2016 11 09 16 50 49 849 Jameson Kuehl Corinne 400

In dental practices throughout the U.S., certain employee issues continue to be concerns from dentist bosses. These concerns can be typically narrowed down to the following:

  • Employees who are simply the wrong fit for the position in which they were hired
  • Employees who violate office polices regularly without regard or consequence
  • Employees who create regular negativity within the team by their personal or professional attitudes and work ethic

In most cases, the employee who was once thought was a catch should be released to find a new employment home.

Corinne Jameson-Kuehl, RDH.Corinne Jameson-Kuehl, RDH.

When the dentist boss complains about a problem employee, much of the focus of the conversation comes down to the question of "Can I fire this person?"

This is often followed by a desire to give that person more chances to change. An evaluation is certainly in order if it is discovered that the problem employee has not been properly trained or the job description/expectations through the office manual and written terms have not been read or signed. However, in most cases, the concern that dentist boss expresses regarding the employee in question simply indicates that the individual is no longer the best choice for the practice.

Most dentists are unskilled with human resources (HR) solutions because of the nature of their education. They are skilled clinicians and caring oral healthcare providers, not HR specialists or state employment law experts.

Because of this, many are scared to pursue any process of corrective action, discipline, or an actual employee release. Often, the relationship between dentists and their team has become too personal, therefore skewing the actual employer/employee relationship.

One dentist shared with me that he and his clinical team were "getting tired" of his chairside dental assistant's continual early departure during the work day. In any other job, she couldn't just leave early all the time without permission and not be fired, he said.

When asked why he had not given her a warning or corrective action, and then possibly an employment release if correction actions were not taken, he told me it was her family's financial condition.

"I know her family needs the money, and, therefore, she needs this job," he said.

Being too nice is a poor reason to keep an employee who disregards the office policies and the consideration of co-workers.

Office manuals

How do you make sure everyone understands their responsibilities and duties? One way is to make sure you have an updated office manual in place that clearly states the policies that you want your team to follow to create your office culture and that are within the law to protect yourself. Seek out a legal expert or company that specializes in office manuals and knows your state laws and what can and cannot be stated in your manual.

All employees are required to read and sign that they have read the manual and understand the policies, including HIPAA and confidentially statements. This manual should be updated annually.

Fear of retaliation

Some dentists fear retaliation via a drop in office morale, slander on social media, and a loss of patients if they fire an employee, especially during a practice transition.

Initially, having seemingly solid, long-term employees who know the patients well probably seems like an asset during a practice transition. However, sometimes it becomes obvious that the previous owner's team, or even one member of the team, is not loyal to the new dentist and may even hijack the office culture and not move the new owner's philosophy forward. This is especially frustrating when this is a time when new dentist owners need all the support they can get.

Once a new dentist owner decides not to continue in a working relationship with the previous owner's employees, often there are threats if someone is fired, that person will tell your patients negative things about you, or that a supposedly popular hygienist will take patients with her if she's fired.

The reality is there will be anger, and perhaps some fires will be started, but as the saying goes, "This too will pass." It might be surprising how employees and patients alike start expressing their relief of the bully's departure, and the fear that existed was really not warranted. Everyone is replaceable.

I also recommend having a transition agreement in place with current employees during a purchase. This is not a guarantee of employment, but rather it would outline the new doctor's expectations and set a time frame for employment trial (such as 90 days).

The current employees would also sign an agreement that protects you against a situation in which a released or soon-to-be-released employee attempts to contact patients outside of the practice.

Even if a dentist owner is not experiencing a transition, it is advisable to have written employee documents in place to protect your business.

Trust your gut

In my experience of advising private practice dentists on employee releases, I have found that dentists really should trust their gut when they are contemplating firing an employee. Dentists are naturally compassionate and work every day with patients where they have to discern patient physical, emotional, and financial need. This compassion trickles into the aspect of employee management, and, sadly, jeopardizes the business and work environment of the practice.

If there is any doubt in the ability of the employee, and the proper measures have been taken, it is time to kindly release that person to find their best employment home -- and for your practice to have the excellence you deserve!

Corinne Jameson-Kuehl, RDH, has been involved in the dental field for more than 20 years as a private practice practitioner, business development manager, and dental staffing company founder and owner. She can be reached through her website,

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

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