As I write this, most of the Western world is experiencing some of the highest inflation rates in 40 years. As an employee of any company, this triggers a natural interest in a pay rise. Because if inflation continues to hover about 10%, it will mean that real wages will erode relatively quickly, unless there are corresponding wage increases.
This post is therefore about what you can do as an employee in a dental practice to get a raise.
Competence level
What have you done in the last 5 years to improve your skills?
I'm not thinking about what courses you've taken or how many professional articles you've read.
But rather what you have done to implement your knowledge in your daily work. Because attending courses does not make you more competent unless you actively work on implementing what you have learned in your daily work in the office.
Unfortunately, I still meet employees in companies who think that 20 years of experience* alone is enough justification for a pay rise. I find this idea a little difficult to understand.
If you've been doing the same job for 20 years and haven't changed a thing since you qualified. Then you really have 1 year of seniority and not 20.
*Seniority describes a person's experience in terms of how many years they have worked in a specific field. The term is used to define various agreements in an employment relationship. These typically relate to pay and notice periods. Seniority as a concept is mainly used in the public sector. Therefore, it is typically here that seniority has an impact on the employment relationship.
So it is not a given that "just because" you have worked in the same place for many years, you are entitled to a higher salary. (Sorry if I'm causing you to get the coffee wrong here)
Important considerations
Instead of going to the boss and demanding a higher salary, employees are better off doing a little homework first.
The first thing I think an employee should do prior to a salary negotiation is:
Consider what framework the practice has that allows for a salary increase.
Think about what skills you have added since the last pay rise.
Relate this to improvements in the practice, as a business, these skills have brought about.
The framework of the dental practice
One of the nice things about a dental practice is that it is relatively easy to see where the money for the operation comes from and how it develops over time. Most people have the opportunity to gain insight into the turnover of the practice. If this does not, at a minimum, follow the consumer price index (and therefore inflation), then the earnings of the practice actually fall and so does the basis for a pay rise.
There are really only two ways a dental practice can make more money:
Raising prices
Increase productivity
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Influence of the social economy
The first thing you should do is check whether the practice has increased all prices by at least 10% this year. Why 10% and not "only" 8.5% which corresponds to the inflation rate? Because any publicly dictated prices have not increased. When prices are fixed by law or collective agreement, you can't just raise them. So to compensate for these artificially low prices, the practice has to raise the prices of the free services to cover the loss on the public/insurance services. 10% is therefore an absolute minimum to keep the practice's finances status quo!
The higher the percentage of the practice's total turnover accounted for by services with prices dictated by the public- or isurance sector, the higher the price increase needed for fee for service treatments.
As an employee of a relatively small company, you actually have the opportunity to influence the price development of the practice. If you generally express the opinion that it is too expensive for patients to receive dental treatment, then you are undermining your own salary! It's the same if you perform dental services for which you don't charge. (This is still frequently seen in preventive care and perio treatment).
Direct impact
Instead, if you start looking at the direct link between patients' payment for the services of the practice and your salary, it is much smarter to support price increases and perhaps even articulate the need for price changes. Because there are many dentists who mistakenly believe that they are very expensive. (Which they are not - at all!)
If the dental practice does not raise prices, there is no basis for wage increases. Neither for the employees nor for the practice owner. On the contrary, the profits of the practice fall to a dangerously low level, which could actually threaten the existence of the practice in the long term.
Pressuring the practice owner for a pay rise in such a situation means that the practice owner has to pay out part of his own salary in order to give the staff a higher salary. It's just not a sustainable model for very long!
Would you, for example, want to take a pay cut so that another of your colleagues could get a higher salary... while, by the way, you have all the responsibility for a multi-million dollar business where you hold the financial and professional responsibility for everything that goes on?
Consequences for the dental industry.
The Danish DSO Oris published some months ago a study they were behind. It showed, that about 1/3 of all Danish dental practices, would close if the practice owner paid himself a salary, equivalent to an employed dentist!... As a critical reader of this kind of information, one must of course consider how Oris arrives at their conclusion (I have not done so).
That said, there is certainly something to it.
Over the last 40-50 years, Danish dental profits have gone down and down and down. Just like in most other European countries. It's said that being a dentist is super lucrative.
Maybe it used to be.
Well, not anymore!
Many dental practices have a severely challenged economy, combined with a very large administrative burden.
Instead of looking at the historical reasons for this, we should focus on what we can do about it.
Collaboration
Be proactive, just as you should always be one step ahead of the dentist in a course of treatment, you should also be proactive when it comes to your salary.
You can ask that you and the rest of the staff have some insight into the finances of the clinic. You don't need to have full insight into the accounts, but you should at least have some understanding of what it takes to achieve financial success (in addition to all the other parameters by which success can be measured) and how you can keep track of how things are going.
Find out how much the practice needs to turn over per month, EVERY month, before the practice is profitable at all. Find out what percentage of profit the practice made last year, what percentage of profit is expected this year, and what it will take to achieve it.
If the expected profit is 10% of total turnover or less, there are generally no resources to increase salaries.
Get together with your team and find out if you can work more efficiently together and thus increase productivity, without having to work faster or longer. As a team, you are stronger, smarter and better than if all initiative had to come from the boss.
The impact of skills on better pay
If we look at the dental practice as a business. Is our value (in dollars and cents) directly reflected in the revenue we generate. There's just no room to raise salaries if turnover isn't also increased. In that way, it's all pretty simple.
So if you've become more skilled at doing a job, you should also be paid more for it - by patients - they're the ones who actually pay your salary. Not the owner of the practice!
It may also be that you have acquired skills that enable the dentist to delegate tasks to you and thus become more efficient himself. This should be reflected positively in your clinic's accounts and may provide a basis for a pay rise.
Help the practice owner to help you
In the above, I have tried to illustrate how the practice needs to see an improvement in its accounts in order to meet a demand for higher pay. If this basic condition is not present, there is just no chance that the practice will survive salary increases in the long run.
So help the practice owner to achieve the possibility of being able to give you a pay raise. When you as a team can celebrate that you have actually been together to drive the business forward, the pay rise feels much better too. It's the community and the connection with others that the joy is found.
A solid financial foundation
The posting here has been primarily about pay in the form of money. In any job there are many other elements that together give pleasure and the desire to do something for and with others. A high salary alone is never going to make you happy.
Of course, you need to have a reasonable financial foundation in order to maintain and improve your private life. If you want to be inspired about ways to achieve a better private finances, without feeling short of money, follow the blog. Because the next 2 posts are going to be about how to optimize your personal finances so you don't constantly feel trapped in a hamster wheel.
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Many kind regards
Dental consultant
Jesper Hatt DDS
P: +41 78 268 00 78
Hatt Consulting advises and teaches the dental industry, dental practice owners, associates and their teams in the areas of practice optimisation, patient communication and dental customer service.
Other than having been a practice owner and manager myself, I have no financial background. The content on the blog is created based on my own opinions and experiences from 18 years in practice and working with the dental industry.