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In most dental practices, the average staff member has been there three years, but when you go into the dental offices where they're just crushing it (the dentistry is great, the revenue is high, the word-of-mouth referrals are high, the net income is high), you start finding that if you want to be a dentist who makes $200,000 a year, your average staff member has to be with you five to six years or more. Every dentist I know who's making $250,000 to $300,000 a year has staff members who have been there 10 years or more. 

To keep staff members that long, you have to reduce burnout and increase hope. They need to have hope that their jobs will either stay great or have hope that if their jobs aren't great, the situation will get better. 

There's a business reason for reducing turnover. When patients walk into a dental office and the dentist says, "You need a root canal," some patients will trust the dentist no matter what, but other patients will need more assurance that the dentist is trustworthy. Your team can offer that assurance. See, if the patient knows that the dentist has been able to keep his or her receptionist, hygienist and assistant there for 10 years, it increases trust. The patient thinks, "I like those people—I know they wouldn't work here with a lying sociopath. If you were telling me I needed a root canal when I didn't, I don't think those employees would keep working for you. I think they'd quit and turn you into the board." 

When we plot highest net income with all the variables that can be associated with it, we don't find it related to where you went to school or what institute you did some training at; we find it linked to longevity of the average staff member. 

So what keeps turnover high? What keeps staff members from staying with an employer long term? 

Toxic people and loss of hope. They're sometimes related. Let's start with toxic people. 

I pay a lot of attention to teams and I've seen that the No. 1 destroyer of good teams is that the owner doesn't get rid of toxic people. Sure, you want employees long term, but not if they're toxic. The most dangerous type is the moody person. You know who they are. They come in one day and they're adorable and the next day they're mad at the world. You have to get rid of toxic people. It goes back to the playground. Are we all going to have fun in the sandbox? I don't care how good your dentistry is, if you're toxic and you're throwing instruments, or you're tolerating toxic people, it's a morale destroyer. Then you have staff turnover and then people aren't trusting treatment plans, and your business stops growing. 

Think of how valuable it is when you have your staff take an online dental course from Dentaltown and they learn something great, and then stay on your team for the next 15 years implementing what they learned. That value is long term. I see a lot of business owners who aren't reaching their top and it's because they're holding on to toxic people. You want the kind of person, where, every time you see them, it's the same person you first met. They should be allowed to be upset about specific situations, but not just be grouchy for the sake of being grouchy. Your staff will start to wonder why you keep that person, that employee who is nice to you but mean to others, who refuses change and who drags people down. All this, and other mismanagement, will lead to your team losing hope. 

You have these staff meetings and employees tell you what's wrong and initially they have hope that there's light at the end of the tunnel and that you're going to make changes. You acknowledge that it's not good today but it's going to be better someday. Well, 30, 60, 90 days go by and nothing changes. The same toxic people get protection and favoritism, and the same people don't pull their weight but act like they work harder than everyone else. 

Then what happens? No one's playing to win; they all start looking for a better job. They don't give you insight, they don't take risks, they don't care anymore. 

Here's another scenario I see all the time. The first person out the door is the dentist and then one assistant follows him out the door. Then the other, more caring, dental assistant wants to make sure everything is done, so she's cleaning everything up. She gets everything ready for the next day and realizes the next day there's a bridge scheduled that is coming back from the lab and it's not in, so she's freaking out calling the lab and then the lab says, "I didn't know that was scheduled. Do you want to reschedule the appointment?" And the assistant is sitting there like, "It's hours after the dentist left. The other staff left too. That toxic person who doesn't work hard left as soon as the boss left. Why am I being paid salary, working my butt off, going long, doing everything right when no one even cares?" 

This person might keep thinking, "I don't think the doctor is ever going to notice it. He never says anything. I'm not going to make any more money. I don't care anymore. I've lost hope that I'm going to be recognized, that I am going to see my effort rewarded in any way. Why am I going to tell my boss what's wrong with this place and what we need to do when it's all talk, no walk and nothing ever gets done? I've lost hope. I'm not going to share with my team what needs to be done around here. I'm going to quit going to CE. I'm going to quit trying to improve this place." 

Invest in your staff. For instance, at conferences and shows, the dentists who don't bring their staff because of cost are losing out the most. They end up going back to the practice and try to cram an eight-hour seminar into a five-minute meeting and no one learns and nothing gets implemented. Then you have doctors who only take a few staff and the rare doctors who bring the whole staff. The dentist who sends his whole staff to seminars and stays home makes the most money. That staff is the staff that's crushing it, doing $2 million a year and the newest girl on the team has been there six years. That's an office that's fired up. If you give people hope, growth and abundance, you're going to crush the future. 

Your team loses hope when they see all talk and no walk, and see you protecting toxic, manipulative people. To notice this, you've got to be all over the practice and you have to ask people what's going on. Get involved. Don't just take one or two people's opinions. Get a cross section of input and then act on that input. Don't let your team lose hope. It hurts your employees, creates turnover and hurts your bottom line. There's a better way.

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