Th 186297

‘I need a raise’

July 1, 2005
Dear Dianne: I have not had a pay increase for just over two years now...

Dear Dianne:

I have not had a pay increase for just over two years now, and I need a raise! Can you address how to approach the doctor about this sensitive subject?
Feeling Deprived in PA

Dear Deprived:

I know the feeling. Time keeps marching on, and no mention of a pay increase comes forth. Frustration builds, and the issue becomes like a rock in your shoe that irritates you daily. It haunts you. You think about it every working day. You feel unappreciated and taken for granted. Resentment builds. You lose sleep thinking about marching into the doctor’s office and demanding more pay.

Finally, you reach the limits of your patience. You gather your courage and ask to speak with the doctor privately. You feel your heart race and pound within your chest. Your mouth is extremely dry, but your palms are dripping with sweat. Seated across from your boss and separated by his big office desk, you feel insignificant, unimportant, and possibly ready to cry. You somehow find your voice and nervously stammer, “The reason I asked to see you is because I need a raise. It’s been a long time, and I work very hard for you.” There! You did it! Whew!

Depending on the circumstances, the doctor could respond in a variety of ways. The answer could be “yes,” “no,” or “maybe.” Or, he could respond more specifically:

• “Why do you think you deserve a raise?”

• “I can’t talk about this right now. Could we schedule a later time?”

• “The practice is not growing, so I cannot give any increases right now.”

• “How much do you think you should get?”

• “What are others in the area making?”

• “Yes, I’ve been working on that. Let’s see what we can do.”

Dental practices are businesses that compete with other businesses in the area, both dental and non-dental. In order to attract and keep high quality staff members, the doctor must be a willing to compensate at or above the current prevailing wage. I’ve heard my good friend, speaker and consultant Linda Miles, say, “Doctors who pay peanuts get monkeys.” Exceptional doctors who do exceptional dentistry have exceptional staff members and pay exceptional wages.

Years ago, I heard of a doctor who informed his staff members that there would be no raises in the foreseeable future. Why? He was remodeling his house and building an extra room and a larger garage. Needless to say, this did not sit well with his team! His unpleasant decree cost him a valuable business assistant, and, in the long run, much more than if he’d given his staff members a raise.

Most doctors want to pay their staff members fair and competitive wages. In fact, there is a certain pride for an employer to feel that he or she takes good care of the staff members employed there. However, I am aware that there are employers who pay just as little as they can and still manage to retain staff members. I believe it was George Carlin who said, “There are people who work just enough not to get fired, and employers who pay just enough to prevent employees from quitting.”

In order for the doctor to be able to compensate well, the practice must be financially healthy. Dental practices fight an ongoing battle to keep overhead expenses down. The three most expensive overhead items are laboratory fees, dental supplies, and staff salaries. Salary expenses typically account for 20 to 25 percent of the practice overhead, and 10 percent or more of that is apportioned to the hygiene department, depending on the number of hygienists and the pay scale. In good collection/production months, overhead comes down and vice versa.

The production to salary ratio is important in discussions about wages for hygienists. The industry standard is that the hygienist should be producing a minimum of three times his or her wages. If your daily wage rate is $250, then you should be producing a minimum of $750. However, I have seen situations on both sides of this standard, with the hygienist producing much more and much less than the industry standard.

Click here to enlarge image

Do you monitor your production everyday? If you want to convey your interest in contributing to the health of the practice, you should certainly monitor your production. It’s easy for hygienists to ignore the fact that their production has a strong effect on the health of the practice. I recommend and use a spreadsheet for keeping a record of hygiene production (see related sidebar).

Monitoring your production can provide you with sound, supporting evidence of your production to salary relationship. Let’s say that, for March 2005, a particular hygienist’s production was $8,500 and her salary was $4,100. Then divide $4,100 by $8,500. The answer is 48 percent, which is a poor salary/production ratio. In this case, there may be problems with unfilled openings in the schedule (down time), low fees, or the hygienist being scheduled inefficiently. In this example, the hygienist would need to significantly increase production, in order to qualify for a pay increase.

Another hygienist produced $11,000 and was paid (gross pay) $3,200. Her salary/production ratio is 29 percent. In this case, a salary increase is reasonable.

While production alone is not the only factor in wage increases, it is very important. Simply put, the doctor cannot pay out what does not come in (collections). All team members should work toward the common goal of making the practice as successful as possible by striving for excellence in their job performance.

Across the country, many businesses have seen lethargic growth or even declining profits over the past couple of years. In some areas, demand for dental services is down because people are struggling to pay for both nonessential items and basic necessities, such as housing, food, transportation, medical care, etc. In other words, you’re not the only one who hasn’t had a raise in a couple of years. Some dentists find themselves in this group too.

Many doctors coordinate salary increases with fee increases. This way, the salary portion of overhead does not go up inordinately. Additionally, doctors have to ascertain that they are staffed properly, with not too many and not too few staff members. In most highly productive offices, slackers are not tolerated, and every staff member has a stake in the financial health of the practice. My experience is that practices that are understaffed will under produce. Practices that are overstaffed will find that the staff salary percentage of overhead is disproportionately high.

An employee’s value to the practice is determined by several factors, in no particular order:

• Work ethic, which influences production

• Attitude

• Ability to get along with co-workers

• Promptness

• Absenteeism

• Clinical or technical skill levels

• Communication skill level

Also, keep in mind that if an employee stays with a company long enough, that person will reach a pay plateau, which is the uppermost pay limits for their particular job class. Future pay increases may come in the form of tax-free benefits, such as medical reimbursement or insurance, child care reimbursement, and/or a uniform allowance. This benefits both the practice and the staff member by reducing the tax burden.

Hygienists who work on commission get a pay increase any time the doctor raises fees.

Many years ago, I worked in a practice that never gave me a raise unless I asked for it. Asking for a raise was the most demeaning, uncomfortable thing that I have ever done. When I left that practice, I made a vow to myself that I would never again ask for a raise.

In fact, I had developed quite the “armadillo” hide! I rather boldly informed my next employer that I would never ask him for a raise, but if he did not provide pay increases at appropriate times, I would leave. With raised eyebrows, he informed me that in many years of practice, he had never had an employee come to him and ask for a raise. He took care of his employees and was proud of that fact. Furthermore, I’m happy to say that he took very good care of me during all the years I worked for him. (Thanks Dr. D!)

So, my advice to you is this:

• Monitor your production every day and determine your salary/production ratio to see if it falls within the industry standard

• Instead of boldly demanding a raise, talk with the doctor privately, and come armed with the facts

• Ask the doctor to provide feedback about your job performance and if there is anything he or she feels you need to improve upon

• Determine the value of your current benefits package, if you have one, because that counts too! It’s so easy for staff members to discount or ignore what doesn’t actually show up in their paycheck.

I wish you well, and if you deserve a raise, I hope you get one!
Best wishes,

Dianne D. Glasscoe, RDH, BS, is a professional speaker, writer, and consultant to dental practices across the United States. She is CEO of Professional Dental Management, based in Frederick, Md. To contact Glasscoe for speaking or consulting, call (301) 874-5240 or email [email protected]. Visit her Web site at