How DSOs are solving the staffing shortage in dentistry

Higher pay, career advancement, and a better work environment have been the three biggest drivers of dentist and team member turnover in 2024.

Dental leaders at this summer's Dykema dental service organization (DSO) conference shared how employee expectations combined with marketplace pressures have led DSOs to adjust salaries, benefits, and perspectives.

C-suite turnover at DSOs

Staffing changes have occurred at every level.

Jon Fidler and Heidi Arndt. Image courtesy of the Dykema DSO Industry Group.

"Starting in January 2023, we saw a lot of restructuring and layoffs from some of the larger dental groups," Jon Fidler, CEO of Fidler & Associates, an executive search firm, said.

"Up until 2023, money was flowing well for the acquisition side due to favorable interest rates, doctors looking to transition, and more practices joining DSOs. In 2023, the rates skyrocketed, financing was tougher to get, and sellers became more timid because the multiples were lower. Dental groups that had primarily grown through M&A had to shift and show same-store growth instead, which can take a different skill set. That led to leadership changes at a lot of companies. I think the bulk of layoffs have happened, but some groups are still tightening up," Fidler said.

Who's looking to change jobs

The number of dentists and team members looking for new jobs in 2024 is staggering.

"According to DentalPost's annual salary survey, 57% of dentists polled said they were looking for a new job before the end of 2024," Heidi Arndt, founder of Evolve Dental Associates said.

The survey also reported the following findings:

• 45% of all respondents were considering a job change in 2024.
• 13.8% of owner-dentists planned to retire within three years.
• 15% of hygienists planned to retire within three years.

While associate dentists are primarily seeking career advancement, the other clinical team members and front office staff are leaving for higher pay, according to the survey.

"Generational differences are changing how companies communicate with their employees. Gen Z and millennials want to be developed. Many of them grew up texting and they need to be taught interpersonal skills, including soft skills, communication skills, and leadership skills," Arndt said.

Creative ways to attract and retain employees

At this year's conference, dental industry leaders shared some of the creative ways they're attracting and retaining talented employees. Higher hourly rate tradeoff

Companies are finding that employees prefer a higher starting salary rather than robust retirement benefits.

"One of the biggest things we found is that employees want their money now," Dr. Robin Reich, founder of Reich Dental Centers and a past president of the Georgia Dental Association, said. "So while we do still have a very good retirement benefit, it’s lessened so we're able to pay more in wages."

Hiring from other industries

Want to increase your case acceptance rate? Dental consultant Dee Fischer recommends hiring jewelry store clerks, realtors, and other sales professionals for treatment coordinator positions. People who work in service industries such as hospitality often make great front-office employees, Fischer said, while bookkeepers, medical coders, and auditors may excel at insurance billing and revenue cycle management.

Job sharing

"We have to be flexible. In fact, we have two hygienists who are expecting babies, and they're going to come back and job-share, and they’re going to watch each other's children," Reich said.

Gas stipends

"Were hearing from employees that they want innovative benefits like gas stipends," Teresa Williams, chief operating officer and chief financial officer of Dental Express, a dental group with six affiliated locations in California said.

Staff referrals

"Staffing has been a challenge since COVID. We've really worked on staff referrals, that that's helped us build our workforce," Dr. Hamid Barkhordar, co-president of Care Dentistry Group, a DSO with 16 affiliated locations said.

Assisted hygiene and temps

According to the DentalPost 2024 salary survey, one-third of hygienists plan to retire by 2030. Unfortunately, that means the hygiene shortage will remain a problem for years.

"With hygienists, we have found temp agencies help, because a lot of hygienists like the freedom to pick up a shift when they want to. It's not ideal, but it's much better than nothing," Dr. Bradley Dykstra, founder of MI Smiles Dental Group, which has seven affiliated practices in Michigan, said.

"We're looking at a whole plethora of areas to help with hygiene patient flow. That could be assisted hygiene, temp staffing companies, going into high schools to get people interested in the profession," Dr. AJ Acierno, president of clinical operations at Smile Brands, a DSO with almost 700 affiliated locations, said.

Culture and job satisfaction

Dr. Saam Zarrabi and Jeff Adams. Image courtesy of the Dykema DSO Industry Group.

At the Dykema DSO conference in July, Dr. Saam Zarrabi, CEO of Rodeo Dental & Orthodontics, and Jeff Adams, CEO of Risas Dental and Braces, showed how a positive company culture directly leads to greater job satisfaction and higher productivity.

"People want to work for a company that has a common purpose, that will invest in you, that has great leaders, and is a place where you enjoy the people you work with. That's when people will go through brick walls for you," Adams said.

Signs that it's getting easier to hire again

There are signs that it will be easier to hire moving forward.

"We’re seeing a bit of a change because there have been layoffs. For example, we put out an ad for a front desk position and got 121 applications. That was much higher than we had previously," Fischer said.

"Recruit, recruit, recruit, and create a great experience for your team. That's the best way to solve the staffing situation," Acierno added.

Beth Gaddis is the editor in chief at Planet DDS, a dental technology company specializing in cloud-based practice management systems, digital imaging, and dental marketing services. Previously, Gaddis was the marketing director for two large dental service organizations. Prior to entering the dental industry, Gaddis was a journalist for 16 years in a variety of roles, including as a TV news producer at the CBS affiliate in Boston. You can connect with Gaddis on LinkedIn.

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.