PEOPLE

Amid a staffing crunch, retention requires more than a steady paycheck

You've benchmarked wages against the market. You've sweetened signing bonuses. But your best hygienists and early-career associates are still eyeing the exits. What gives? 

What's happening: A research brief from the ADA Health Policy Institute found that new dentists working in affiliated private practice settings are roughly six times more likely to plan to leave than those in unaffiliated practices (48% versus 8%). 

• What’s driving that gap? Complaints about autonomy, influence on business decisions, clinical/nonclinical balance, career advancement, CE access, and workplace culture—in other words, career-path issues.

• It’s a problem outside of dental, too. The Work Institute reports that "career" issues have been the leading category of employee turnover for 14 consecutive years, accounting for 18.9% of exits in its latest dataset.

Zoom out: It’s not just dentists who can easily job hop right now. A recent ADA survey found that more than 88% of dentists actively recruiting hygienists and almost 70% recruiting dental assistants rate the process as "very" or "extremely" challenging.” 58% of practices recruiting administrative staff called it very or extremely challenging. 

• Hygiene-specific research reinforces the point. A survey published in the Journal of Dental Hygiene found that lack of fringe benefits and lack of promotion opportunity stood out as salient weaknesses within broader job satisfaction, and higher satisfaction predicted lower intent to leave.

• ADA HPI's own workforce shortage research notes that continuing education funds remain "rare overall" in dentistry, and that practices that do offer them tend to face fewer staffing shortages.

What it means for you: Dissatisfaction with career prospects is actually a strategic opening for smart DSOs to attract talent they otherwise may not be able to otherwise recruit. A well-designed career architecture is one of the few retention levers competitors can't match by cutting a bigger check. Here are some tactics to consider as you build this out: 

• Build visible ladders with real rungs. Every role should have levels defined by scope, competencies, pay bands, and milestone-based promotion criteria. Associates, hygienists, and admin each need their own track—not a generic org chart.

• Offer dual tracks. Clinical-excellence and leadership paths let your best people grow without forcing everyone into management.

• Turn admin into a career. Create explicit routes into office management, revenue cycle, and centralized shared-services roles.

• Hold managers accountable. Managers are the linchpin for retention. If staff under one manager are consistently turning over at a higher rate, that’s a red flag. Track turnover by manager and make coaching a job requirement.

Bottom line: Paying market wages and offering competitive benefits are table stakes. In a tight, highly mobile labor market, the operators winning the staffing war are going beyond that and giving people a clear path to advance in the organization.