December 17, 2025 • 28 mins
Every time a team member asks for a raise, the pressure is instant — but it doesn’t have to be. In this episode, find out how to talk money with your team, set clear expectations, and lead raise conversations without it getting awkward. We explore inflation, bonuses, and systems that give your team a clear path for growth without blowing up your payroll. Listen now to take the stress out of every raise decision!
Topics discussed:
- The trap of throwing money at problems
- Mistakes owners make when asked for a raise
- Henry's dental assistant ladder and pay scale
- How to avoid losing team members when you say “no”
- How bonuses impact pay decisions
- How to handle the inflation and market pay argument
- How to stay competitive and keep team members happy
This episode was produced by Podcast Boutique https://www.podcastboutique.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Paul Etchison (01:06):
Let's be honest.
There are moments in ownershipwhere money feels like the
fastest way out.
A team member, they might beunhappy.
Give them a raise.
The systems are super messy.
More raises and people justaren't performing the way that
they should.
Well, maybe we should pay themmore with more and more raises.
But what if that quick fix isactually training your practice
(01:29):
to stay broken and be much moreexpensive?
That's what we're going to betalking about today.
How can we as practice ownersresist the urge to throw money
at problems and instead fix themwithout increasing our payroll?
We dive into why money isn't thefix we think it is, how to
reward value instead of timeserved, and why handing out
(01:50):
titles can be just as dangerousas handing out raises in the
simple systems that keep youfair, competitive, and still in
control.
Now you're listening to theDental Practice Heroes podcast,
where we help dentists workfewer clinical days, increase
profits, and build team-drivenpractices that run without you
being the bottleneck.
(02:10):
I'm your host, Dr.
Paul Etcherson, author of twobooks on dental practice
management, dental coach, andthe owner of a large group
practice in the south suburbs ofChicago.
And today I am joined by my DPHcoaches who live what we teach
at a very high level.
The first is Dr.
Henry Ernst, the owner of an18-out practice in the
Carolinas, only practicing twodays a week, and also Dr.
(02:32):
Steve Markowitz, the owner ofsix practices in the Boston
area, only practicing just oneday each week.
All right, let's jump in.
We got a good topic today.
We're talking about somethingwe're all guilty of.
I'm guilty of.
I feel like I've done thisrecently.
And we were just discussing,we're like, what is going to be
helpful for our listeners today?
(02:53):
And we see it in a lot ofcoaching clients is we tend to
throw money at problems.
We see issues and we wonder if araise is going to fix this for
us.
If I could only throw more moneyat this, this would fix it.
Surely my problem is I'm notpaying enough.
That must be the solution.
Steve, going to you.
Any you ever been guilty ofthis?
SPEAKER_01 (03:13):
Very much so.
As we were trying to think oftopics, I got slapped in the
face with the first time I wasever asked for a raise was from
one of one of the members of ourteam who was probably liked the
least and would always find away to bring things down.
I didn't know.
She came, she asked me for araise, and I didn't just give
(03:35):
her a small raise, I gave her apretty significant raise, like a
15% raise or something likethat.
And I thought she came, she'slike, Well, it's been, you know,
I just bought the practice.
It's been a a year or two sinceI last got a raise.
And I was like, okay, and whatkind of stuff are you doing?
She's like, I run the clinicfloor.
Okay, wow.
(03:55):
Here's an extra three dollars.
And then all of a sudden I gotto work the next day, and
everyone was in line, upset atme.
And I was so confused, and Ithought I was doing a good
thing, and ended up this teammember, the first raise, and
also the first person I let go,all within the same month
(04:16):
because of just me not knowingand trying to have money be the
solution to my problems.
Paul Etchison (04:22):
Was it weird that everybody knew about it?
Like, I know like there's nolaws, like some people like want
to fire people over talkingabout their salaries.
And I think you got to checkyour state laws.
In my state, you cannot.
It is like you cannot tellpeople they can't talk about
their salaries, but it's stillkind of a faux pas.
Like, don't do it.
Were you surprised that?
SPEAKER_01 (04:38):
Yeah, at the time I wasn't surprised about anything.
I have learned that I can'tcontrol what people say, and I
can't be in the business ofthat.
But what I can make sure is Ifully understand the situation
before I start rewarding people.
And I think that I hope that'swhat we get into today is how do
we reward things that we want toencourage and not reward things
(05:04):
for things that don't align withwhat we're trying to do.
Paul Etchison (05:07):
Yeah, I like that.
That's a great way of framingit.
I feel like when I've had theseconversations where people have
asked me for a raise, and thisis me, now my leads do it.
I don't handle theseconversations anymore.
I mean, I do them withspecifically with my leads, but
I don't like the sometimes Ifeel like I'm saying, like, hey,
I can give you this raise.
And like deep down, I'm like,it's not enough.
It's not enough.
Like, I've got this like deepdown shame, like, there's no way
(05:29):
they're gonna take this, they'regonna be pissed.
This is a slap in the face.
And I can't think of any timeswhere that's actually happened,
where they've actuallyinterpreted it that way.
But like deep down in my heart,I think of I feel like that.
But like then I know like thepayroll.
If I give a three dollar raiseto everybody on the team, like
it doesn't work.
Like, there's just not themoney.
Henry, you're you're sittingover there.
What are you thinking, man?
SPEAKER_02 (05:48):
Well, I know thinking about where we just
rather throw money at problems.
There's a couple things thatcome to my mind, but jumping on
Steve's bandwagon about theraise issue, I think it's super,
super important to establishyour office and not get into the
mentality of letting your staffto think, well, the passage of
time has occurred and so I needanother race.
Passage of time, raise.
(06:09):
It shouldn't be like that.
If somebody comes to you forraise, it should be what's the
value?
What's the value that you'regiving me since the last time
you had a race?
So if I'm a DA1 and we trainDA1s to become DA twos in our
office.
Well, talk about what that isfor listeners that don't know
what that means.
So in our office, an entry-leveldental assistant starts as a
hygiene assistant.
So we have a certain level ofskills that you should be able
(06:31):
to master.
Taking x-rays, talking to thepatients, collecting medical
histories, placing sealants,placing desensitizer, all these
things you should become amaster of.
And then at some point, maybethey've been with us for a
while, then we start to graduateto the doctor side.
And we don't call them a DA2right away.
They have to learn certainskills that are DA 1.5,
(06:52):
suctioning with the doctor, youknow, doing all this stuff
that's not by yourself.
DA2 is by yourself.
So not getting too much intothat, but when assistants start
to come over to that sign, thenmaybe they would value a raise
because somebody would come upto me and say, Hey, I haven't
had a raise in a while.
Well, let's see, what skills doyou do now that you didn't do
before?
(07:12):
And if they don't have any, thenI will direct them to a skills
list.
Why don't you learn these skillsand then come back to me when
that happens?
Same thing goes for admin.
Learn these skills and then comeback to me.
At least now you're establishingsome sort of value-based reward
system instead of just passageof time.
And I wanted to jump on boardwith the other thing, just
(07:33):
taking this, throwing money atproblems.
This came at our mastermindmeeting we had last weekend,
which was great, Paul, by theway, and Destin.
It was beautiful.
Great time.
One of the doctors, and thisthis is pretty common, was
talking about all these problemsthat they're having in their
practice.
And oh, we had schedulingproblems.
So we went to this course.
And after the weekend came, itdidn't get fixed.
(07:53):
And then my assistants don't dothis, and we went to this
course, it didn't get fixed.
Well, I kept asking this doctor,I said, Well, what did you do
afterwards?
You can't just go to a courseand spend a lot of money and
inspect this magical course tofix it.
You have to take action and youhave to have steps and you have
to audit those steps.
So I think that's a commonmistake that doctors make is
they just think that somemagical course that they see in
(08:14):
a dental magazine is going tofix all their problems.
When you still have to be aleader in the practice, you
still have to be a visionary andhave all the steps to implement
what you learned.
Paul Etchison (08:24):
Yeah, I remember when this person was bringing
this up, we do the hot seats atthe mastermind event, which is
essentially where you sit there,you tell everybody about your
issue, you give all theinformation, and then everybody
in the mastermind, there were 13of us this weekend, and we all
went around the table and we allgave advice.
And this person got a lot ofgood advice about kind of one
thing just Henry just said.
But then also, like, I rememberwhat came up too was we need to
(08:46):
lead the team.
Somebody's got to lead.
And I know it sounds a littlecliche, but what I mean is we've
got, hey guys, this is wherewe're going, this is what we're
doing.
And then it has to be, I need tocheck in on this over and over
again.
I can't just revisit this onemonth from now.
You know, I talk to a lot ofcoaching clients and they say,
Will you talk to my team?
Are you going to be working withmy team?
And I always tell them, I'mhappy to work with your team to
(09:08):
some extent, but I need to teachyou how to do it.
Like, if I can't teach you howto do it, it doesn't stick.
Like, I can't make your teambehave a certain way.
So just coming back to whatHenry said, I think the DA1, DA2
thing is great.
As far as I'm concerned, withI've seen like this pay scale
that you have, Henry.
And like for my team, mostpeople would be at the top of
that within 90 days.
(09:29):
You know, whereas like I don'tfeel like they're fully
experienced at 90 days.
They could say they do theskills, but they've got extra
skills that they've already, youknow, just from being there,
they know how we do things, likethose little things that come
up.
I think it works fantastic foran admin position.
I think that is a great payskill.
But what comes to mind for me isthere's been times in my, I
remember one employee came tome, wanted a raise, and I really
(09:52):
didn't want to give it.
But then it was like, okay,well, if I'm gonna give this to
you, this is what's going tohappen.
This is what I need you to do,which I think is a step in the
right direction.
But what I really wish, Iremember giving this to this
person.
I'm sitting there, they'reasking, I've said, okay, do you
think you could do this?
She says, Yeah, I could do that.
I could do that.
Okay, cool.
All right, I will give you thisraise if you start taking over
(10:12):
this thing.
So she took it over.
And wouldn't you know, three,four months later, fizzles out,
didn't do it.
And I kind of wish I would haveonce said, Hey, I will give you
the raise once you take thisresponsibility.
And that would have been abetter way of doing it, and it
would have stuck better.
What do you think, Steve?
SPEAKER_01 (10:30):
The only place where you think you guys are are
throwing money at problems ispeople.
SPEAKER_02 (10:33):
That's all I can think of.
I'll throw this another way.
Another thing we caught and it'sfresh in our minds from the
mastermind meeting.
Another mistake that's tied intothe money is doctors will make
the mistake when somebody comesto them for a raise, is not only
maybe throwing a little money,but also throwing a title out
there.
So, a good example is a doctorwho has a great billing person,
steadfast, they do all thebilling, their collections are
(10:55):
100%, doesn't have to worryabout anything.
And all of a sudden, this personcomes to a raise, and what does
the doctor do?
The doctor says, Oh, okay, I'llgive you a raise, and your
practice manager.
And this person does not havethe title of practice manager of
it's stolen valor, basically,because she's not a practice
manager.
She's basically a glorifiedbiller.
Now this doctor has this personat such a high pay scale that
(11:17):
what do you do from there?
So not only there's the moneybut the title Tell the stolen
valor analogy you told over themastermind weekend.
Paul Etchison (11:25):
I really liked it with the airplane.
SPEAKER_02 (11:26):
Well, it's basically we we all go to the airport and
we all see people that go togroup one, group two, and you
know, we always see the militarygets first privy to go first,
which they should.
They deserve it.
And so, gosh, there's people inthis society now that will wear
like a fake military uniformjust to go into the airplane
first, and that that'scompletely stolen valor.
They didn't earn it, they didn'tdeserve it.
(11:46):
You know, the military should beheld in high regard.
So, I mean, this is a smallexample, but this doctor just
got nervous and threw thepractice manager title out at
them.
Paul Etchison (11:55):
Yeah, and then it's oh wow, I have an office
manager.
Wow, cool.
I'm I'm leveling up.
No, not at all.
You gotta give them what to do.
Now, Steve, I feel like thissense that you're wanting to
take this episode down a holeand you want to dig us in.
And we I want to come with you.
Take me, Steve.
Go, baby.
SPEAKER_01 (12:12):
I don't know how how deep I want to go.
Deeper.
I'm just trying to exploredifferent ways that I've thrown
money at problems, whichsometimes it's was intentional
and sometimes it's just was likethe path of least resistance.
So that's typically where I go.
What I had written down was weneed to take time to understand
what market value is for eachposition.
(12:33):
And if a job in our area pays 25and we're paying 21 and someone
wants a raise, we need to givethem a big raise or we're gonna
lose our whole team becausewe're under market value.
So just because someone isasking for a raise doesn't mean
that they're wrong.
We need to get more data tounderstand, and then we can
throw money at real problems.
(12:54):
That's what we should be doing.
We should be throwing money atreal problems, and then we
should use the money, which is away for us to fix these things,
but we need to understandactually what we're fixing.
Is it if it's just to likeappease someone, then or give
them a title so it it gets offour plate, and then we can move
on to the next thing and notthink about it for right now.
(13:15):
We don't have a strong enoughsystem to have consistent
practice growth.
Paul Etchison (13:19):
I think it's great that you mentioned the
pathway of least resistancebecause I think that's what
we're doing when we're throwingmoney at a lot of these raise
requests.
We're buying ourselves a quickway out of this conversation
that we don't want to have.
There is so much merit in how tounderstand the market value of
each position.
Someone told me once early in mypractice management career that
a person is only as valuable astheir replacement.
(13:42):
And that sounds really crappy.
I mean, that doesn't reallyresonate with the DPH attitude
of what we're supposed to treatour teams like, but to some
extent, it's true.
You reach a point where it'slike good luck finding this
somewhere else.
You've got it pretty good here.
I think you need to appreciatewhat you have.
How do we even like know whatthe market value is?
If someone's saying that I haveno idea what people are getting
paid, I'm so I'm on my littleisland here.
(14:03):
Perfect.
Can I answer that?
SPEAKER_01 (14:04):
Yeah.
The first thing you do is justgo look for jobs.
Go on Indeed, go on Craigslist,go look at what's on the
Facebook groups.
If your people are paid at acertain level, and then you go
on there and the market issaying three dollars less for
that same position, thenperfect.
(15:23):
Your job is not to overpayeveryone, your job is to make
sure they are well compensatedfor the value they're creating
for your practice.
And most times you have tocommunicate that.
People don't leave jobs for adollar, they just don't.
They leave for feelingunderappreciated, they leave for
feeling like making an impact.
And if we're not able tocommunicate with our team,
(15:45):
they're gonna ask for more andthey should have every right.
And then it's our responsibilityas the leader, as the owner of
their practice, to educate themon what the marketplace is
because they don't know.
All they hear is that theirfriend down the street is making
$90 an hour for two hours atwork or whatever it is.
So it's our job to educate them.
She's temping.
(16:05):
Yeah, she's whatever.
And then it's our job to makesure that they feel cared for in
our that's what we talk abouthere.
It's like, how do we make surepeople truly feel cared for and
understand the value thatthey're creating?
And then if if we're still on aline and we love this person, we
think they're a good values fitand they need more, let's create
a path with them, not just givethem.
Paul Etchison (16:27):
You know, I'm gonna give a hack for all the
listeners here.
If you go on Indeed and you lookat some job posting for
positions in your area and theygive a range, the actual pay is
the bottom of the range.
It is not the top of the range.
They're not giving out the topof the range.
It's the bottom.
That's the number.
Don't get confused by the range.
Henry, like, what are yourthoughts on?
(16:50):
We're giving the listeners someidea of like how to figure out
what people are worth andvalue-wise, and we're looking
monetarily.
But what is the proper way todeflect and have this really
uncomfortable conversation?
Because I think it's we we getbacked into the corner when we
don't know it, we get surprisedwith it, we're not prepared for
it.
And then we would they walk outof the room and we just give out
(17:10):
this huge rage and we just go,damn it, why'd I do that?
Man, I hope nobody else findsout about that.
I'm gonna have to give everybodya raise.
Like, what is the right way tolike handle this conversation so
it's like respectful and youdon't make that person feel
unappreciated, but at the sametime you protect the rights and
the well not protect the rights,but protect the interests of the
business.
SPEAKER_02 (17:28):
I think on the front end, the praxes are very
successful in this are the onesthat share their numbers.
You know, when they have teammeetings quarterly meetings, you
share your numbers.
And Paul, you often say this ishey, you know, the going rate
for staff is, you know, 25%.
We do 30, because I want mystaff to be, I want you guys to
be compensated at the highestlevel.
Well, when you share yournumbers, I mean, it makes them
(17:48):
think like an owner like alittle bit, right?
That there's a cost involvedwith everything.
And if somebody comes to me, Imean, the first thing is, you
know, always be grateful.
I'm grateful for everything youdo here.
Sometimes you can deflect.
I like this technique is well,you know what, I'm grateful for
everything you do here.
You know, let me look into thenumbers, let me look into your,
your, your history.
Let's have a meeting next week.
(18:08):
And then you never have it.
No, well, in the perfect world,it gives your time.
And some of our, I know you are,some of our team members have
been here for like eight, 10years.
So it does give you valid timeto look over when was the last
time they had a pay raise?
When was it?
And it is valid to say, like,what have you done for me
lately?
Right?
What have you learned since thelast time?
(18:29):
And I'll say another littletechnique that works really
well.
For those of you guys who havebonuses in your office, get
credit for your bonuses.
Have some sort of system.
Our office manager does thiswhere if you get a$120 bonus
every week and you make, let'sjust say easy math,$20 an hour.
You didn't make$20 an hour lastweek when you worked 30 hours.
You made, you know, what wasthat,$24.
(18:51):
So get credit for your bonusesif you give them.
Paul Etchison (18:54):
Yeah, that's the reason why with our bonus
nowadays, we do a dollar perhour bonus.
Because I I hated the idea oflike, oh, your bonus is$100, but
like that's really, you know,for most people, that's gonna be
uh if it's one week, that's$250an hour for a full-time
employee.
I think a lot of my payroll woesuh have been situations like
this that have gotten me into apickle because I want to be the
(19:14):
nice guy.
Steve, how do you handle these?
Like, what's your take on whatHenry just said?
What would your opinion be?
SPEAKER_01 (19:19):
I think that communicating with the team
assists them to have these typesof conversations.
So what I feel is if I amwaiting for the team member to
come to me to ask for a raise, Ihave failed them.
So we try to be proactive in thein those one-on-one
conversations to have a sense ofwhere they are feeling
appreciated and if they at leastonce a year have that money
(19:42):
conversation as far as are wemeeting their expectations.
So we try and be as proactive aswe possibly can.
There are still times where thatwhere we fall and are misaligned
with with the team member.
We also need to know like, dothey want more in their out of
their job?
There was a woman that workedfor my dad that worked for me
(20:03):
for my first, she was there for40 years.
When I first was in dentalschool, my dad was like, I once
asked Carol to be the officemanager, and she she said she
didn't want it.
She loved her job.
She wanted to be at the frontdesk, welcoming patients, and
that's all she wanted.
And she was super happy.
And for us, we call that rockstars that they're great at
(20:24):
their job, but if you give themmore, they're gonna get super
uncomfortable.
They don't want it.
And they know that aboutthemselves.
That's so cool.
Then you could have that, youknow, once a year, once every 18
months conversation about likethe market's changing, and
here's an extra dollar orwhatever it is.
And then on the other side,there are people who are really
hungry and they want growth andthey want more.
(20:46):
And superstars, this is from umuh radical candor, this is
stolen from radical candor.
Those people want growth andthey need they need more.
We need to make sure that we'reunderstanding what that employee
wants for themselves, so that ifthere's times where we've given
out, you know, a dollar raiseand the employee was pissed
because we didn't know that theywere looking for a new position,
(21:09):
a new more responsibility.
And I think that's why havingsome kind of proactive system,
making sure you're having thoseconversations, and if you're
seeing that people on your teamare consistently coming to you
asking for raises, you'reprobably doing it wrong.
Paul Etchison (21:24):
Yeah, you know what one thing I think about
when you just mentioned that isthat I think in my 13-year
career as being a practiceowner, I've been asked for a
raise maybe less than 10 times.
And I don't know what thatmeans.
I don't know what to take aboutthat, but I will tell you, like
Henry said, I've always beenvery forthcoming about this is
the payroll percentage ofcollections we're shooting for.
This is what I pay you guysbecause your guys are worth it.
(21:48):
And our bonus is based on that.
There's so much about that.
And there's times where, like, Icould tell you recently, I've
been asked for a few raisesrecently, and we've been down.
This was our first year that weactually did less than the
previous year, where like we'reseeing this month where less
than last last year.
Uh, like, for instance, lastOctober of 2024 was better than
October 2025.
(22:09):
And it's very easy for me tosay, gosh, I appreciate you so
much.
And I I hope you're happy here.
I just don't have it.
I just can't do it.
I'm so sorry.
And it sucks, but at least I'mstanding on some evidence.
I'm standing on some culturalthing that I've been talking
about.
I'm curious, you know, we'recoming up on time, but I'd love
to know like, how do we addressthe whole man?
(22:31):
I get that we're not doing more.
I get that I'm not providingmore value, but things cost a
lot of money now.
Look at all the inflation.
Steve, what do you say?
SPEAKER_01 (22:40):
It just goes back to understanding what the market
is.
And if we're offering below whatmarket is, we need to fix that.
So when we hire a renewalemployee, we have a pay scale
spreadsheet.
It has their first name, theirlast name, the data hire, their
current rate, and their date oftheir last raise.
And at least every six months wego and look at that.
(23:04):
And on the second tab of that issalary.com, payscale.com,
indeed, Craigslist, andZipRecruiter of what is offered
for those certain positions.
And every six months we go backand we look at that and we make
sure that we're, I don't want tobe the highest in the our area.
We cannot overpay for positions,but we better be at the highest
(23:26):
point we possibly can.
And we share that with the team.
I'm not going to overpay.
We're not going to pay the sameas someone whose wife works in
that position, but we're goingto make sure that you are very
highly compensated compared toother people in our area.
SPEAKER_02 (23:39):
I love that.
Henry, take us home.
So one thing, it's a littletweak here, is when you have
your bonus system, for those ofyou guys who have bonus systems,
make sure that it's tied to yourongoing costs.
Because as the ongoing costsrise, the bonus level rises.
So that makes it not asbothersome when you have to give
a raise because you say toyourself, all right, now we're
the level that they had toachieve just went up.
So I think that's reallyimportant because it's going to
(24:02):
happen.
And another thing, too, is don'tlet people come at you with
something from Indeed that says,hey, look at this ad.
It says this much.
Or look what I saw on Facebook.
Because some of that, like Paulsaid, is bullshit.
So just be careful.
Paul Etchison (24:16):
Yeah, I had somebody come in my office.
She sat down and she reachedinto a bag and she set a stack
of papers and she said, I wouldlike to show you the national
average for dental assisting in1970.
And I would like to show youinflationary data from the past
50 years and show you how dentalassistants are really.
And I said, put that away.
I said, you gotta talk to yourlead.
(24:37):
And I was like, my God, get meout of this situation.
Why?
Yeah, I think that the moral goahead, Steve.
SPEAKER_01 (24:45):
When you were talking about people asking you
for raises, I think that thetake-home is people don't leave
for money.
99% of people don't leave formoney.
And the reason why you don't getasked is because you're a
freaking rock star boss and theylove working for you.
Paul Etchison (24:59):
Maybe.
I appreciate that.
SPEAKER_01 (25:01):
Yeah, this is a feel-good hour with uh Dr.
Atchison.
But if we have realrelationships with our team and
we know they love us, that goes,and they're well compensated,
they're not going to ask for arace because that's not why
they're there.
Paul Etchison (25:15):
Yeah.
That's a good point.
I think we're looking at we'relooking at how to solve the what
do we do when people talk aboutit.
And you're right, it's not theright area of solving the
problem.
I'll just close off on one thingbecause we're coming up on time.
But I I work with a lot ofcoaching clients and they'll say
this to me I need a secondhygienist.
And but this is what they'remaybe they're getting$60 an
(25:36):
hour.
They're getting$60 an hour in myarea, and I don't want to pay
that because my existinghygienist is only getting$40.
And I don't want to give thatone a raise.
And the thing is, is like,market rate.
Like, aren't you concerned thisperson's gonna leave too?
Like, and I'm not saying yougotta jump this person up to 60,
but we've got to be competitive.
I think that's the main thing.
(25:57):
Be competitive, share yournumbers with your team.
You don't have to share how muchyou're taking home, but share
what the payroll percentage isand speak from the heart.
You know, talk about what it'slike to run a business.
Man, explain how much you wouldlove to give everybody an extra
like$50,000 a year.
It's just not reasonable.
It's just not possible.
It doesn't work like that.
And if you're looking at issuesin your practice and you're
(26:17):
saying, I have a whole mess ofissues in my practice, I'd love
to have one of these two guyslooking at my practice with me
on a month to month basis sothat I can go next level, create
more time off, and have betterfreedom.
Please reach out to us atdentalpracticeheroes.com.
Go on there, set up a freestrategy call with us.
Happy to talk you through what'spossible and at the bare
minimum, give you some advice onwhat are some next steps in your
(26:38):
practice career.
So thank you so much forlistening, and we'll talk to you
next time.
Let's be honest.
There are moments in ownershipwhere money feels like the
fastest way out.
A team member, they might beunhappy.
Give them a raise.
The systems are super messy.
More raises and people justaren't performing the way that
they should.
Well, maybe we should pay themmore with more and more raises.
But what if that quick fix isactually training your practice
(01:29):
to stay broken and be much moreexpensive?
That's what we're going to betalking about today.
How can we as practice ownersresist the urge to throw money
at problems and instead fix themwithout increasing our payroll?
We dive into why money isn't thefix we think it is, how to
reward value instead of timeserved, and why handing out
(01:50):
titles can be just as dangerousas handing out raises in the
simple systems that keep youfair, competitive, and still in
control.
Now you're listening to theDental Practice Heroes podcast,
where we help dentists workfewer clinical days, increase
profits, and build team-drivenpractices that run without you
being the bottleneck.
(02:10):
I'm your host, Dr.
Paul Etcherson, author of twobooks on dental practice
management, dental coach, andthe owner of a large group
practice in the south suburbs ofChicago.
And today I am joined by my DPHcoaches who live what we teach
at a very high level.
The first is Dr.
Henry Ernst, the owner of an18-out practice in the
Carolinas, only practicing twodays a week, and also Dr.
(02:32):
Steve Markowitz, the owner ofsix practices in the Boston
area, only practicing just oneday each week.
All right, let's jump in.
We got a good topic today.
We're talking about somethingwe're all guilty of.
I'm guilty of.
I feel like I've done thisrecently.
And we were just discussing,we're like, what is going to be
helpful for our listeners today?
(02:53):
And we see it in a lot ofcoaching clients is we tend to
throw money at problems.
We see issues and we wonder if araise is going to fix this for
us.
If I could only throw more moneyat this, this would fix it.
Surely my problem is I'm notpaying enough.
That must be the solution.
Steve, going to you.
Any you ever been guilty ofthis?
SPEAKER_01 (03:13):
Very much so.
As we were trying to think oftopics, I got slapped in the
face with the first time I wasever asked for a raise was from
one of one of the members of ourteam who was probably liked the
least and would always find away to bring things down.
I didn't know.
She came, she asked me for araise, and I didn't just give
(03:35):
her a small raise, I gave her apretty significant raise, like a
15% raise or something likethat.
And I thought she came, she'slike, Well, it's been, you know,
I just bought the practice.
It's been a a year or two sinceI last got a raise.
And I was like, okay, and whatkind of stuff are you doing?
She's like, I run the clinicfloor.
Okay, wow.
(03:55):
Here's an extra three dollars.
And then all of a sudden I gotto work the next day, and
everyone was in line, upset atme.
And I was so confused, and Ithought I was doing a good
thing, and ended up this teammember, the first raise, and
also the first person I let go,all within the same month
(04:16):
because of just me not knowingand trying to have money be the
solution to my problems.
Paul Etchison (04:22):
Was it weird that everybody knew about it?
Like, I know like there's nolaws, like some people like want
to fire people over talkingabout their salaries.
And I think you got to checkyour state laws.
In my state, you cannot.
It is like you cannot tellpeople they can't talk about
their salaries, but it's stillkind of a faux pas.
Like, don't do it.
Were you surprised that?
SPEAKER_01 (04:38):
Yeah, at the time I wasn't surprised about anything.
I have learned that I can'tcontrol what people say, and I
can't be in the business ofthat.
But what I can make sure is Ifully understand the situation
before I start rewarding people.
And I think that I hope that'swhat we get into today is how do
we reward things that we want toencourage and not reward things
(05:04):
for things that don't align withwhat we're trying to do.
Paul Etchison (05:07):
Yeah, I like that.
That's a great way of framingit.
I feel like when I've had theseconversations where people have
asked me for a raise, and thisis me, now my leads do it.
I don't handle theseconversations anymore.
I mean, I do them withspecifically with my leads, but
I don't like the sometimes Ifeel like I'm saying, like, hey,
I can give you this raise.
And like deep down, I'm like,it's not enough.
It's not enough.
Like, I've got this like deepdown shame, like, there's no way
(05:29):
they're gonna take this, they'regonna be pissed.
This is a slap in the face.
And I can't think of any timeswhere that's actually happened,
where they've actuallyinterpreted it that way.
But like deep down in my heart,I think of I feel like that.
But like then I know like thepayroll.
If I give a three dollar raiseto everybody on the team, like
it doesn't work.
Like, there's just not themoney.
Henry, you're you're sittingover there.
What are you thinking, man?
SPEAKER_02 (05:48):
Well, I know thinking about where we just
rather throw money at problems.
There's a couple things thatcome to my mind, but jumping on
Steve's bandwagon about theraise issue, I think it's super,
super important to establishyour office and not get into the
mentality of letting your staffto think, well, the passage of
time has occurred and so I needanother race.
Passage of time, raise.
(06:09):
It shouldn't be like that.
If somebody comes to you forraise, it should be what's the
value?
What's the value that you'regiving me since the last time
you had a race?
So if I'm a DA1 and we trainDA1s to become DA twos in our
office.
Well, talk about what that isfor listeners that don't know
what that means.
So in our office, an entry-leveldental assistant starts as a
hygiene assistant.
So we have a certain level ofskills that you should be able
(06:31):
to master.
Taking x-rays, talking to thepatients, collecting medical
histories, placing sealants,placing desensitizer, all these
things you should become amaster of.
And then at some point, maybethey've been with us for a
while, then we start to graduateto the doctor side.
And we don't call them a DA2right away.
They have to learn certainskills that are DA 1.5,
(06:52):
suctioning with the doctor, youknow, doing all this stuff
that's not by yourself.
DA2 is by yourself.
So not getting too much intothat, but when assistants start
to come over to that sign, thenmaybe they would value a raise
because somebody would come upto me and say, Hey, I haven't
had a raise in a while.
Well, let's see, what skills doyou do now that you didn't do
before?
(07:12):
And if they don't have any, thenI will direct them to a skills
list.
Why don't you learn these skillsand then come back to me when
that happens?
Same thing goes for admin.
Learn these skills and then comeback to me.
At least now you're establishingsome sort of value-based reward
system instead of just passageof time.
And I wanted to jump on boardwith the other thing, just
(07:33):
taking this, throwing money atproblems.
This came at our mastermindmeeting we had last weekend,
which was great, Paul, by theway, and Destin.
It was beautiful.
Great time.
One of the doctors, and thisthis is pretty common, was
talking about all these problemsthat they're having in their
practice.
And oh, we had schedulingproblems.
So we went to this course.
And after the weekend came, itdidn't get fixed.
(07:53):
And then my assistants don't dothis, and we went to this
course, it didn't get fixed.
Well, I kept asking this doctor,I said, Well, what did you do
afterwards?
You can't just go to a courseand spend a lot of money and
inspect this magical course tofix it.
You have to take action and youhave to have steps and you have
to audit those steps.
So I think that's a commonmistake that doctors make is
they just think that somemagical course that they see in
(08:14):
a dental magazine is going tofix all their problems.
When you still have to be aleader in the practice, you
still have to be a visionary andhave all the steps to implement
what you learned.
Paul Etchison (08:24):
Yeah, I remember when this person was bringing
this up, we do the hot seats atthe mastermind event, which is
essentially where you sit there,you tell everybody about your
issue, you give all theinformation, and then everybody
in the mastermind, there were 13of us this weekend, and we all
went around the table and we allgave advice.
And this person got a lot ofgood advice about kind of one
thing just Henry just said.
But then also, like, I rememberwhat came up too was we need to
(08:46):
lead the team.
Somebody's got to lead.
And I know it sounds a littlecliche, but what I mean is we've
got, hey guys, this is wherewe're going, this is what we're
doing.
And then it has to be, I need tocheck in on this over and over
again.
I can't just revisit this onemonth from now.
You know, I talk to a lot ofcoaching clients and they say,
Will you talk to my team?
Are you going to be working withmy team?
And I always tell them, I'mhappy to work with your team to
(09:08):
some extent, but I need to teachyou how to do it.
Like, if I can't teach you howto do it, it doesn't stick.
Like, I can't make your teambehave a certain way.
So just coming back to whatHenry said, I think the DA1, DA2
thing is great.
As far as I'm concerned, withI've seen like this pay scale
that you have, Henry.
And like for my team, mostpeople would be at the top of
that within 90 days.
(09:29):
You know, whereas like I don'tfeel like they're fully
experienced at 90 days.
They could say they do theskills, but they've got extra
skills that they've already, youknow, just from being there,
they know how we do things, likethose little things that come
up.
I think it works fantastic foran admin position.
I think that is a great payskill.
But what comes to mind for me isthere's been times in my, I
remember one employee came tome, wanted a raise, and I really
(09:52):
didn't want to give it.
But then it was like, okay,well, if I'm gonna give this to
you, this is what's going tohappen.
This is what I need you to do,which I think is a step in the
right direction.
But what I really wish, Iremember giving this to this
person.
I'm sitting there, they'reasking, I've said, okay, do you
think you could do this?
She says, Yeah, I could do that.
I could do that.
Okay, cool.
All right, I will give you thisraise if you start taking over
(10:12):
this thing.
So she took it over.
And wouldn't you know, three,four months later, fizzles out,
didn't do it.
And I kind of wish I would haveonce said, Hey, I will give you
the raise once you take thisresponsibility.
And that would have been abetter way of doing it, and it
would have stuck better.
What do you think, Steve?
SPEAKER_01 (10:30):
The only place where you think you guys are are
throwing money at problems ispeople.
SPEAKER_02 (10:33):
That's all I can think of.
I'll throw this another way.
Another thing we caught and it'sfresh in our minds from the
mastermind meeting.
Another mistake that's tied intothe money is doctors will make
the mistake when somebody comesto them for a raise, is not only
maybe throwing a little money,but also throwing a title out
there.
So, a good example is a doctorwho has a great billing person,
steadfast, they do all thebilling, their collections are
(10:55):
100%, doesn't have to worryabout anything.
And all of a sudden, this personcomes to a raise, and what does
the doctor do?
The doctor says, Oh, okay, I'llgive you a raise, and your
practice manager.
And this person does not havethe title of practice manager of
it's stolen valor, basically,because she's not a practice
manager.
She's basically a glorifiedbiller.
Now this doctor has this personat such a high pay scale that
(11:17):
what do you do from there?
So not only there's the moneybut the title Tell the stolen
valor analogy you told over themastermind weekend.
Paul Etchison (11:25):
I really liked it with the airplane.
SPEAKER_02 (11:26):
Well, it's basically we we all go to the airport and
we all see people that go togroup one, group two, and you
know, we always see the militarygets first privy to go first,
which they should.
They deserve it.
And so, gosh, there's people inthis society now that will wear
like a fake military uniformjust to go into the airplane
first, and that that'scompletely stolen valor.
They didn't earn it, they didn'tdeserve it.
(11:46):
You know, the military should beheld in high regard.
So, I mean, this is a smallexample, but this doctor just
got nervous and threw thepractice manager title out at
them.
Paul Etchison (11:55):
Yeah, and then it's oh wow, I have an office
manager.
Wow, cool.
I'm I'm leveling up.
No, not at all.
You gotta give them what to do.
Now, Steve, I feel like thissense that you're wanting to
take this episode down a holeand you want to dig us in.
And we I want to come with you.
Take me, Steve.
Go, baby.
SPEAKER_01 (12:12):
I don't know how how deep I want to go.
Deeper.
I'm just trying to exploredifferent ways that I've thrown
money at problems, whichsometimes it's was intentional
and sometimes it's just was likethe path of least resistance.
So that's typically where I go.
What I had written down was weneed to take time to understand
what market value is for eachposition.
(12:33):
And if a job in our area pays 25and we're paying 21 and someone
wants a raise, we need to givethem a big raise or we're gonna
lose our whole team becausewe're under market value.
So just because someone isasking for a raise doesn't mean
that they're wrong.
We need to get more data tounderstand, and then we can
throw money at real problems.
(12:54):
That's what we should be doing.
We should be throwing money atreal problems, and then we
should use the money, which is away for us to fix these things,
but we need to understandactually what we're fixing.
Is it if it's just to likeappease someone, then or give
them a title so it it gets offour plate, and then we can move
on to the next thing and notthink about it for right now.
(13:15):
We don't have a strong enoughsystem to have consistent
practice growth.
Paul Etchison (13:19):
I think it's great that you mentioned the
pathway of least resistancebecause I think that's what
we're doing when we're throwingmoney at a lot of these raise
requests.
We're buying ourselves a quickway out of this conversation
that we don't want to have.
There is so much merit in how tounderstand the market value of
each position.
Someone told me once early in mypractice management career that
a person is only as valuable astheir replacement.
(13:42):
And that sounds really crappy.
I mean, that doesn't reallyresonate with the DPH attitude
of what we're supposed to treatour teams like, but to some
extent, it's true.
You reach a point where it'slike good luck finding this
somewhere else.
You've got it pretty good here.
I think you need to appreciatewhat you have.
How do we even like know whatthe market value is?
If someone's saying that I haveno idea what people are getting
paid, I'm so I'm on my littleisland here.
(14:03):
Perfect.
Can I answer that?
SPEAKER_01 (14:04):
Yeah.
The first thing you do is justgo look for jobs.
Go on Indeed, go on Craigslist,go look at what's on the
Facebook groups.
If your people are paid at acertain level, and then you go
on there and the market issaying three dollars less for
that same position, thenperfect.
(15:23):
Your job is not to overpayeveryone, your job is to make
sure they are well compensatedfor the value they're creating
for your practice.
And most times you have tocommunicate that.
People don't leave jobs for adollar, they just don't.
They leave for feelingunderappreciated, they leave for
feeling like making an impact.
And if we're not able tocommunicate with our team,
(15:45):
they're gonna ask for more andthey should have every right.
And then it's our responsibilityas the leader, as the owner of
their practice, to educate themon what the marketplace is
because they don't know.
All they hear is that theirfriend down the street is making
$90 an hour for two hours atwork or whatever it is.
So it's our job to educate them.
She's temping.
(16:05):
Yeah, she's whatever.
And then it's our job to makesure that they feel cared for in
our that's what we talk abouthere.
It's like, how do we make surepeople truly feel cared for and
understand the value thatthey're creating?
And then if if we're still on aline and we love this person, we
think they're a good values fitand they need more, let's create
a path with them, not just givethem.
Paul Etchison (16:27):
You know, I'm gonna give a hack for all the
listeners here.
If you go on Indeed and you lookat some job posting for
positions in your area and theygive a range, the actual pay is
the bottom of the range.
It is not the top of the range.
They're not giving out the topof the range.
It's the bottom.
That's the number.
Don't get confused by the range.
Henry, like, what are yourthoughts on?
(16:50):
We're giving the listeners someidea of like how to figure out
what people are worth andvalue-wise, and we're looking
monetarily.
But what is the proper way todeflect and have this really
uncomfortable conversation?
Because I think it's we we getbacked into the corner when we
don't know it, we get surprisedwith it, we're not prepared for
it.
And then we would they walk outof the room and we just give out
(17:10):
this huge rage and we just go,damn it, why'd I do that?
Man, I hope nobody else findsout about that.
I'm gonna have to give everybodya raise.
Like, what is the right way tolike handle this conversation so
it's like respectful and youdon't make that person feel
unappreciated, but at the sametime you protect the rights and
the well not protect the rights,but protect the interests of the
business.
SPEAKER_02 (17:28):
I think on the front end, the praxes are very
successful in this are the onesthat share their numbers.
You know, when they have teammeetings quarterly meetings, you
share your numbers.
And Paul, you often say this ishey, you know, the going rate
for staff is, you know, 25%.
We do 30, because I want mystaff to be, I want you guys to
be compensated at the highestlevel.
Well, when you share yournumbers, I mean, it makes them
(17:48):
think like an owner like alittle bit, right?
That there's a cost involvedwith everything.
And if somebody comes to me, Imean, the first thing is, you
know, always be grateful.
I'm grateful for everything youdo here.
Sometimes you can deflect.
I like this technique is well,you know what, I'm grateful for
everything you do here.
You know, let me look into thenumbers, let me look into your,
your, your history.
Let's have a meeting next week.
(18:08):
And then you never have it.
No, well, in the perfect world,it gives your time.
And some of our, I know you are,some of our team members have
been here for like eight, 10years.
So it does give you valid timeto look over when was the last
time they had a pay raise?
When was it?
And it is valid to say, like,what have you done for me
lately?
Right?
What have you learned since thelast time?
(18:29):
And I'll say another littletechnique that works really
well.
For those of you guys who havebonuses in your office, get
credit for your bonuses.
Have some sort of system.
Our office manager does thiswhere if you get a$120 bonus
every week and you make, let'sjust say easy math,$20 an hour.
You didn't make$20 an hour lastweek when you worked 30 hours.
You made, you know, what wasthat,$24.
(18:51):
So get credit for your bonusesif you give them.
Paul Etchison (18:54):
Yeah, that's the reason why with our bonus
nowadays, we do a dollar perhour bonus.
Because I I hated the idea oflike, oh, your bonus is$100, but
like that's really, you know,for most people, that's gonna be
uh if it's one week, that's$250an hour for a full-time
employee.
I think a lot of my payroll woesuh have been situations like
this that have gotten me into apickle because I want to be the
(19:14):
nice guy.
Steve, how do you handle these?
Like, what's your take on whatHenry just said?
What would your opinion be?
SPEAKER_01 (19:19):
I think that communicating with the team
assists them to have these typesof conversations.
So what I feel is if I amwaiting for the team member to
come to me to ask for a raise, Ihave failed them.
So we try to be proactive in thein those one-on-one
conversations to have a sense ofwhere they are feeling
appreciated and if they at leastonce a year have that money
(19:42):
conversation as far as are wemeeting their expectations.
So we try and be as proactive aswe possibly can.
There are still times where thatwhere we fall and are misaligned
with with the team member.
We also need to know like, dothey want more in their out of
their job?
There was a woman that workedfor my dad that worked for me
(20:03):
for my first, she was there for40 years.
When I first was in dentalschool, my dad was like, I once
asked Carol to be the officemanager, and she she said she
didn't want it.
She loved her job.
She wanted to be at the frontdesk, welcoming patients, and
that's all she wanted.
And she was super happy.
And for us, we call that rockstars that they're great at
(20:24):
their job, but if you give themmore, they're gonna get super
uncomfortable.
They don't want it.
And they know that aboutthemselves.
That's so cool.
Then you could have that, youknow, once a year, once every 18
months conversation about likethe market's changing, and
here's an extra dollar orwhatever it is.
And then on the other side,there are people who are really
hungry and they want growth andthey want more.
(20:46):
And superstars, this is from umuh radical candor, this is
stolen from radical candor.
Those people want growth andthey need they need more.
We need to make sure that we'reunderstanding what that employee
wants for themselves, so that ifthere's times where we've given
out, you know, a dollar raiseand the employee was pissed
because we didn't know that theywere looking for a new position,
(21:09):
a new more responsibility.
And I think that's why havingsome kind of proactive system,
making sure you're having thoseconversations, and if you're
seeing that people on your teamare consistently coming to you
asking for raises, you'reprobably doing it wrong.
Paul Etchison (21:24):
Yeah, you know what one thing I think about
when you just mentioned that isthat I think in my 13-year
career as being a practiceowner, I've been asked for a
raise maybe less than 10 times.
And I don't know what thatmeans.
I don't know what to take aboutthat, but I will tell you, like
Henry said, I've always beenvery forthcoming about this is
the payroll percentage ofcollections we're shooting for.
This is what I pay you guysbecause your guys are worth it.
(21:48):
And our bonus is based on that.
There's so much about that.
And there's times where, like, Icould tell you recently, I've
been asked for a few raisesrecently, and we've been down.
This was our first year that weactually did less than the
previous year, where like we'reseeing this month where less
than last last year.
Uh, like, for instance, lastOctober of 2024 was better than
October 2025.
(22:09):
And it's very easy for me tosay, gosh, I appreciate you so
much.
And I I hope you're happy here.
I just don't have it.
I just can't do it.
I'm so sorry.
And it sucks, but at least I'mstanding on some evidence.
I'm standing on some culturalthing that I've been talking
about.
I'm curious, you know, we'recoming up on time, but I'd love
to know like, how do we addressthe whole man?
(22:31):
I get that we're not doing more.
I get that I'm not providingmore value, but things cost a
lot of money now.
Look at all the inflation.
Steve, what do you say?
SPEAKER_01 (22:40):
It just goes back to understanding what the market
is.
And if we're offering below whatmarket is, we need to fix that.
So when we hire a renewalemployee, we have a pay scale
spreadsheet.
It has their first name, theirlast name, the data hire, their
current rate, and their date oftheir last raise.
And at least every six months wego and look at that.
(23:04):
And on the second tab of that issalary.com, payscale.com,
indeed, Craigslist, andZipRecruiter of what is offered
for those certain positions.
And every six months we go backand we look at that and we make
sure that we're, I don't want tobe the highest in the our area.
We cannot overpay for positions,but we better be at the highest
(23:26):
point we possibly can.
And we share that with the team.
I'm not going to overpay.
We're not going to pay the sameas someone whose wife works in
that position, but we're goingto make sure that you are very
highly compensated compared toother people in our area.
SPEAKER_02 (23:39):
I love that.
Henry, take us home.
So one thing, it's a littletweak here, is when you have
your bonus system, for those ofyou guys who have bonus systems,
make sure that it's tied to yourongoing costs.
Because as the ongoing costsrise, the bonus level rises.
So that makes it not asbothersome when you have to give
a raise because you say toyourself, all right, now we're
the level that they had toachieve just went up.
So I think that's reallyimportant because it's going to
(24:02):
happen.
And another thing, too, is don'tlet people come at you with
something from Indeed that says,hey, look at this ad.
It says this much.
Or look what I saw on Facebook.
Because some of that, like Paulsaid, is bullshit.
So just be careful.
Paul Etchison (24:16):
Yeah, I had somebody come in my office.
She sat down and she reachedinto a bag and she set a stack
of papers and she said, I wouldlike to show you the national
average for dental assisting in1970.
And I would like to show youinflationary data from the past
50 years and show you how dentalassistants are really.
And I said, put that away.
I said, you gotta talk to yourlead.
(24:37):
And I was like, my God, get meout of this situation.
Why?
Yeah, I think that the moral goahead, Steve.
SPEAKER_01 (24:45):
When you were talking about people asking you
for raises, I think that thetake-home is people don't leave
for money.
99% of people don't leave formoney.
And the reason why you don't getasked is because you're a
freaking rock star boss and theylove working for you.
Paul Etchison (24:59):
Maybe.
I appreciate that.
SPEAKER_01 (25:01):
Yeah, this is a feel-good hour with uh Dr.
Atchison.
But if we have realrelationships with our team and
we know they love us, that goes,and they're well compensated,
they're not going to ask for arace because that's not why
they're there.
Paul Etchison (25:15):
Yeah.
That's a good point.
I think we're looking at we'relooking at how to solve the what
do we do when people talk aboutit.
And you're right, it's not theright area of solving the
problem.
I'll just close off on one thingbecause we're coming up on time.
But I I work with a lot ofcoaching clients and they'll say
this to me I need a secondhygienist.
And but this is what they'remaybe they're getting$60 an
(25:36):
hour.
They're getting$60 an hour in myarea, and I don't want to pay
that because my existinghygienist is only getting$40.
And I don't want to give thatone a raise.
And the thing is, is like,market rate.
Like, aren't you concerned thisperson's gonna leave too?
Like, and I'm not saying yougotta jump this person up to 60,
but we've got to be competitive.
I think that's the main thing.
(25:57):
Be competitive, share yournumbers with your team.
You don't have to share how muchyou're taking home, but share
what the payroll percentage isand speak from the heart.
You know, talk about what it'slike to run a business.
Man, explain how much you wouldlove to give everybody an extra
like$50,000 a year.
It's just not reasonable.
It's just not possible.
It doesn't work like that.
And if you're looking at issuesin your practice and you're
(26:17):
saying, I have a whole mess ofissues in my practice, I'd love
to have one of these two guyslooking at my practice with me
on a month to month basis sothat I can go next level, create
more time off, and have betterfreedom.
Please reach out to us atdentalpracticeheroes.com.
Go on there, set up a freestrategy call with us.
Happy to talk you through what'spossible and at the bare
minimum, give you some advice onwhat are some next steps in your
(26:38):
practice career.
So thank you so much forlistening, and we'll talk to you
next time.
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