming out of survival mode. We're trying to figure out. What do we want in life? Can we put food on the table and shelter, you know, metaphorically in our career? Like, what do we want from our careers? That is a huge discussion among hygienists, among assistants. And even now among dentists, I'm hearing it more and more simply because there's more career opportunities for all of us now, too, outside of just the clinical role. But I think practice owners and teams and hygienists. we are still coming out of that survival mode and still figuring out, oh my gosh, like, what do I want in life? Like, is this what I want to do? We've all been through this traumatic experience and we're now trying to recover. Some people have thrived and they're moving on. Majority of people I don't think have yet. Let's talk about a solution for staffing because of this kind of crisis we're in. Talk about some of the solutions that are available for dental practices so that they can meet the challenges of staffing today. What are some of the things they can use to help fix this? The easy answer is to say, OK, there's lots of staffing companies out there that you can work with that are now apps that are now practice facing and clinician facing. And you can real time talk to the. clinician and see if you like them and have them come in, use a flex workforce or contingent workforce is kind of a new thing for dentistry. But that is one way to really maximize the square footage that you have. So what that means is basically bringing in temp workers, or we can call them guest workers to help with the ebb and flow of your schedule, right? So we know the end of the year insurance, people don't want to lose insurance, everyone's going to come in. bring in an extra hygienist, bring in an extra dentist on those days. You know, during the summer, it usually dies off a little bit. So maybe those hygienists who you hired as a flex workforce are okay, not working as many hours in the summer. And back in the day, I think when I first started in dentistry, I think one of the... strong themes was patients wanted to see the same hygienist or the same dentist or the same provider every single time they came in and i think that's why back then we didn't really use temps as often as we do now it was a little bit frowned upon you know we didn't want to use them because we didn't want to make the patient upset well now especially the younger generations they're used to seeing a different provider anytime they go anywhere and so it's important to understand that we don't have to keep the same provider you know in our practices we can use a contingent workforce a flexible workforce if we need to and it's okay from the patient standpoint to do that yeah no it's a different generation for sure i mean even the dating apps you know you my daughter is in that area of dating uh beautiful young lady but when she swipes another profile it's like okay i went out with him for a quick drink and then swiped to another person so I hope she doesn't listen to this podcast. But when you talked about how. used to seeing a different person every time. It's a generation. It's just everything is so kind of temporary, transient, fast. You know what I'm talking about. I'm a couple of generations away from that. But I think I have an understanding having kids that are in their 20s. So you work with companies and individuals on brand strategy. Now, brand strategy is very, very important. It's important in... dental manufacturing, along with every other company that sells everything consumable to wholesale to everything. Brand integrity is really important. I know Viva Learning's brand is very important because a lot of people, when they're looking for continued education, they just type in Viva Learning, which is we're very happy about that. So how does company branding play into dental staffing shortages? They seem like two different things, but they're actually not. So what is your thought on that? Well, back in the day when I started 20 years ago in dentistry, all the dental practices were getting websites, right? That was their branding. Marketing wasn't even a thing before that. Dental marketing wasn't, right? But now we had these dental practice websites, new patients welcome, you know, all over. And it was great. So that introduced the marketing side into dentistry. Now what we're seeing is marketing is inauthentic. This is what the younger generation is saying. Marketing is inauthentic. Now when a patient walks in your door, they want to feel a certain way. They want it to look a certain way. They want it to be authentic and trustworthy, and they want to feel safe. This is what patients, I'd say anybody younger than 45, wants to feel when they walk in your door. A lot of this was kind of launched when Starbucks, you know. came around and built this amazing brand. It's gone downhill in recent years, but they created a brand where, you know, I backpacked Europe for four months and it was exhausting and I was mentally, emotionally tired. But anytime I saw Starbucks, I knew I could walk in and sit on down and I would sit there for an hour or two just to regroup. You know, that's the epitome of branding. So pulling that into dentistry, right, is a whole different story. We know how to market dental practices in dentistry. what dental practices don't understand yet is how to create a brand and pulling it all together here phil once you can create that ideal brand it will naturally attract patients but will also naturally attract staff and that's one of the things i'm seeing for practices who are really working hard on creating a brand for their dental practice whether they've got multiple locations or one the their staffing challenges are a little bit easier compared to the rest. Yeah, no, that's well said and well explained. So my question to you is, what is the, I hate to say easiest path, but I'll say it anyway, what is the easiest path for a dental practice to establish a brand that attracts not only the patients that you were talking about, but also the staff? Well, you have the internal brand that I think is the core of it. A lot of dental practices don't even have an employee handbook, right? they don't have contracts with their employees when they start and that's difficult it's difficult for the employee because they don't know what to do or where to go or they don't have a clear set of expectations in their role so creating just even starting there having a mission statement a vision statement creating an internal brand for your team goes a very long way because it trickles to the patient that really means creating a team culture a workplace culture We'll be getting back to our guest in a second, but first, are you looking for an air-driven handpiece that rivals the power and torque of electric? Well, I have good news. It's finally here. It's called the TMacZ, and it's from NSK, a company we all know and trust as a world leader in dental handpieces. In addition to being lightweight and ergonomic, this revolutionary air-driven handpiece delivers unprecedented 44 watts of power, allowing it to cut through tough zirconia smoothly and quickly. In fact, the TMac-Z reduces overall cutting time by 30%. That means less chair time, reducing the burden on you and your patient. Take a test drive of the TMAX Z air-driven handpiece from NSK. For a free 10-day trial, go to nskdental.com and find your local rep to inquire. Experience the power and excitement of the TMAX Z series. It's hard because I say this, I talk about this to dentists all the time. They're like, yeah, we have a great team culture in our dental practice. I say, do you really? Do you make your team clock out if patients don't show up? Do you offer benefits to part-time? You know, and a lot of this comes down to P&L, right? I understand that. But do you make your hygienist replace herself before she can even ask off work, right? These easy things. Can the hygienist end her workday at the same time her child ends the school day? Can she pick up those hours, you know, later somewhere else? Things like this create... great workplace culture it's not necessarily about having a tap a beer tap in the in the employee you know break room or having a ping pong table there it's about these little things that we're not used to seeing in dentistry that go a long way for the team and once you have a core brand set up for the team then that's when you can start publicizing it and making it patient facing and consumer facing. Yeah. And I was going to mention culture. Culture is very, very important in defining the brand. If you don't have a culture that you're trying to develop that has a certain mission, then how are you going to ever get a brand strategy? And that's very true. Now, you mentioned a lot of examples that are employee focused. What about customer service in the culture and slash branding so that your employees are aware of what is expected of them to provide exceptional customer service? This comes back to any kind of consumer, any kind of patient today wants three things from us as business owners, from Amazon, from Target. They want convenience, they want flexibility, and they want transparency. So any way that a dental practice can provide those things for the patient is going to immediately connect with the patient. what needs to be done is is training creating training and systems and processes for the team to exemplify those things so for instance if if a patient needs to have a quick post-op appointment it takes two seconds to look in the in the mouth you know if you implement a virtual appointment for that appointment then the team can say can spot that and say hey you know sally you don't need to come in for this appointment we can just do a quick look and see on a virtual video chat would you like to do that instead Right. Then they can spot that and it opens up your clinical schedule. It creates efficiencies. We've talked about all this in past and other podcasts. But that's really what needs to happen is to create more more convenience, flexibility and transparency for our patients, because that's what they're expecting these days. So another important factor is staff retention, team retention. Right. Because in the midst of a staffing crisis, the last thing you want to do is lose somebody you already have. Right. Developing a culture and brand strategy that promotes career satisfaction is very important, meaning that they're looking at their job more than just a job where they clock in and clock out. There's something in it for them where they have autonomy and they have the ability to make more impact on the health care of the patient. Does that fall under branding where that would help? Because to me as a dentist who's no longer practicing, that seems to me, and I did it with my office many years ago, where I gave as much independence to the employees and responsibility where they felt they had. impact on the practice and patient care. And they stayed with us for many, many years. Is that something you're a proponent for? A huge proponent. I can't tell you. Early on in my career, I was ready to do anything practices wanted. I will take charge. I'll do this. I'll do this. I'll do this. And I would sit back and wait for the practice owner or the manager to say, hey, Melissa, could you do this for us? I was waiting. Just ask. Just ask. All they had to do was ask. And nobody asked, with one exception. When I was an assistant, I was the youngest on the team. And the dentist knew I was a photographer. And he said, Melissa, will you be the lead photographer for us in the dental practice? So he sent me to a class for intraoral photography. It was new back then. And just he created that position out of thin air. And that was one of the. probably one of the only milestones in the clinical mindset, in my clinical career, where I felt that growth happen, you know? And honestly, I feel all a practice owner has to do these days is to go up to a team member and say, hey, how can we improve this practice? Do you want to help, right? What can you do to make, what is your skill set? If there's one thing you could change in this practice, what would it be? Can you follow through and can you help us do that? If they get more ownership, I mean, you said it yourself, they get more independence, they feel more involved. That's a win-win for everybody. It's not always about how much you're getting paid. It's about feeling safe, feeling validated, feeling respected, and it comes down to that ownership. A lot of what you've been saying in this podcast and in other discussions we've had is that you have to take advantage of the team that you have and make it the most efficient as possible because of the staffing crisis that's going on. So let me ask you about salaries. you know, money, should a dentist or a dental practice owner approach an employee like a hygienist and assistant and say, hey, you know, you've performed so well over the last year and a half, you know, we would like to offer you a raise. Is that something you think is a good idea? Instead of having the employee ask the dentist and say, you know, I've been here four years, time for a raise. That's a little awkward. What do you suggest? I'm getting a little butterflies in my stomach because this is such an important issue right now. Yeah, it is common courtesy for the business owner to at least begin that conversation every year. You know, you look at the biggest Fortune 500 companies, you look at what the federal government does. They have a crappy workplace culture, right? Yes, they do. But the employees know that every year. They're on a fee, you know, a salary chart every year. They have they have that chance at a bonus. They have that chance at being at least an increase because of cost of living increase. Right. That is just a common courtesy. and it's lacking in dentistry and i could go on and on and on and i wish everybody could see my face right now but i couldn't go on and on in the in my years as a clinical hygienist probably there was only one dentist out of many many many permanent positions one dentist that approached me with their raise and it wasn't because i wasn't good it wasn't because i wasn't giving a thousand percent it was simply because it's not something we do in dentistry so if you if you just have easiest thing to do every year we're just going to sit down and talk you're going to tell me, you know, you hygienists are going to tell me the practice owner, if there's one thing you could change about your job, what would it be? Right. And then, and then the hygienist gets more ownership there. And then the dentist says, well, at least we're going to, we're going to do a cost of living raise this year. That's what we can, you know. That's what the budget says we can afford. We're happy to give that to you, you know, and just kind of be real and authentic. One of the things, one of the misconstructs in dentistry is that the practice owner often expects the team to understand business and the team often doesn't. And so for them to even have to approach somebody about a raise is off the chart. It just doesn't compute. Right. And so if we can have those expectations in place, it goes a long way, even if you can't give a raise that year. Just having that conversation will go a very long way with the team. Yeah. And I would think that it's the responsibility of the dental practice owner to reward really good employees as soon as possible with raises. Of course, that's not my money. I'm talking in a microphone about someone else's money. But to me, that's something that would be very important to do, especially. in a time where there's a shortage of staffing because another dentist could easily approach one of your staff members and make a better offer, especially if they're really good. So let's pivot a little bit and talk about staffing strategies. Now, we do things traditionally. We've been doing them the same way for years. That's why they call them traditional. But there are newer ways. You've discussed it on previous episodes. You've touched upon it today. There are newer ways that you actually like. when it comes to staffing up an office. So talk to us about that. What are the advantages of these new strategies? What are they, first of all, and what are the advantages? Well, under the traditional staffing strategy category would fall the old school staffing agencies. It would be, you know, even Facebook. Facebook. i can't tell you how many times i see practices relying on facebook to acquire team members and it just doesn't work it doesn't work you know face you're lucky if you're if facebook even shows your post to anyone right even if it's the perfectly designed post and perfectly worded job ad right back in the day when i started i was looking in craigslist and in the newspaper for jobs like that's how far we've come and so even now to say that Traditionally, we've been looking in Facebook for team members, and we shouldn't be doing that anymore. This is a whole new animal here. So what I preach, and I have lectures on this, when I work with dental practices on staffing, I say, now you need to preload your workforce. And that's a term I made up. But what it is, Phil, is this. It's you go on social media. You create a good brand for your dental practice, which we've been talking about. You push out, yes, on social media, how great your brand is, you know, your team photos, not just stoic photos where you're in scrubs with your hands in front of you, your team photos where you're laughing, you're engaging with patients, HIPAA compliant, of course, and push your brand, a good dental practice brand that's authentic out into social media, right? But then you also can't forget about in-person. networking. And I think this is one of the keys that we have forgotten about specifically since COVID, but we were going that way anyway for the last decade because social media took off. If you go and spend time at your local dental events, hygiene events, assistant events, and you start to network, you will be astounded at how you can preload your workforce. If even if you say to somebody, Hey, Jenny, I just met you two minutes ago. I really like you. I think you'd be a good fit for our team. we're not hiring right now maybe you're not looking right now but here's my business card right when you're looking you give us a call right it's that old school networking that we have totally forgotten about and if you do that that'll preload your workforce right right there you can call them when you need them maybe even as a temporary contingent worker and that it's a whole learning curve because there's an entire generation of practice owners that i think we have just forgotten about how to in-person network we think that if we make a post saying hey rockstar hygienist needed that it's going to attract attention and it just doesn't anymore so you're recommending in person and you mentioned like schools dental hygiene schools are assisting schools. Do some dentists feel a little reluctant to hire someone right out of school and they're looking for someone with three or four years experience so they stay away from those events? Or do you say, hey, it's actually beneficial to get a person straight out of school because you can actually train them and they don't have any bad habits, for instance? There's benefits to both. But there's a lot of dental events that... even related to schools right so going to your local state dental event there's all of these hygiene events and hygiene component meetings that are happening almost every month every quarter that you just go and you just hang out there for two hours and it's amazing the network that will grow and if you're an authentic person and if you have a good workplace culture then people these hygienists these team members will be naturally attracted to you so it takes it takes a little bit and it doesn't have to be the practice owner that goes to these events right you can send your hygiene team to these events and just have them meet two or three new people that they like and get their contact information And when that person's ready for a new role, they will contact them. Right. So it's it's it works for established hygienists and team members as well. So as we wrap up this podcast, Melissa, talk to us about the importance of being open minded about hiring a temp service flex time, because I know you're a big proponent of that and you've used it in the past. You continue to use it and it offers some real advantages, especially in today's day and age with the staffing crisis we're in. You know, we've talked about having a flex workforce, a contingent workforce. Basically, that means bringing in temp workers, right? I can't tell you how many times I've tempted an office for half a morning and the dentist comes to me and says, Melissa, do you want a full-time job here? Please say yes, right? And I say, no, I'm not looking for one right now. That is another trick. When you preload your workforce, if you do start to use these temp workers, you will be astounded at the quality of people they are. And I think in the past, temp workers got a bad rep. But these days they are kick butt workers. And so if you get them to come in and work for you, it acts as that job interview, right? It acts already as an interview with no strings attached. And if you like them, you say, hey, when you're looking for a full time job, here you go. You come back to me. So what attracted you to the flex workforce arena when you were practicing or you still are? Are you still doing flex clinical work? I am very part-time. What attracted me to it is a big pain point in dentistry, and it's why I'm very passionate about dentistry right now. But two things happened. The first was my husband went on this career path where every year, every two years, we had to move to a new state, city, country. So I did that for 10 years. And after about two moves, after about three moves, I'd go in for interviews. uh not tell them that i might only be there for a year or two right but they'd look on my cv on my resume and say um you've never been anywhere for more than a year or two why would we hire you so i was starting to have issues getting hired and i couldn't even say that what my husband was military right like that would have been an okay excuse to say instead it was just like well i don't really have an excuse except it's my husband i have to do this and so i wouldn't get hired because they didn't trust that i would be there long term so there was that And so I'm like, I'm just going to take it in my own hands. I'm going to start tempting. And then when I started having children, Phil, and this is another huge pain point for anybody, not just women, but anybody in dentistry that has kids. Dentistry, clinical dentistry is not a friendly career to have when you are a parent. It is tough, right? And so I know a lot of parents, dentists alike, who are now tempting because they want to stay home or they need to get off at two for their, for the child to leave school or daycare or whatever it is. It makes it more flexible. Your point is very well taken, Melissa. And I think there's a huge benefit on both sides for the employer and the employee when it comes to flex time workers. I think it's an important strategy to be in the hiring mix in any dental practice for sure. Melissa, again, a great conversation. You have so much to offer. What's the best way for our audience to reach out to you if they have any questions? Sure. You can find me on any social media platform or visit my website at melissakturner.com. That's Melissa K. Turner and Melissa spelled with one L. And we really do appreciate your time. Fantastic discussion and look forward to having you on Viva Learning programs more in the future. Thank you so much, Melissa. Thank you, Phil.