You gotta know when to hold 'em...

Most of us will remember this 1978 song by Kenny Rogers chronicling the life of a gambler and life lessons learned. And although Texas Hold 'Em has become a popular pastime, this is not an article about winning at cards. It is an article about winning the staffing game.

Overview

Just as in poker, winning at hiring takes a combination of luck and strategy. What's the deal? Exactly what are the factors that are impacting our ability to hire competent, committed staff? How do we improve our odds of winning? And lastly, once we get a "winning hand" how do we play it?

What's the Deal?

Over the past 30 years, more and more women have entered the workforce, particularly the corporate world. According to the Bureau of Labor Statistics, in 2004 women held half of all management, professional, and related occupations. Almost one-third of women age 25-64 held a college degree as compared to 11 percent in 1970. The vast majority of households in the U.S. have more than one wage earner and in almost one-quarter of these households, women are the major wage earners. What does this mean to the dental profession where the majority of auxiliaries are women and where dentists are becoming more and more dependent on competent staff in order to become more efficient? It means a smaller pool of labor, as women are presented with more career choices. And it means we must become more skilled, creative, and competitive in our hiring practices! Lady Luck may have dealt us a mediocre hand, but with a comprehensive strategy, we can increase our odds considerably.

How Do We Improve Our Odds?

A winning strategy begins with expanding our search. Start with current staff, particularly those who have been with the practice for many years. Ask for their help in crafting a vibrant ad. What is it about your practice that keeps them happy? For example, do you offer continuing education reimbursement or shorter summer hours? These benefits should be part of your ad. Ask newer staff what about your ad made them respond? Include that as well. Avoid abbreviations and standard language. Develop an exciting, interesting ad that will encourage potential candidates to call you first.

Next, ask staff for their help in recruiting. Chances are if they are happy in your practice they have told others. Never underestimate the power of networking. Many of your staff belong to professional associations such as the ADAA and will have access to like-minded individuals who may be thinking of either re-entering the workforce, or changing jobs. Be sure to offer a "reward" to any staff member who successfully recruits a new team member!

Be creative in "selling" your practice. If a potential candidate is not able to immediately meet with you, send along a letter highlighting the benefits of working in your practice, along with a practice brochure and business cards. If you have a website, be certain to direct her/him to the site for more information. This technique works extremely well for any candidates who are moving into your area. Remember that this candidate is also looking at other practices. You want to stand out as a superior employer!

Lastly, be proactive, not reactive with staffing needs. I believe that there is always room for a competent self-starter. Remember that in order to add one "extra" staff person, it is necessary to cover the costs of that one person. As long as the new hire is able to increase practice production by the amount of salary and benefits, you can afford them. If this is a clinical person, splitting time between clinical and administrative duties may be a possibility. In other words, be creative. The costs of hiring a new person in a crisis are enormous. Desperation often causes managers to hire the less-than-ideal candidate for above-average compensation.

How Do We "Play the Hand"?

Once you have determined through careful selection the best match for your practice, how do you go about creating a winning employer/employee relationship? My three "R's" of hiring, "Reveal, Review, and Reward," will help you to remember the critical steps to "playing out your hand."

Reveal

Revealing your expectations begins in the first interview. The candidate should be given a detailed job description that lists all duties of the position. With a clinical candidate, this job description should include both clinical and administrative duties. Failed relationships often happen as a direct result of miscommunicated expectations. For example, if you require the applicant to water the plants and dust as part of the job, include that in your job description, possibly listed under "other miscellaneous duties."

A very useful tool in the initial interview is a critical skills assessment questionnaire. (See Figure 1.) This self-evaluation forces the applicant to candidly evaluate the level of proficiency in the essential duties for which he or she is being considered. The interviewee is asked to rate each skill on a scale from "strength" to "very limited," "strength" indicating expertise in the area and "very limited" indicating training is necessary in that skill set. This assessment questionnaire accomplishes four things. First, it establishes a minimum level of expertise for the position. Second, it identifies those areas of deficiency and determines what further training is needed. Third, it helps to determine the appropriate compensation to offer. And fourth, it serves as a baseline for future performance reviews.

Be certain to give the applicant a written description of your benefits package. This will be an excellent reference to help the candidate with her/his decision and also a wonderful promotional tool for your practice. Also, provide a copy of your personnel section of your office policy manual. This will reinforce those policies and expectations that are critical to your practice.

Last in this "Reveal" process is the working interview. I recommend this step as an opportunity to evaluate the "fit" of the candidate with the rest of the team and as a second chance to reinforce expectations. It also gives the candidate the ability to ask questions and express concerns before the hire. It is a "no strings" opportunity for each of the parties to get to know each other. I also recommend paying a stipend for the time spent in your practice.

Review

After carefully interviewing and checking references, you have chosen the "perfect match" for your team. What next? Unfortunately, the new hire is often tossed into the fray with little or no training and high expectations, a "baptism of fire." Patience and skillful mentoring are critical at this stage. Ideally, a standardized training program should be in place to accommodate the new staff person. This program would include a timeline for training along with periodic skills testing. One staff person would be assigned as the trainer and be given the time needed to adequately coach the trainee.

If this is not possible, identifying a mentor for the new person to shadow is the next best tactic. The mentor should know the results of the skills assessment questionnaire in order to assist the trainee in those areas of deficiency.

The day of the hire, schedule the new employee's first review for three months after employment. At this review, the new employee will be evaluated and will learn what additional training is required. He or she will also have the opportunity to discuss how their training is progressing. Compensation should not be discussed at this review, unless a promise has been made to do so as a condition of employment. Everyone should leave this meeting with a clear understanding of what further training needs to occur, who will do the training, and when the next review will take place.

By the time the new hire has reached the one-year anniversary, he or she should be familiar with the review process and well on the way to becoming a valued long-term employee. From this point on, reviews should be used to set goals for the coming year. Reviews should never be used to introduce deficiencies for the first time. Substandard performance and any disciplinary matters should be addressed as they occur. Appropriate and timely action is critical in dealing with either of these issues. It should not be put off until a scheduled performance review. Avoid any unpleasant surprises at a review. This will encourage staff to look forward to reviews, not dread them.

Pleasant surprises are always welcome at a review. Recognition and rewards are appropriate and encouraged at anytime, but do not discount the value of bestowing them at a review. Conducting win/win reviews is another "ace" in your hand!

Reward

The last step in playing a winning hand is to reward your high performance team. Many articles have been written on the best ways to reward staff. Although a fair, competitive salary and benefits package is a critical component of retaining excellent employees, it must not end there. Daily recognition for a job well done should come naturally and be heartfelt. Criticism should be done in private and praise should be generously shared with the entire team. Lee lacocca, the former CEO of the Chrysler Corporation and noted businessman, once said, "When I must criticize, I do it orally; when I praise somebody, I put it in writing." Do not underestimate the power of the written word when it comes to praise. A personal handwritten note to a valued employee for exceptional work will become a testament to that employee's value and your appreciation. Dentists and office managers alike are in a position to express appreciation on a regular basis.

Become creative in your rewards. Find out what employees would appreciate by asking them[ More than likely it will be different for each person, but personalizing a reward can become a very powerful motivational tool.

And do not forget other significant "R's" in this quest for a high performance team: Respect, Recognition, and Renewal. Make each of these words part of your vocabulary and you will have a winning team!

Action Plan

Now that you are ready to develop your vision of a happy high performance team, what are the next steps you should take? First review your staffing needs. Will you need any new staff within the next year? Perhaps your practice has grown considerably. Perhaps a staff member will either be cutting back on hours or moving out of the area. If you find that you will need to hire within that time period, make certain that you have all the tools you'll need to start your search.

Second, determine the general state of the employment market. Will you be competing with many other practices for the same people? Are your salaries and benefits competitive with others or do you need to make adjustments with current employees' compensation before hiring new staff? Making these changes now will help you avoid hiring someone out of desperation at a higher compensation level than current staff.

Next, review and revise all of your employee documentation. Update your office policy manual and benefits package. Create or modify all job descriptions. Begin now to craft a creative ad. If you do not already have one, develop a skills assessment questionnaire to be used in the hiring process. Check your employment application for legal compliance and completeness. Revise it as necessary.

Lastly, respect, reward, re-energize, and rejuvenate current staff. They will be your greatest goodwill ambassadors in your search. Empower them to help in this process and you will be utilizing your most valuable resource!

Summary

Putting together a winning team is certainly not a game. It requires skill, diligence, and a little bit of luck. The poker analogy is simply a tool to present critical information in a fun, relevant format. However, with a proactive, pragmatic, and creative approach to hiring, you will improve your odds of successfully hiring the perfect match for your practice.

Good luck!

References

Bureau of Labor Statistics. Women in the Workforce: A Databook; www.bls.gov/cps/wlf-databook2005.htm

Figure 1: An example of a Skills Assessment Questionnaire

DENTAL ASSISTANT APPLICATION

NAME:                                        DATE: __/__/__

Please rate the following skills as a strength (you can perform
the procedure with speed and accuracy), as limited (you need
some further training), or very limited (you understand the concept but
have never been trained to do the procedure):

SKILL                                      STRENGTH   LIMITED     VERY
                                                               LIMITED

Identification of all primary teeth          ---        ---        ---
Identification of all permanent teeth        ---        ---        ---
Place rubber dam isolation                   ---        ---        ---
Place sealants                               ---        ---        ---
Coronal polishing                            ---        ---        ---
Assist in restorative procedure              ---        ---        ---
Assist in crown & bridge                     ---        ---        ---
Assist in extraction                         ---        ---        ---
Assist in endo procedure                     ---        ---        ---
Expose, process & mount BWXs                 ---        ---        ---
Expose, process & mount PAs                  ---        ---        ---
Expose & process panoramic film              ---        ---        ---
Expose & process cephalometric film          ---        ---        ---
Expose & process occlusal film               ---        ---        ---
Take intra-oral photographs                  ---        ---        ---
Take alginate impression                     ---        ---        ---
Take compound impression                     ---        ---        ---
Pour & trim work models                      ---        ---        ---
Pour & trim study models                     ---        ---        ---
Preparing tooth for bonding brackets         ---        ---        ---
Preliminary fit of ortho bands               ---        ---        ---
Removing excess cement from tooth            ---        ---        ---
Removing archwires                           ---        ---        ---
Placing & ligating archwires                 ---        ---        ---
Fabricating retainers                        ---        ---        ---
CPR                                          ---        ---        ---
Knowledge of OSHA regulations                ---        ---        ---
Working with patients with disabilities      ---        ---        ---
Maintenance of equipment                     ---        ---        ---
Sterilization of instruments                 ---        ---        ---

Sheila Clancy is the cofounder and a Past President of Project Stretch, Inc: Dentistry Reaching Out to Children, an organization that since its inception in 1988 has provided disadvantaged children in the United States and around the world with preventive and emergency services. Ms. Clancy is also a Past President of the Massachusetts Dental Assistants Association. She is a national lecturer and a practice management consultant with over 35 years in dentistry.