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I just got an email from a friend and client about a new hire he was about to make. He wanted my comments and thoughts about an email that he just received from a new hygienist that will be starting soon. Before you read this let me set the stage. The doctor is excited about the prospect of employing this qualified (over qualified??) hygienist. Like a lot of us, he began the search and will make the hire in desperation rather than with a slow and careful search. Sometimes you just have to act. He was really impressed with what she said she could do, her production potential, and her ability and willingness to sell dentistry. This could be an incredible addition to his team and for his practice.

When looking at hygienists, associates, or any potential employee, you need to understand how important the first email, calls, and conversations are to making this work in terms of “on-boarding” any new team member. There is typically a lot of posturing, so keep in mind that these first encounters set the stage for the rest of their relationship with the office. With this in mind I made these comments to the doctor about what she wrote (the commented areas have a C-1 thru C-9 and correspond to the same indicator below the email).


Thank you SO much for the opportunity to be a part of your team.  I look forward to a long and happy career with your dental practice!!  I was encouraged when we met Thursday as I believe we have similar visions, goals, and expectations for your practice!!  I happily accept the position, and look forward to finding a date for me to start. (C-1) I will be finished with my Chemistry class on December 16th, so a normal schedule of Wednesdays will be possible as of that date.  After our meeting, I would like to clarify all details so there is no ambiguity to our agreement 🙂

  1. Start date 🙂  (Wednesdays will begin immediately after December 16, 2016)
  2. $40 an hour (C-2)
  3. 30% Commission (C-3)

• I will keep track of my production and adjustments daily on a spreadsheet that I have perfected       over the last 17 years 🙂(C-4)

• Daily Production to include everything I do (minus the exam) minus adjustments = net production   for the two week pay period. (C-5)

• If my net production exceeds my hourly rate I will be compensated the difference. (C-6) (I hope to   be SO productive that we won’t have to worry about this detail for long as it is my goal to be so         productive that I will be strictly commission!!) (C-7)

• In 90 days we will revisit production and increase my percent commission (I’d like to eventually       be strictly commission at 40%). (C-8)

  1. Holidays – Days that the office is closed and not open for seeing patients:

• I know we touched on this, but did not follow through.  May I suggest on days that the office is           closed that I receive a rate equal to the hours I would have worked (not commission) had the office   been open? (C-9)

  1. Please address vacation pay / PTO (paid time off to be used in event of illness or vacation) as we didn’t discuss this at length. (C-10)
  1. I’d like the freedom to adjust the schedule and appointment times to maximize production for me and the practice (i.e. no blocks). (C-11)
  1. What would you like me to wear?  Are Friday’s casual? (C-12)
  1. PLEASE consider getting a Cavitron/Prophy Jet!!  (C-13) It is an essential piece of equipment that will maximize time and efficiency in cleaning appointments.  Patients REALLY love the Ultrasonic and the prophy jet.  EVERYONE is happy with their cleanings as it is new and exciting to them and their dental experience is an extremely pleasant one!!  This ensures patient satisfaction and a successful referral program!!  I promise it will make up for its cost in profit 🙂  

In conclusion, I look forward to starting with your office soon and being an asset to your practice, I believe this is a good fit!!  I am a motivated, energetic, dependable, friendly, bubbly, team player looking for my forever home where I can build long-term relationships with my patients and coworkers. I’ll talk to you soon!! (C-14)


C-1: I don’t know about you, but I would feel like I was being set up for the fall. Most employees want to get on your good side, but I bet there is something coming after this intro.

C-2: In his area the going rate is $32-$40 an hour depending on whether they have other benefits, but I always encourage doctors to use a commission based pay scale for associates and hygienists.

C-3: This might be fair, but it depends on the current overhead of the office. If it was 70% you are losing money every pay period with her. If your collections are less than 100%, say 98%, you have to compensate for your inability to collect everything. Most offices should be in the 25-30% range for commissions but this includes taxes, benefits, and even a hygiene assistant if one is supplied.

C-4: NO, NO, and NO. If you relinquish the oversight and control of doing this, you lose. Your computer can give you adjusted production (production after write offs and lack of collections).

C-5:   She is now telling you when you must pay her. If you are paying weekly, the first and fifteenth, or any other way, the answer is you will get paid as all other employees are paid.

C-6: NO, NO, and NO, again. It is one or the other, and I prefer the commission with no safety net. No guarantee of $40/hour.

C-7: No problem. She will be on straight commission from the start or she will not start.

C-8: This will never happen. The only thing that would increase that commission rate would be a drastic change in overhead and collection rates to over 100%. Even then the only increase in pay would be in the form of a bonus paid equally to the entire office staff. This employee may end up being a nightmare if you do not take back the control that saying yes to this email would abdicate.

C-9: No you may not suggest. I would find the going rate for a hygienist on hourly pay for your zip code. Go to, and click the word “Salaries” at the bottom of the landing page and insert your zip code and the position that you are looking for. It will tell you the exact pay in your zip code and list all of the people they have placed in the last 12 months.

C-10: Hopefully you have an incredible policy manual from CEDR but at least you should already have a written policy for holidays, vacations, and sick pay (if any). The new employee should read this policy along with the entire policy manual and they must sign a paper that says they have read it, understand it, and will abide by the policies of the office.

C-11: No block = No way. I would be fine with having her work on her schedule but we have to make sure we have peak demand times in the future to insure that we can process our new patients within 4-10 days from the time they call during 7-9 AM, 3-6 PM, and Saturdays.

C-12: This should be addressed in your policy manual, but there should never be a “Fridays casual”. Every day is the same: Uniforms, pressed, cleaned, and coordinated with the rest of the office.

C-13: This is pretty much standard of care in hygiene and is a reasonable request.

C-14: I would tattoo this on her forearm. If she is correct and you take the time to train and on-board her, you might just have a keeper.

             As you can see, new employee on-boarding and agreements can be a little more convoluted that one might think. Don’t go too fast until both of you have the time to thoroughly define the job description and expectations in a very transparent and clear way. Every point you can cover will create remedy to the inevitable problems we all have with our staffs. This is how you Summit.

Michael Abernathy, DDS
972-523-4660 cell
[email protected]