Dental Assisting Profession is Disappearing

[Cold Front]

we actually needed the hygienist to come back, and now in some places they are asking 60 + an hour.

I have dentist friends in Seattle who told me that it’s not unusual for hygienists in their market to ask $60/hr. That’s $125k a year before benefits! It’s insane!

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[Cold Front]

The relief fund will eventually run out and people will have get out of their house to find work again. When that happens, you can be picky about hiring the right hygienist with the right salary again. Right now, just increase the treatment fee to make up for the higher overhead. A lot of your patients also get some kind of stimulus money. They can afford to pay more for their dental treatments.

The relief funds/stimulus will stop, but the changes it created are irreversible, specially wages. Price of gas can go up and down, so as food and other goods, but once you pay someone a x amount of $ in wages, you can’t just tell them “I will cut your pay from $25 to $20”... they will leave you, and a DSO office or someone else will pay them the $25, even if it gets harder to find. Wage inflation is permanent. We are an aging demographic, there will be so many jobs open in the future. We currently have 10M jobs open... if everyone who gets the relief funds got back to work today, we would still have millions of open jobs that would compete with the filled jobs.

 

[Cold Front]

To be honest you are the only person I have come across thats not seeing this issue as a dentist, every dentist in person I talk to and online is complaining about this issue.

I think the dentists who haven’t experienced the DA shortage yet will eventually experience it. There are about 6,500 new dentists who just got their dental license this summer.... and on average, they will need 2 assistants each... that’s at least 13,000 new DA demand on top of the existing demand. In economics, the only option in such situation is to pay the DA’s more... until every dentist has enough DA’s.... which won’t happen for a while for a multitude of reasons (state regulations roadblocks to produce more DA’s, competing non-dental wages, etc). I started this thread a year ago and I predicted the issue to get worse, even without a pandemic... and here we are!

 

[Cold Front]

Yeah, we have excess of everything here in CA....too many doctors, dentists, lawyers, restaurant workers, healthcare workers, dental assistants etc. Does your state require the assistants to have RDA license in order to perform certain procedures? If not, why not just hire any HS kid and train him/her? Sometimes it's better to train someone with no experience to work the way you want than to hire one with dental assisting experience but has bad habits.

CA is losing population... but they haven’t hit the threshold for you to see fewer doctors and other medical professionals yet, but it’s a slow population loss that will mount to a bigger population loss someday. The most moved to city in America last year was Phoenix, Arizona. I wonder what the DA shortage in that city is like. Arizona is also one of the states most people who moved from CA ended up in... according to U-Haul metrics. The state also has very friendly business laws, even for dentists - you can just show up and work there for the most part; fewest hurdles to practice there than any other state.

Also, you can’t just train anyone to be a DA in most states, it would be against the laws of those states.

 

[charlestweed]

I have dentist friends in Seattle who told me that it’s not unusual for hygienists in their market to ask $60/hr. That’s $125k a year before benefits! It’s insane!

As long as this $60+/hr hygienist continues to produce 2-3x more the amount that she gets paid, her boss should be fine. It’s a good source of passive income. The owner gets paid for doing nothing. He also gets the PPP loans + other stimulus money on top of that. Life continues to be good for many dentist owners during this pandemic.

 

[charlestweed]

CA is losing population... but they haven’t hit the threshold for you to see fewer doctors and other medical professionals yet, but it’s a slow population loss that will mount to a bigger population loss someday. The most moved to city in America last year was Phoenix, Arizona. I wonder what the DA shortage in that city is like. Arizona is also one of the states most people who moved from CA ended up in... according to U-Haul metrics. The state also has very friendly business laws, even for dentists - you can just show up and work there for the most part; fewest hurdles to practice there than any other state.

Also, you can’t just train anyone to be a DA in most states, it would be against the laws of those states.

We still don't experience any shortage despite a large number of people leaving our state. Most places (theme parks, restaurants, dental offices, shopping centers etc) have been very crowded (more crowded than before the Covid level) eversince the mask mandate and other Covid restrictions were lifted on June 15th. Construction workers and engineers continue to work on many freeway widening projects to alleviate the traffic jamp problems due to growing number of motorists. I am glad that everything is back to normal in CA.

Also, you can’t just train anyone to be a DA in most states, it would be against the laws of those states.

Why is it illegal? Yes, it’s illegal for a DA perform procedures that only the assistant with RDA license can perform. But for things like suctioning, cleaning the chairs, sterilizing instruments, mixing cement, delivering instruments to doctors etc, any person can legally perform them in my state. If you are not picky, you can just hire any recent HS grad to work for you.

 

[Cold Front]

I am glad that everything is back to normal in CA.

That’s good. I read earlier that LA county is going back to mandatory masks for all indoor activities now. Don’t leave your mask behind at home if your live in that region. Los Angeles County reinstates indoor mask mandate amid growing COVID-19 cases

 

[charlestweed]

That’s good. I read earlier that LA county is going back to mandatory masks for all indoor activities now. Don’t leave your mask behind at home if your live in that region. Los Angeles County reinstates indoor mask mandate amid growing COVID-19 cases

I am in Orange country, where the rules are less strict. We still require all of our patients to wear masks inside our facilities. Only the patients, who have appointments, are allowed to be inside. Their parents and friends all have to wait outside. We use this pandemic as an excuse not to allow a lot of people to be inside our offices….less wear and tear on the furniture and less cleaning to do afterward.

 

[DDS9994]

The relief fund will eventually run out and people will have get out of their house to find work again. When that happens, you can be picky about hiring the right hygienist with the right salary again. Right now, just increase the treatment fee to make up for the higher overhead. A lot of your patients also get some kind of stimulus money. They can afford to pay more for their dental treatments.

unfortuneatley Charles when you are in network you cant just increase fees. You are legally bound by the fee schedule.

 

[DDS9994]

Yeah, we have excess of everything here in CA....too many doctors, dentists, lawyers, restaurant workers, healthcare workers, dental assistants etc. Does your state require the assistants to have RDA license in order to perform certain procedures? If not, why not just hire any HS kid and train him/her? Sometimes it's better to train someone with no experience to work the way you want than to hire one with dental assisting experience but has bad habits.

Yep, that was something we did as well training folks on the job, eventually they will leave since they have experience for higher paying positions or offices with lots of benefits, some have also gone back to hygiene school. But now it seems even that well has dried up, strange times.

 

[DDS9994]

I think the dentists who haven’t experienced the DA shortage yet will eventually experience it. There are about 6,500 new dentists who just got their dental license this summer.... and on average, they will need 2 assistants each... that’s at least 13,000 new DA demand on top of the existing demand. In economics, the only option in such situation is to pay the DA’s more... until every dentist has enough DA’s.... which won’t happen for a while for a multitude of reasons (state regulations roadblocks to produce more DA’s, competing non-dental wages, etc). I started this thread a year ago and I predicted the issue to get worse, even without a pandemic... and here we are!

I agree, people keep forgetting about all these new dentist being pumped out and how you need assts for these jobs, and you are correct no one is gonna take a paycut and not be out looking for another job. Lucky for me I can manage with my one asst and 2 hygienists and an isolite but hard to do when you keep getting bussier and busier.

 

[2TH MVR]

It's a vicious cycle. Lose a DA --> other DA's are asked to do more at the same pay scale --> DA's become disillusioned and leave. It's not just the private offices. It's Corp also.

When I 1st started out in Corp 5 yrs ago .... I had 4 ortho assts. Life was good. Post covid .... I have 3 assts if I'm lucky. Most days it's 2 assts. And of course ..... Corp still insists we see that SAME number of patients as pre-Covid . With LESS staff. The loyal, long term ortho assts are being asked to do so much more that morale is pretty low right now.

Probably a combination of a greedy Corp along with this shortage of DAs.

 

[charlestweed]

unfortuneatley Charles when you are in network you cant just increase fees. You are legally bound by the fee schedule.

I see. But you can always raise fee on other patients who are not in the network (….ie cash patients), right? My office used to accept medicaid and I didn’t get paid much for treating those patients. My cash and insurance patients helped finance the treatments for those medicaid patients. At the beginning, I needed patients to fill the appointment book. As my office got busier, I stopped accepting medicaid because of the amount of paperwork and headache that my office manager had to deal with.

 

[charlestweed]

Yep, that was something we did as well training folks on the job, eventually they will leave since they have experience for higher paying positions or offices with lots of benefits, some have also gone back to hygiene school. But now it seems even that well has dried up, strange times.

As business owners, we all have to deal with the assistants who come and go….assistants who call in sick....assistants who take vacations…..staff hiring and firings etc. I too have lost a few of my P/T assistants to other offices that were willing to offer them more work hours and better pay. A few months before the Covid, I lost a very important F/T assistant, who could do chairside assisting make in-house retainers. He passed the commercial driver’s license test and wanted to drive truck full time. It was a good thing because when our offices were shut down due to Covid, I only had to pay salaries for 2 F/T employees instead of 3.

For this reason, I cross-train my staff so they can perform different tasks in case one of them quit or call in sick. For example, my office manager can take xrays, take impressions, sterilize instruments, cut poky wires for emergency patients. I pay her a lot (bonus+ vacation pay+holiday pay+ 401k) because she's the only person I can’t lose. She’s 55 and I am 49….we plan to retire at the time…probably in 10-15 years. 3 of my 7 P/T assistants can make retainers. I can also multitask. I can work as an assistant and I work much faster than most of them. My staff don’t mind working harder (when one of their co-workers is absent) for me because they all want to go home ontime. To keep them happy, I use the salary portion of the assistant, who quit, to pay each of them 1 overtime hour on top their regular daily salary. It’s only temporary until I hire a new employee.

 

[Cold Front]

I agree, people keep forgetting about all these new dentist being pumped out and how you need assts for these jobs, and you are correct no one is gonna take a paycut and not be out looking for another job. Lucky for me I can manage with my one asst and 2 hygienists and an isolite but hard to do when you keep getting bussier and busier.

Well, it sounds like you are flying with 1 engine. What if your 1 DA calls off sick? Or tests positive for covid? Or even worse, she asks for pay raise later this year because her jobs duties is carrying the weight of 2 DA’s assistants? How does it effect your schedule? Hopefully none of this happens to you, but you are definitely threading the needle like many other offices who have DA labor shortage.

I personally think some offices will have to scale back on their schedule; maybe open less hours, adjust/reduce treatments that are highly DA dependent, maybe have front desk perform some aspects of DA related duties, etc. Whatever it takes to survive the DA scarcity. I can see the highly spoiled and highly dependent dentists by DA’s will be very annoyed by all this... lol

Also, America entrepreneurship sky rocketed during the pandemic. People who were furloughed without notice last year got a big wake up call. People are exploring alternative job security and the chance to control their financial destiny. People had a lot of time to reflect on their lives during the lockdown, and I think that’s another wrinkle in the uneven labor supply. Wages will continue to go up because it’s simply an employee market.

 

[charlestweed]

It's a vicious cycle. Lose a DA --> other DA's are asked to do more at the same pay scale --> DA's become disillusioned and leave. It's not just the private offices. It's Corp also.

When I 1st started out in Corp 5 yrs ago .... I had 4 ortho assts. Life was good. Post covid .... I have 3 assts if I'm lucky. Most days it's 2 assts. And of course ..... Corp still insists we see that SAME number of patients as pre-Covid . With LESS staff. The loyal, long term ortho assts are being asked to do so much more that morale is pretty low right now.

Probably a combination of a greedy Corp along with this shortage of DAs.

At the beginning of the pandemic, it’s completely understandable that corp offices had to furlough many of their assistants due to lost revenue. I am not sure if they are qualified for government aids (such as PPP, EIDL) since they are big companies with 500+ employees. As a corp’s employee, I wouldn’t want my corp to file bankruptcy and lose my job. I’d rather work with fewer assistants than being unemployed. When the offices were allowed to reopen, fewer assistants were needed because fewer patients were allowed to be inside the office (for proper social distancing). Now, everything is back to normal. If you can still produce the same for the corp with fewer assistants, there’s no reason for them to hire more new assistants to replace the ones who quit. They don’t care about the workers’ morale. They don’t care if one of the assistants at your office quits because they have a large pool of assistants, who can travel to work at multiple offices. They can also get one of the assistants from general department and train him/her to become an ortho assistant.

 

[Cold Front]

At the beginning of the pandemic, it’s completely understandable that corp offices had to furlough many of their assistants due to lost revenue. I am not sure if they are qualified for government aids (such as PPP, EIDL) since they are big companies with 500+ employees. As a corp’s employee, I wouldn’t want my corp to file bankruptcy and lose my job. I’d rather work with fewer assistants than being unemployed. When the offices were allowed to reopen, fewer assistants were needed because fewer patients were allowed to be inside the office (for proper social distancing). Now, everything is back to normal. If you can still produce the same for the corp with fewer assistants, there’s no reason for them to hire more new assistants to replace the ones who quit. They don’t care about the workers’ morale. They don’t care if one of the assistants at your office quits because they have a large pool of assistants, who can travel to work at multiple offices. They can also get assistants from general department and train him/her to become an ortho assistant.

There is a recent thread on dental town, and it has a poll on DA wages with about 200 dentists who responded. 2/3 of the dentists said they pay their DA at least $41,000 a year. 1 in 5 said they pay at least $52k a year or more. Imagine what the big DSO’s might be paying in this market... they typically pay more than private offices to compete. I think if you are a DA today, it’s not hard to find a $50k a year position, in most states.

 

[charlestweed]

Well, it sounds like you are flying with 1 engine. What if your 1 DA calls off sick? Or tests positive for covid? Or even worse, she asks for pay raise later this year because her jobs duties is carrying the weight of 2 DA’s assistants? How does it effect your schedule? Hopefully none of this happens to you, but you are definitely threading the needle like many other offices who have DA labor shortage.

I personally think some offices will have to scale back on their schedule; maybe open less hours, adjust/reduce treatments that are highly DA dependent, maybe have front desk perform some aspects of DA related duties, etc. Whatever it takes to survive the DA scarcity. I can see the highly spoiled and highly dependent dentists by DA’s will be very annoyed by all this... lol

Also, America entrepreneurship sky rocketed during the pandemic. People who were furloughed without notice last year got a big wake up call. People are exploring alternative job security and the chance to control their financial destiny. People had a lot of time to reflect on their lives during the lockdown, and I think that’s another wrinkle in the uneven labor supply. Wages will continue to go up because it’s simply an employee market.

Having one DA may not be enough but having 2 DAs may be too many. I don’t know anything about DDS9994’s office. But for my office, I’d rather be understaffed than being overstaffed and having to pay the assistants for standing around doing nothing. My office manager can work in the front and in the back if one of my assistants calls in sick. Being a small business owner, I am the last one who gets paid. The less money I have to spend on staff salaries, the more money I will make.

 

[charlestweed]

There is a recent thread on dental town, and it has a poll on DA wages with about 200 dentists who responded. 2/3 of the dentists said they pay their DA at least $41,000 a year. 1 in 5 said they pay at least $52k a year or more. Imagine what the big DSO’s might be paying in this market... they typically pay more than private offices to compete. I think if you are a DA today, it’s not hard to find a $50k a year position, in most states.

Wow! I didn't know DA's in other states get paid so much....and they are treated like kings and queens. My niece, who is an RN, didn't get paid that much after her graduation....and it took her a while to find a job. Dental assisting jobs are in high demand. I wonder why not so many people want to work in this field. My highest paid office manager makes about $50k/year and she has been with me for nearly 20 years. She's in her mid 50s. At this age, I don't think she will be able to find another job that pays her similar or higher salary.

It's good to live in a country that has very low unemployment rate. With good jobs, people can afford to pay for their dental treatments and that's good for us, dentists.

 

[DDS9994]

Well, it sounds like you are flying with 1 engine. What if your 1 DA calls off sick? Or tests positive for covid? Or even worse, she asks for pay raise later this year because her jobs duties is carrying the weight of 2 DA’s assistants? How does it effect your schedule? Hopefully none of this happens to you, but you are definitely threading the needle like many other offices who have DA labor shortage.

I personally think some offices will have to scale back on their schedule; maybe open less hours, adjust/reduce treatments that are highly DA dependent, maybe have front desk perform some aspects of DA related duties, etc. Whatever it takes to survive the DA scarcity. I can see the highly spoiled and highly dependent dentists by DA’s will be very annoyed by all this... lol

Also, America entrepreneurship sky rocketed during the pandemic. People who were furloughed without notice last year got a big wake up call. People are exploring alternative job security and the chance to control their financial destiny. People had a lot of time to reflect on their lives during the lockdown, and I think that’s another wrinkle in the uneven labor supply. Wages will continue to go up because it’s simply an employee market.

Lol, I sure am, luckily my HS daughter is working with me now as an asst, she is doing well, so when my other asst is doing kid prophies, my daughter assists me by suctioning etc, but yeah at some point I need to be able to find someone else, we have been nonstop busy sonce May 2020, its a good thing but doesnt change the fact I need that second asst. My schedule has definitely had to adjust a bit, but the pts have been very supportive and understand. Not unlike when you walk into a restaurant and see tons of empty tables but you have to wait 30 minutes, its not the tables its the lack of servers.

 

[DDS9994]

As business owners, we all have to deal with the assistants who come and go….assistants who call in sick....assistants who take vacations…..staff hiring and firings etc. I too have lost a few of my P/T assistants to other offices that were willing to offer them more work hours and better pay. A few months before the Covid, I lost a very important F/T assistant, who could do chairside assisting make in-house retainers. He passed the commercial driver’s license test and wanted to drive truck full time. It was a good thing because when our offices were shut down due to Covid, I only had to pay salaries for 2 F/T employees instead of 3.

For this reason, I cross-train my staff so they can perform different tasks in case one of them quit or call in sick. For example, my office manager can take xrays, take impressions, sterilize instruments, cut poky wires for emergency patients. I pay her a lot (bonus+ vacation pay+holiday pay+ 401k) because she's the only person I can’t lose. She’s 55 and I am 49….we plan to retire at the time…probably in 10-15 years. 3 of my 7 P/T assistants can make retainers. I can also multitask. I can work as an assistant and I work much faster than most of them. My staff don’t mind working harder (when one of their co-workers is absent) for me because they all want to go home ontime. To keep them happy, I use the salary portion of the assistant, who quit, to pay each of them 1 overtime hour on top their regular daily salary. It’s only temporary until I hire a new employee.

Interesting we are the same age, my outlook as well is to be done in about 13 years at 62, thats my number.

 

[Cold Front]

Lol, I sure am, luckily my HS daughter is working with me now as an asst, she is doing well, so when my other asst is doing kid prophies, my daughter assists me by suctioning etc, but yeah at some point I need to be able to find someone else, we have been nonstop busy sonce May 2020, its a good thing but doesnt change the fact I need that second asst. My schedule has definitely had to adjust a bit, but the pts have been very supportive and understand. Not unlike when you walk into a restaurant and see tons of empty tables but you have to wait 30 minutes, its not the tables its the lack of servers.

I think you‘re over the hump and should be able to navigate around the strong headwinds in dentistry at this stage of your career. If you have a little over a decade of dentistry to plan for, some of those years closer to retirement should come with a part-time schedule at the office - in your late 50’s to early 60’s. That’s what most dentists typically do as they near their endgame. Their demand for a DA starts to taper due to a lighter schedule at their office. Meanwhile, I think we will continue to see the DA workforce shortage to persist for the foreseeable future.

 

[charlestweed]

I think you‘re over the hump and should be able to navigate around the strong headwinds in dentistry at this stage of your career. If you have a little over a decade of dentistry to plan for, some of those years closer to retirement should come with a part-time schedule at the office - in your late 50’s to early 60’s. That’s what most dentists typically do as they near their endgame. Their demand for a DA starts to taper due to a lighter schedule at their office. Meanwhile, I think we will continue to see the DA workforce shortage to persist for the foreseeable future.

It’s a cycle. Old people retire and young people will take over their jobs. Old dentists lose patients to younger dentists because young dentists have more energy to work hard (to pay off debts), accept more insurance plans, and have more convenient office hours. With fewer patients, old dentists have less demand for hiring new DAs. With this decline in demand, there should be more DAs available for the young dentists to recruit.

I think the shortage of DAs that dentists in other states are experiencing is only temporary. When the stimulus money run out, people have to go back to work. There shouldn’t be a problem finding assistants if you pay them well. Dental assisting is much better than many jobs out there. I worked as a busboy at one of the Disneyland’s restaurants and earned a minimum wage when I was a HS (and college) student. The job I had was 100x harder than working in a dental office. I think restaurant owners are the ones who should be more concerned about finding employees to work for them.....and not us, dentists, because we pay our assistants more than most fast food restaurants pay their workers.

 

[charlestweed]

I've just got another message from another former assistant, who is looking for work.

 

[Cold Front]

I think the shortage of DAs that dentists in other states are experiencing is only temporary. When the stimulus money run out, people have to go back to work. There shouldn’t be a problem finding assistants if you pay them well.

The stimulus money stopping won’t fix the “new dentist to new DA” ratio, that’s the real problem.

About 6,500 new dentists graduated this summer... probably 7,500 new dentists will graduate 4-5 summers from now due to new schools opening/schools increasing their class sizes. Meanwhile, about 4,000 dental assistants tops graduate every year, and majority leave the profession in 5 years; they find better pay at another career, some have kids and don’t go back to work, others take other duties in the dental office (like front desk, etc), some get married to dentists and quit (it happens!), some advance to dental hygiene or even apply to dental school, etc. Is this a temporary problem in your opinion?

I agree with your second statement, DA’s will get paid more due to the workforce dynamics.... And their pay raises will be permanent. The dentists will be holding the bag.

 

[charlestweed]

The stimulus money stopping won’t fix the “new dentist to new DA” ratio, that’s the real problem.

About 6,500 new dentists graduated this summer... probably 7,500 new dentists will graduate 4-5 summers from now due to new schools opening/schools increasing their class sizes. Meanwhile, about 4,000 dental assistants tops graduate every year, and majority leave the profession in 5 years; they find better pay at another career, some have kids and don’t go back to work, others take other duties in the dental office (like front desk, etc), some get married to dentists and quit (it happens!), some advance to dental hygiene or even apply to dental school, etc. Is this a temporary problem in your opinion?

An increase in number of graduating dentists doesn’t necessarily mean that more DAs will be needed. The demand for DAs depends the number patients who seek dental treatments. The problem is we don’t have unlimited supply of patients. The field is saturated. Less patients who seek treatments = less demand for DAs. Slow dental offices will let their DAs go....and these DAs will have to get job at busy dental offices nearby. One assistant can assist multiple dentists. For example, my assistants also work for other doctors; they only work P/T for me. Some dentists who start a new office may not need to hire a DA right away; they may have to do many things by themselves. I didn’t have any DA when I first started. I cleaned the chairs and mopped the floor myself.

...... some have kids and don’t go back to work, others take other duties in the dental office (like front desk, etc), some get married to dentists and quit (it happens!), some advance to dental hygiene or even apply to dental school, etc. Is this a temporary problem in your opinion?

If they stop working, how will they support their kids? Applying for welfare? The older the kids get, the more money the parents have to spend for their kids...new clothes, sport equipment, ortho treatments etc.

About 3.7 millions of kids are expected to graduate from HS each year. Only a fraction of them will go to college. The majority of them will have to find jobs to support themselves. And working as a dental assistant should be a good option for many of them.

I agree with your second statement, DA’s will get paid more due to the workforce dynamics.... And their pay raises will be permanent. The dentists will be holding the bag.

Smart dentists will learn to adapt…..ie start a small low overhead office, avoid wasting money on high tech equipment, hiring HS students and train him/her to become assistant etc. Any person can work as a dental assistant…it’s much easier than working at a fast food restaurant, where one has to deal with more than a hundred customers every day. The dentists who can’t adapt will be stuck with the low pay associate jobs for the rest of their lives.

 

[2TH MVR]

The Corp I work for used to have a steady stream of young DA's who would extern at the Corp. They would work for free for 2-3 weeks (fulfil their graduation requirements?) and then the Corp typically would hire most of them.

Post Covid. No externs. Nada. We are seriously lacking dental and ortho assts. Asst's leave for better jobs and I never see replacements. I'm actually getting quite pissed at the situation. I don't see any serious movement to replace the asst vacancies. I'm actually considering moving to another Corp (I've had a few offers) if this Corp does not figure this Asst situation out soon.

Interestingly .... my Corp is actually paying the existing Assts OVER TIME pay since we have a shortage. Jeez. If they would have just considered paying the GOOD, LONGTERM, LOYAL assts a little more money .... maybe they wouldn't have left and the Corp would have saved money in the long run.

But I get it. The past OWNER in me remembers all the staff politics re: one asst getting paid X and another getting paid 2X. Always a hassle dealing with this. The now EMPLOYEE in me just wants assts regardless of what the situation is. Not my problem.

I don't envy my private practice colleagues having to deal with this asst shortage and asst's wanting more money.

 

[Cold Front]

The Corp I work for used to have a steady stream of young DA's who would extern at the Corp. They would work for free for 2-3 weeks (fulfil their graduation requirements?) and then the Corp typically would hire most of them.

Post Covid. No externs. Nada. We are seriously lacking dental and ortho assts. Asst's leave for better jobs and I never see replacements. I'm actually getting quite pissed at the situation. I don't see any serious movement to replace the asst vacancies. I'm actually considering moving to another Corp (I've had a few offers) if this Corp does not figure this Asst situation out soon.

Interestingly .... my Corp is actually paying the existing Assts OVER TIME pay since we have a shortage. Jeez. If they would have just considered paying the GOOD, LONGTERM, LOYAL assts a little more money .... maybe they wouldn't have left and the Corp would have saved money in the long run.

But I get it. The past OWNER in me remembers all the staff politics re: one asst getting paid X and another getting paid 2X. Always a hassle dealing with this. The now EMPLOYEE in me just wants assts regardless of what the situation is. Not my problem.

I don't envy my private practice colleagues having to deal with this asst shortage and asst's wanting more money.

This!

I’m 100% with you. Dentists with loyal assistants don’t know how good they have it and probably take their DA’s for granted.

Like I said before, assistants will have to be paid lot more than what they get paid now. The DSO’s have no problem with doing that and they will lead the wage increases that the market demands. I don’t think your corporation is not against higher wages for assistants, but they’re simply struggling to find the help/assistants, period. Some DSO’s are paying temp agencies $25-30 an hour to get them an assistant. Would you say your corporation would be willing to pay the same rate if this shortage persists for another month or 2? I would if I was the person to make that call at the DSO. Which one is worse? Lose the dentist/orthodontist in the office due to staffing issues or attract and hire assistants at a higher wage? It’s no brainer.

Again... dentists are sleeping behind the wheel as usual on imminent challenges until it comes to their front door.

 

[allDAT]

I've just got another message from another former assistant, who is looking for work.

View attachment 340728

This is exactly why we’re going to have so few left that are willing to work for us. Why is she texting you? I bet it’s because the owner is going on vacation and she’s been told to take unpaid leave. Who wants a job like that? Nobody.

 

[Cold Front]

I bet it’s because the owner is going on vacation and she’s been told to take unpaid leave. Who wants a job like that? Nobody.

She can always go through a temping agency, but she prefers to contact the dentists she knows first for a temporary fix/bridge her paychecks - until her doctor comes back for vacation. It’s not common, most dentists force employees to take their paid vacation or make a similar arrangement.

 

[charlestweed]

Post Covid. No externs. Nada. We are seriously lacking dental and ortho assts. Asst's leave for better jobs and I never see replacements. I'm actually getting quite pissed at the situation. I don't see any serious movement to replace the asst vacancies. I'm actually considering moving to another Corp (I've had a few offers) if this Corp does not figure this Asst situation out soon.

I think you should think carefully before making the decision to leave your current job. The grass is always greener on the other side. What if the other Corp office also has similar assistant shortage problem like your current Corp? You told us that your current corp is very good at maintain high treatment fee. What if other Corp office charges lower fee and makes you see higher volume of patients a day? At least the corp manager of the current Corp sees the value in you.....you are one of their top producing orthodontists.

 

[charlestweed]

This is exactly why we’re going to have so few left that are willing to work for us. Why is she texting you? I bet it’s because the owner is going on vacation and she’s been told to take unpaid leave. Who wants a job like that? Nobody.

Right now, it's hard to sympathize with your colleagues, who own a practice. When you own a practice and have to pay all the fixed expenses (rent, staff salaries, worker comp insurance, property insurance, practice loan repayment etc) regardless your office has patients or not, I think you will understand why your colleagues have to do what they do. I too used to criticize my and wife's bosses when I still worked F/T as an associate.

I can't criticize my former assistant's current boss because I don't know anything about his practice. What if her boss offers her a paid vacation but instead of staying home doing nothing, she wants to work for me to earn extra cash?

None of my P/T assistant gets paid when I take vacation. I always give them at least a month advance notice so they can find other places to work. I only pay my 2 F/T employees because they still have to answer phone calls, bill insurance companies, and do all the tasks that I assign for them. If my P/T assistants don't like how I treat them, they can always quit. When I hired these P/T assistants, I told them that I only needed them a few days in a month and they still accepted my offer. They need me more than I need them. It's supply and demand. And we have an oversupply of ortho assistants here in CA. And by keeping the overhead low, I can pass on the low cost ortho treatments to my patients.

The only person I can't afford to lose is my office manager. Everyone else can be replaced.

 

[2TH MVR]

I think you should think carefully before making the decision to leave your current job. The grass is always greener on the other side. What if the other Corp office also has similar assistant shortage problem like your current Corp? You told us that your current corp is very good at maintain high treatment fee. What if other Corp office charges lower fee and makes you see higher volume of patients a day? At least the corp manager of the current Corp sees the value in you.....you are one of their top producing orthodontists.

As always. Lots of wisdom in your replies. I agree with you. I was just venting a little. I just need to be patient. Been at the current DSO for the last 5 years. Pretty comfortable there.

 

[reapply2007]

Also agree. Good DAs are almost extinct when looking to hire. Cannot work without a dental assistant. Pay them well. Treat them better. You can always recruit and train a DA from a nondental field. Former Ortho assistants are also usually good.

 

[ElCubanito]

Its really hard to find new DAs, younger generation do not want to go into a field that you have to deal with peoples saliva splash (covid), nasty breath, sharps and cranky dentists. Most offices also offer no benefits. Younger DAs also quit at the first sign of adversity. There are plenty of office jobs that pay over $20. I had one assistant quit to work restocking a salad bar for $25 and cash tips. I wouldn't want to be a DA.

 

[alexteethdocman]

Just on here to say that, although sometimes we predents disagree with the perceived negativity of 'doomed' posts coming from practicing dentists, the insight is always appreciated. It's nice to know about all of the issues within the field before you dive in head first to a crap load of debt. (for me it's HPSP or bust)

Also, I'm currently attending undergrad in the midwest and I can concur- seems like there are far fewer DA's than needed. Also seems like a good point to discuss with the practicing dentists that I know and another current issue within the field that I'm glad to be made aware of!

 

[Cold Front]

Its really hard to find new DAs, younger generation do not want to go into a field that you have to deal with peoples saliva splash (covid), nasty breath, sharps and cranky dentists. Most offices also offer no benefits. Younger DAs also quit at the first sign of adversity. There are plenty of office jobs that pay over $20. I had one assistant quit to work restocking a salad bar for $25 and cash tips. I wouldn't want to be a DA.

Hygienists are now demanding $70+ an hour in some states now, but $50-70/hr is now the new norm, which is $105-145k a year as a full time position. Insane! There is a big thread on dental town discussing these numbers.

So we currently have a big shortage of dental assistants, and existing DA’s and hygienists asking for significant pay raises now during the pandemic. Meanwhile, dental insurances prophy fees have been stagnant since DA’s made $12/hr and hygienists made $28-34/hr over 10-15 years ago.

Dentists will take home less and less as a result, plus inflation which reduces the purchase power of their income. It’s unsustainable.

 

[charlestweed]

Also agree. Good DAs are almost extinct when looking to hire. Cannot work without a dental assistant. Pay them well. Treat them better. You can always recruit and train a DA from a nondental field. Former Ortho assistants are also usually good.

The problem is most of the ortho assistants are “spoiled.” Most of them had assisted general dentists before they switched to assisting ortho. Once they switched to assisting ortho, it’s hard for them to come back to assisting general dentists again. It’s much less stressful working as an ortho assistants and the pay is also higher.

 

[charlestweed]

Hygienists are now demanding $70+ an hour in some states now, but $50-70/hr is now the new norm, which is $105-145k a year as a full time position. Insane! There is a big thread on dental town discussing these numbers.

No matter how high the dentists pay their hygienists, it’s still a nice passive income for the dentists. Most dentist owners are very smart business people. They don’t just pay the hygienists big bucks for sitting around doing nothing...and suffer a financial loss. If the hygienists fail to produce, their dentist bosses will cut their hours or let them go.

So we currently have a big shortage of dental assistants, and existing DA’s and hygienists asking for significant pay raises now during the pandemic. Meanwhile, dental insurances prophy fees have been stagnant since DA’s made $12/hr and hygienists made $28-34/hr over 10-15 years ago.

You can’t keep paying the DAs $12/hr like you did 10-15 years ago and expect them to stay with you long term. The minimum wage in CA is now at $14/hr. You have to pay your DAs at least $19-20/hour (at least $2-3 more per hour than the fast food restaurant workers) if you want them to stay with you.

During this pandemic, most dentist owners shouldn’t have any problem paying their assistants, who are still loyal to them, higher salaries because the most of them got the first and the second PPP loans, which were meant to be used for paying their staff. In order for the PPP loans to be completely forgiven, they have to prove that they use the entire PPP amount to pay their staff. There were also HHS stimulus funds that the dentists received so they could buy more PPE (masks, gloves, cavicide etc) products for their offices. The dentists who own dental offices are actually getting paid more for working less during this pandemic. Only the associate dentists are suffering…..but at least they can defer their student loan repayments.

We are very fortunate to live in this great country. We have the best vaccines. And our government are doing their best to help all of us. My birth country is currently in a complete lockdown for another month due to the spread of the Delta variant. It was supposed to be a 15-day lockdown starting July 1st....then another 15 days....and now 1 more month...until Sept 15th. The harsh communist regime doesn't help its people and let them starve. People get monetary fine by the police if they step outside of their houses. I have to send money to help my relatives who live there and are stuck in their houses.

 

[Cold Front]

No matter how high the dentists pay their hygienists, it’s still a nice passive income for the dentists. Most dentist owners are very smart business people. They don’t just pay the hygienists big bucks for sitting around doing nothing...and suffer a financial loss. If the hygienists fail to produce, their dentist bosses will cut their hours or let them go.

You can’t keep paying the DAs $12/hr like you did 10-15 years ago and expect them to stay with you long term. The minimum wage in CA is now at $14/hr. You have to pay your DAs at least $19-20/hour (at least $2-3 more per hour than the fast food restaurant workers) if you want them to stay with you.

During this pandemic, most dentist owners shouldn’t have any problem paying their assistants, who are still loyal to them, higher salaries because the most of them got the first and the second PPP loans, which were meant to be used for paying their staff. In order for the PPP loans to be completely forgiven, they have to prove that they use the entire PPP amount to pay their staff. There were also HHS stimulus funds that the dentists received so they could buy more PPE (masks, gloves, cavicide etc) products for their offices. The dentists who own dental offices are actually getting paid more for working less during this pandemic. Only the associate dentists are suffering…..but at least they can defer their student loan repayments.

We are very fortunate to live in this great country. We have the best vaccines. And our government are doing their best to help all of us. My birth country is currently in a complete lockdown for another month due to the spread of the Delta variant. It was supposed to be a 15-day lockdown starting July 1st....then another 15 days....and now 1 more month...until Sept 15th. The harsh communist regime doesn't help its people and let them starve. People get monetary fine by the police if they step outside of their houses. I have to send money to help my relatives who live there and are stuck in their houses.

Vaccine mandates has arrived at some states, and now some assistants will flat out say no to them and quit. Adding more headaches to the dental assistants labor market.

 

[charlestweed]

Vaccine mandates has arrived at some states, and now some assistants will flat out say no to them and quit. Adding more headaches to the dental assistants labor market.

Yes, I have to submit the proof of vaccination in order to work at the corp office. For the doctors and assistants, who don't want to get vaccinated, they have the option to submit the proof of negative Covid test result every week.

Dental assistants quit their jobs. Restaurant workers quit their jobs. Hotel workers quit their jobs. Amazon drops the drug test requirement because they desperately need more workers. I wonder why 2 years ago (before the pandemic), we didn't have this labor shortage problem. And now all of the sudden, our country is facing this shortage problem. I'd rather have the problem of not having enough workers than having a high unemployment rate problem.

Edit: I've just learned that after Sept 30th, all healthcare workers are required to show proof of vaccination.

 

[2TH MVR]

Interesting. After months and months of not enough dental/ortho assts ....... I'm finally seeing new hires at my Corp. Dental/ortho assts. Hygeinists. Front office. Here in Arizona .... it helps that we get tons of people moving to our state. Especially from Cali.

Hope we don't run out of water.

 

[Cold Front]

After months and months of not enough dental/ortho assts ....... I'm finally seeing new hires at my Corp. Dental/ortho assts. Hygeinists.

Yes, population growth = easier to find workers. However, it’s not the case for majority of the country. Finding workers will cost them a lot of $$$, if they can find them. I know a dentist who can’t make 40% of his employees comply with the vaccine mandates and he would have to let them go by next month.

Crazy times!

 

[Cold Front]

I'd rather have the problem of not having enough workers than having a high unemployment rate problem.

We do have a high unemployment, 8 million people are still on unemployment benefits. Many of them can’t get their good paying jobs back. Majority of jobs available are in low wage jobs... fast food, warehouses, etc. Companies used the pandemic to lower/cut their payroll and overheads.

It’s going to be interesting fall and winter. 75% of the country’s ICU beds are CURRENTLY full. About 1,500 people died yesterday of covid, another 1,500 died today... that’s going to disrupt the economy and labor market. Specially with the vaccine hesitancy face off with the vaccine mandates, a lot of people will quit because they believe “the vaccine will kill them in 5 years” - a direct quote from my patient.

Three-quarters of ICU beds across country are full

Hospitals report that three-quarters of the intensive care units in the United States are full, as COVID-19 continues to rampage the country.Federal data shows almost 77.3 percent of all ICU b…

thehill.com

 

[charlestweed]

We do have a high unemployment, 8 million people are still on unemployment benefits. Many of them can’t get their good paying jobs back. Majority of jobs available are in low wage jobs... fast food, warehouses, etc. Companies used the pandemic to lower/cut their payroll and overheads.

I see. So a lot of people would rather stay home collecting the unemployment checks than getting low wage jobs. This is just one of many benefits that American people are enjoying. They should know how fortunate they are to live in this great country.

It’s going to be interesting fall and winter. 75% of the country’s ICU beds are CURRENTLY full. About 1,500 people died yesterday of covid, another 1,500 died today... that’s going to disrupt the economy and labor market. Specially with the vaccine hesitancy face off with the vaccine mandates, a lot of people will quit because they believe “the vaccine will kill them in 5 years” - a direct quote from my patient.

Really? I’ve always thought the main reason that many American people are against getting vaccinated is they don’t want the government to coerce them into getting it. And another reason is probably due to the religious belief…..the usage of fetal tissue to develop a vaccine.

A lot of people in my birth country are actually afraid of the China-made Covid vaccine. Despite the severe vaccine shortage problem, they’d rather die from Covid than getting the Chinese vaccine injected into their bodies. Many rich people had paid a lot of money to fly to the US so they could get the “real” vaccines, Moderna and Pfizer. Unfortunately, the communist government stopped this travel program. The US government recently donated 3 million doses of Moderna to my birth country. The problem is the country has 95 million people.

 

[Cold Front]

The US government recently donated 3 million doses of Moderna to my birth country. The problem is the country has 95 million people.

And those 3M vaccines are probably for both first and second shots, so technically the donation is only for 1.5M people in that country. Also, those vaccines without a booster are only good for 6 months. Covid is winning around the world, even herd immunity doesn’t stand a chance.

U.S. plans COVID-19 booster shots at six months instead of eight - WSJ

U.S. health regulators could approve a third COVID-19 shot for adults beginning at least six months after full vaccination, instead of the previously announced eight-month gap, the Wall Street Journal reported on Wednesday.

www.reuters.com

 

[laundry]

Some of my clients have seen the "side gig" exodus of RDA's and DA's. DSO's aren't helping much, but I don't think they are as big of a threat as they are made out to me. Working for a DSO sucks in most cases, as the corporate management structure is pretty dysfunctional for most of them (trust me, I've seen it first hand many times).

In Bay Area, btw, going rates for RDA/DAs are waaaay higher than $15-20. Until recently, I had a great DA that was paid $32/hr +$900/month in bonus. We just hired an RDAEF for $45/hour plus same bonus.

 

[2TH MVR]

Some of my clients have seen the "side gig" exodus of RDA's and DA's. DSO's aren't helping much, but I don't think they are as big of a threat as they are made out to me. Working for a DSO sucks in most cases, as the corporate management structure is pretty dysfunctional for most of them (trust me, I've seen it first hand many times).

In Bay Area, btw, going rates for RDA/DAs are waaaay higher than $15-20. Until recently, I had a great DA that was paid $32/hr +$900/month in bonus. We just hired an RDAEF for $45/hour plus same bonus.

Do those DAs live in the Bay area or do they travel there? Cost of living is so high there that the wages have to be high. It's all relative dependent on the COL. In Phx we have the reverse issue. COL is relatively low and we attract plenty of low wage earners. Good and bad.

 

[Cold Front]

Some of my clients have seen the "side gig" exodus of RDA's and DA's. DSO's aren't helping much, but I don't think they are as big of a threat as they are made out to me. Working for a DSO sucks in most cases, as the corporate management structure is pretty dysfunctional for most of them (trust me, I've seen it first hand many times).

In Bay Area, btw, going rates for RDA/DAs are waaaay higher than $15-20. Until recently, I had a great DA that was paid $32/hr +$900/month in bonus. We just hired an RDAEF for $45/hour plus same bonus.

You paid a DA almost $40/hr before payroll taxes! That’s the highest I’ve ever heard. Very steep!

Also, working for some DSO offices can suck as much as working for some private practices. DSO’s are hiring 50-100 DA’s a week on average, but they could also be losing half of that for the same period. They are in the retention game 24/7, and will throw money at hiring new assistants at competitive rates. Just look at dental assistants on YouTube and social media, they discuss how to game the system to their advantage regularly.

I still think we currently have too many dentists per assistant, and it will only get worse unless assistants are paid $25+/hr nationwide moving forward. Sink or swim pressure for dental offices. If the pay increases, a lot of people will leave Walmart, Target, Chipotle, Amazon and the likes to look into dental assisting as a career. In the meantime, finding a dental assistant will continue to be a frustrating cul-de-sac for dentists.

 

[gryffindor]

The ones I have now; 1 has a side eyelash business that she does from her home (and she makes more money on that gig than I pay her - she easily gets clients form Instagram and by word of mouth)

I missed this earlier. I have one who is also doing exactly this. I literally dropped my jaw that she can glue who knows what onto people's eyes in her basement with no oversight yet she needs 324963240 exams and licenses to become a full blown RDA. (I haven't looked into if there are any licensing requirements for this eyelash thing.) Today I just paid for this same assistant to take the Infection Control exam, 300-something dollars for just the first of 4 exams plus a licensing fee to become an RDA! Someone is going to unfortunately need to lose an eye or two for this latest "trend" to shut down.