Wednesday, April 9, 2014

Bridging Generational Gaps in 2020

As we move towards the 2020 workforce, companies face an interesting demographic dynamic in terms of talent acquisition - a workforce comprised of millennials, Gen Xers, baby boomers and traditionalists. While each of these groups has their own generational differences, the most notable are the expectations and approaches to work between millennials, who will make up the majority of the workforce, and baby boomers. With the latest Bureau of Labor Statistics Occupational Outlook handbook projecting total employment to increase by 15.6 million jobs between 2010 to 2020, generational differences will become an additional component of diversity relations at the workplace. Recruiters and hiring staff must learn to recognize the combined value, perspectives and impact of successfully integrating these distinctly different generations into an organization's teams, ultimately improving the company's ability to develop solutions, products and services for the future.

Millennials entering the workforce have frequently been characterized as individuals born between 1980 and 2000, who are entitled, lazy, job-hoppers, overly ambitious and unaware of business etiquette. Regardless of how accurate these descriptions are, this generation has demonstrated that it is in search of meaning and purpose. "Millennials want more than just a job; they seek careers that hold their attention and fulfill their ambition, all while providing competitive pay and work-life balance," says Suzanne Rice, director of U.S. franchise development for MRINetwork. "They want to work for companies that have a reputable brand, as well as products and services of which they can be proud. Unlike older generations, that didn't have the same access to technology, millennials are driven by out-of-the-box thinking, collaborative approaches to solutions and the ability to leverage the fastest, most efficient means of accomplishing goals."

Baby Boomers
A growing number of workers age 55 to 64 are continuing to work longer, yet in 2020 this generation of workers will only make up about 20% of the workforce. They have an entirely different approach to work than millennials and are often characterized as conscientious, dedicated, independent-minded workers that enjoy working alone on projects and then rejoining the team to reveal results. "Baby boomers can find it difficult to work with millennials, because they don't understand the younger generation's need for coaching, mentorship and collaborative work," says Rice. "They grew up in a time of stability, economic prosperity and opportunity when higher education and wider career options were becoming more accessible. Parents were away from the home more and children became latch-key kids. As a result, this generation tends to have a work ethic that is focused on self-reliance, paying your dues, putting in overtime and doing everything needed to accomplish tasks."

Despite the generational differences, millennials and baby boomers do have things in common. Both groups are focused on excellent job performance, and that can work to an organization's advantage. Millennials bring technology savvy and work efficiencies that can benefit companies. Baby boomers have the ability to provide millennials with insight on work etiquette, the company's culture and career tracking by demonstrating clear paths for advancement in the company. This type of relationship satisfies millennials' need for ongoing training, mentorship and collaboration, while providing baby boomers with job stability and value as experienced employees. Companies end up with improved work synergies and succession planning for the organization's future leaders.

We face an interesting paradox as the industry ushers in the next generation of workers. Adds Rice, "Recruiters and hiring managers will have to become knowledgeable about the different expectations of millennials and baby boomers, providing them with the growth opportunities they seek, while also leveraging their generational differences to create effective teams that can lead companies forward."

ETS Dental is a Dental Recruiting firm specializing in finding and placing General Dentists, Dental Specialists, and Dental Staff throughout the United States.

Wednesday, March 26, 2014

What Can an Associate Dentist Earn in Different Parts of the United States?

Last year we ran an article about how much Associate Dentists make across the United States.  The data provided was from the Dental Economics Annual Practice Survey.  This week I took an informal poll of our recruiters to learn about the current trends in compensation structures across various regions of the United States

Very important to note the following:
  • Most of our experience is with private or local group practices
  • These compensation averages are based on what we typically see in the market place, so what you may see or hear could potentially be higher or lower. 
  • Income based on percentages is relative to what will be produced/collected, so it is not necessarily fair to compare offers solely based on the percentage paid
  • The more saturated an area, the lower the percentages and average income will typically be for a doctor. However, this is not a universal fact, just likelihood.
  • These numbers were based on doctors with 1 to 5 years of experience
  • We understand the ever-present debate of collections versus production.  What we see is greater than 4 out of 5 practices pay on a collections-based system.
  • We are only talking about Associate Dentists’ income levels.  Not all dentists.  Owners absolutely make more income.  For example, Department of Labor statistics will be significantly higher than what is listed below. 

General Average of Doctors with 1 to 5 years of clinical experience

Total Annual Compensation
Percentage of Collections/Production
Base minimum or guaranteed salary
Other points of note
New England and North East U.S.
35% of collections
Lab expense of 35-50%
South Eastern  and Mid-Atlantic U.S.
30-33% of collections
$110,000 to $120,000 per year; $500/day
Equivalent lab percentage
Midwest and Great Lakes
$130,000 to $140,000
30-33% of collections
$120,000 per year; $500/day
Equivalent lab percentage up to 50%
Great Plains and Rockies
$130,000 to $150,000
30% of collections
$500/day; $120,000/year
If a practice charges lab it will be equivalent to percentage up to 50%
Texas / Oklahoma / New Mexico
$130,000 to $150,000
25-30% of collections
$500-$600/day; $120,000 to $130,000 per year
Rarely seeing any lab fee charged to the associate in recent years
Western Seaboard
25-30% of collections
$400 to $500 per day
50/50 chance the practice charges any amount of lab to the doctor. If they do it is equivalent up to 50%.

Multi-state and National Dental organizations do vary from some of the above, but only in some ways.  Overall, they offer a strong base salary in the area of $120,000 to $145,000 per year, depending on experience.  They pay a percentage of collections/productions that ranges from 25% to 33%.  Some pay the same percentage regardless of the level of production, while others will offer a tiered scale that increases the paid percentage for levels of production/collections that are met.  For example: up to $40,000 = 25%; $40,001 to $50,000 = 27%...  These organizations more often than not offer a full complement of benefits such as 401k, malpractice, medical insurance, CE, etc. 

Overall, what you see here is fairly similar earning amounts across the country.  However, the way doctors are paid varies from the Northeast over to the Northwest.  Something to consider when you are looking for your next practice opportunity.

Posted by Carl Guthrie, Senior Dentist Recruitment Consultant with ETS Dental. To find out more, call Carl at (540) 491-9104 or email at

Wednesday, March 12, 2014

Qualities of a Great Leader in a Dental Practice

As many experienced dentists know, learning and applying the technical aspects of dentistry is only half of what it takes to be successful. Whether a doctor is running his or her own solo practice or working as an associate alongside many others, leadership plays an enormous role in setting the course for your professional career as well as the future of your practice as a whole.

Here are some leadership qualities we often see successful dentists portray in their own practices:
  1. Have a clear vision - If a patient were to walk into your practice a year from today, what would be different? What about five years? Or ten? Having a written, clearly-defined vision for your practice not only help set future goals and objectives for sustaining and improving patient care, but it also gives your dental team a target to shoot for each and every day.
  2. Get your team motivated - Motivate your team in a style that matches the vision of your practice. Setting clear goals and measuring success through performance targets is a great way to increase productivity and keep everyone on task. Learn how your team responds to different stimuli as well. If you sense your morning routines are becoming drab and motivation is low, consider having special days, change in dress, or activities that involve patients to help shake things up. 
  3. Don’t settle for less – With competition at an all-time high in the dental industry, now is not the time to sit back and coast when it comes to providing excellent care each and every time a patient is in the chair. Excelling in all areas of your practice, from friendly customer service when a patient walks in the door to the dental treatment itself and your own bedside manner, will all play pivotal roles in determining the success of your practice.
  4. Continuing education = continuing success – Continue to challenge yourself to grow professionally and personally every day. Whether its books and articles, classes, or professional peer groups, find a way to continually develop and hone your leadership skills.
  5. Be a good example – When it comes to your actions, attitude, and reactions, how you control your own emotions will become a clear indicator of how the rest of your team should control theirs. Maintaining a positive energy and treating each team member with respect are key elements in developing your role as a successful leader.
  6. Clearly communicate your expectations – This is an area where many dentists (and bosses in general) really struggle. Developing great policies and procedures for your practice is great in theory, but if none of those ideas and expectations are communicated effectively, they become useless. Reinforce your expectations in employee handbooks, morning huddles, and one-on-one meetings with staff regularly. Hearing the same expectations daily reiterates their importance and helps keep everyone on-track.
Becoming an effective leader doesn’t happen overnight, and it most certainly doesn’t come without intentional effort. How successful you are at becoming an effective leader ripples through every aspect of your dental practice, and can in many cases make or break the success of your team as a whole. With some patience and practice, though, any dentist can mature into a great leader and set their practice on course for many years of success and prosperity.

ETS Dental is a Dental Recruiting firm specializing in finding and placing General Dentists, Dental Specialists, and Dental Staff throughout the United States.

Wednesday, February 26, 2014

Hiring an Associate Dentist Who Requires Visa Sponsorship

Long a part of medical doctor staffing, dentists requiring visa sponsorship have come to represent a much larger segment of the available work force. Often these associate candidates bring extensive training and geographic flexibility that is not easily found in the domestic applicant pool. Also, they often offer a longer-term associate solution, as the visa process discourages the kind of “job-hopping” that is more routine with traditional early career dentists.
Whether a practice is considering sponsoring a new Visa or transferring an existing Visa, the process is not as intimidating as it may appear. Our friend Ken Gauvey of The Law Practice of Ken C. Gauvey ( provides the following overview of the Visa sponsorship process from the employer’s perspective. For more information or to consult with an immigration lawyer, please contact Ken Gauvey at

Hiring Doctors in the Era of Health Care Shortages
The U.S. faces a national shortage of doctors. In fact, the Association of American Medical Colleges released a report indicating that the U.S. shortage of qualified physicians is at 20,000 now with half of the nation’s doctors being over the age of 50. As a result, that shortage, even before the introduction of the Affordable Care Act, is expected to grow exponentially in the coming years. A study in the Annals of Family Medicine projects that the country will need 52,000 more primary care physicians by 2025. According to the Journal of the American Medical Association, only one in five graduating medical residents plan to go into primary care. In the face of this shortage, it is clear that hospitals in the U.S. will have to rely more on qualified foreign doctors to fill this gap.

Unfortunately, the means to hire foreign nationals are limited and complex. In general, when hiring a foreign national doctor, the immigration timeline follows a predetermined schedule. In many cases, a doctor will need a J-1 waiver, followed by an H-1B visa, followed by some form of permanent residency sponsorship. Doctors who come to the U.S. to finish their studies commit to a two-year period of practicing medicine in their home country. The J-1 waiver is required to waive that two-year commitment. In exchange, those doctors agree to work for three years in the U.S. in a medically underserved area. However, once the waiver is approved, the doctor still needs an H-1B visa to actually work in the U.S.

The J-1 Waivers are limited. At present, each state only gets 30 of them. Moreover, each state has its own processes and procedures developed by the state department of health in place to determine who gets one of the waivers. Some states require the putative employer to demonstrate six months of recruiting efforts. Other states have few actually requirements outside of an application. Some states process the waivers at no cost to the employer; others have large fees associated with waiver requests. Having knowledgeable counsel who is familiar with the requirements for multiple states is of significant benefit to the employer. Once the state approves the request, the U.S. Department of State has to approve it. This process generally takes six to ten weeks. Following this, the Department of Homeland Security (DHS), through USCIS provides the final approval.

Concurrent with the review, the employer can file for the H-1B, which is the visa that actually allows the doctor to work. With premium processing, the H-1B can be approved, along with the final waiver, two to three weeks after the Department of State issues its approval. The H-1B is valid for three years, and permits one three year extension. During this period, the employer has to make a determination on whether to sponsor the employee for permanent residency.

There are many ways to obtain permanent residency through an employment relationship. The two most prominent ways are the National Interest Waiver (NIW), and Labor Certification. If a doctor subject agrees to work for five years (two in addition to the typical J-1 service requirement) in a medically underserved area, the doctor can immediately apply for a NIW. Additionally, assuming an immigrant visa is immediately available; the physician can also file for permanent residence, though the final approval of permanent residence is granted only upon proof of five years of service. An additional benefit afforded by the NIW and concurrent application for permanent residence is that the immediate family of the physician may apply for work authorization. Moreover, this process avoids the Labor Certification process which is time consuming and expensive.

The Labor Certification process requires the employer to conduct a specific test of the labor market to determine whether there are any qualified, ready, willing and able U.S. physicians to fill the position. The employer must conduct, at minimum, a two month recruiting effort using methods dictated by the U.S. Department of Labor. The employer must conduct a good faith recruiting campaign using five different types of recruitment efforts such as newspaper advertisements, web advertisements, etc. The employer has to interview minimally qualified candidates and if one candidate meets the qualifications the Labor Certification process fails. Therefore, this process requires an in depth review of the job description, and strict adherence to the regulatory requirements for the recruiting campaign. At the end of the recruiting effort, assuming no minimally qualified candidates are found, the employer, through their attorney, can file the Labor Certification application asking the DOL to certify the position. The DOL can request an audit, approve or deny the application, or have the employer redo the recruitment process under DOL supervision. Once approved, the employer can file the employment-based visa application. Following approval of the visa, and the completion of the three-year waiver requirement, the doctor can then file for permanent residency, subject only to the per country limitations in this process.

The process for hiring foreign national doctors is complex, but manageable with competent legal counsel. Employers should not shy away from engaging in this process especially as the shortage of doctors in this country continues to grow. However, employers do need to know the options when seeking to hire doctors who are subject to the J visa requirements. Competent legal counsel can manage the J waiver process and the H-1B process; and provide legal guidance throughout the Labor Certification process; and can prepare the remaining immigration filings. Therefore, while hiring doctors can be complex, employers cannot afford to shy away from the process in this era of health care shortage.

For more information or to consult with an immigration lawyer, please contact Ken Gauvey at

Monday, February 10, 2014

Electronic Cover Letters

Attached you will find my resume. I have 7 years of Medical Receptionist experience but no dental office experience.  I read that you need to have dental office experience and I don not have that but still feel that I would be a good choice for the job. Thank you for looking at my resume.

Writing a cover letter can be tough.  However, it is an important to getting your foot in the door.  Above is a cover letter that I recently received.  Yes, that is it, spelling error and all.  Honestly, I did not even open this individual’s resume, but it did get me thinking about what other individuals need to do to improve their chances at getting the attention of a potential employer.

In this day and time, the cover letter is especially crucial since communication is electronic.  When your resume is an attachment, this is your first chance to make an impression on a potential employer.  Unless you are copying and pasting your resume into the emails, which I do not recommend, your resume is not staring the reader in the face.

So, what can you do to stand out and get the reader’s attention?

First, address the reader.  Now, in this person’s defense, she was applying to a blind ad.  She could have, however, addressed the email to the hiring manager or with a “Dear Doctor”.

Next, let the reader know which position you are interested in.  They could have more than one opportunity available.

Then, focus on the positives.  The phrase that jumps out at me in this letter is “no dental office experience” a requirement for the position.  She even goes on to say that she read that it is a requirement.  Focus on what you have. 

A few other points to hit on in the body of this email, spell out simple numbers.  Spell check is a wonderful thing-use it.

Finally, there is no way to contact this individual in the email.  What if the attachment does not work?  Always, always, always include contact information! 

Below is a simple letter that would have made a much better impact for the job seeker.

Dear Doctor or Hiring Manager,

Attached you will find my resume for the opening you have available for a dental receptionist.  I have seven years of experience working in the medical field as a receptionist.  I am computer savvy and have strong customer service skills; I believe that my skills would transfer well into your practice and would welcome the chance to interview for your opening.  Please feel free to call me at (xxx)xxx-xxxx if you have any questions or would like to schedule a time to meet.

Thank you for your time and consideration.


Your Name

A few extra minutes and minimal work can mean the difference between your resume getting deleted or you scoring the interview.  Take your time!  Happy job hunting!

Tiffany Worstell is a nationwide Recruiter for Dental Staff at ETS Dental. She can be reached at or 540-491-9112. ETS Dental is a Dental Recruiting firm specializing in finding and placing General Dentists, Dental Specialists, and Dental Staff throughout the United States.