As hiring squeezes persist at dental practices nationwide, several factors beyond wages and benefits are emerging as top priorities for hygienists, reshaping what it takes to attract and retain these professionals in an already competitive field.
Rute Ramalho, DDS, vice president of hygiene strategy and operations at The Aspen Group, recently spoke with Becker's to discuss the current state of hiring challenges in the dental industry and what hygienists are looking for from employers.
Editor's note: Responses were lightly edited for length and clarity.
Question: How have you seen hiring and recruitment trends shift since the pandemic?
Dr. Rute Ramalho: During the pandemic, there was a shift. A lot of people left the industry, at least temporarily, but we do feel things have gotten much better in the last couple of years as we recover from the pandemic. Most people who left the profession, probably during that time, have now returned as the demand for oral health has increased. The industry has also shifted. We're now meeting the providers and their needs more than we were before because there's that demand that maybe we didn't see before, whether that is in terms of flexibility or schedules, [or] in terms of pay, benefits, etc., so it is a better time now to be a hygienist than it was before from that perspective. I think most people have returned to the hygiene profession at this point.
Q: What do you think has led some practices to continue experiencing problems with attracting hygienists? Is it geographic factors?
RR: That's exactly what I was going to say. For us at Aspen, the locations where we struggle to hire the most are definitely related to geographic location. Our difficulty to recruit is not only related to the hygiene role, but where the roles are as well. Sixty percent of the action [at] Aspen practices are in areas that are designated as having a shortage of healthcare practitioners because you try to really meet the patients where they're at, so we open our practices in a lot of rural areas. We're not in the main cities mostly. These areas are hard to recruit for, not only in terms of hygienists, but also doctors and other roles, so we definitely really focus on offering the best opportunities and packages in those locations to attract talent.
Q: What are hygienists looking for from their employers now?
RR: Hygienists are really looking for more flexibility in terms of work schedules. At Aspen, we really adjusted our business model because at the end of the day, we have to be there for our patients after hours [or] on Saturdays, but we also need to give our providers, both doctors and hygienists, the work-life balance they're looking for. That means opening more part-time opportunities than we had before, for example. So we adjusted our business model to really meet the provider where they're at in terms of that flexibility of schedules.
Number two, people are not looking for a job. People are looking for a place where they can grow and develop. They're looking for a career. So everyone who has been chair-side, whether you're a dentist or hygienist, knows that in order for you to grow, you really need to continue to learn outside of the chair, not only to grow as a professional, but also to raise the standards of care for your patients continuously. At Aspen, we offer a robust learning journey for hygienists that we just revamped all new this year that we're really excited about, and this is a mix of virtual, self-paced, in-person and shoulder-to-shoulder training with all of our hygienists that really gives them the skills and tools they need to be successful at every step of their career.
We [also] hear from our hygienists that they're more interested each year in opportunities outside of the chair, too. So at some point in their careers, hygienists are looking for an operations role, a learning and development role, etc., so that's something we are also giving them the opportunity to move into. Under my team, we have 45 hygienists part of our hygiene support team [and] their goal is really to just coach, mentor and onboard all of our hygienists, and they have a crucial role, not only in recruiting, but retention of those hygienists as well. Across all of our other teams, like recruiting [and] academic operations, we also have a lot of hygienists who at some point decided to move to another role outside of the chair, so we're really happy to offer that opportunity at Aspen.
Q: Why do you think some hygienists have become more interested in career opportunities outside of the dental chair?
RR: I think just a change of what people are looking for in terms of contribution. For example, I'm also a dentist. I was practicing, and at some point I was looking to make a different type of impact in our patients' lives. Also, just to be honest, at some point in everyone's career, if you've been in the chair as a dentist or a hygienist, it's hard on your body. So, people are sometimes looking for something they can do while still impacting patients' lives that they can do for longer than being in the chair. Those opportunities are increasing more and more in the DSO space, and that is attracting a lot of talent as well.
Q: Do you have any cost-effective strategies for dental practice owners to support their staff?
RR: Giving our clinicians the autonomy and the recognition they deserve, as well as a positive workplace, can be just as impactful as a wage or benefits because at the end of the day, people want to feel good where they're working. They really want to make sure they are impacting patients' lives, but at the same time, feeling valued and [recognized for] their work. At Aspen, for example, we make sure hygienists have a really important role in the patient journey that empowers them to diagnose and comprehensively treatment plan all patients while building their schedule. So this really recognizes hygienists as both providers and leaders in the practices, [and] that has been a really key differentiator for us. When I talk with hygienists, there's something they mention about the role they play in an Aspen practice as a leader and expert in their field of work that really matters to them at the end of the day.
Q: Is there anything practice owners are missing in conversations about supporting hygienists?
RR: I don't think it's missing, but it's part of the culture and the recognition. It's something we really need to get ingrained in every practice owner because sometimes everyone is so busy, they are easy to overlook. So, we really try to help our practice owners to really be mindful in recognizing their teams — not only hygienists, but their whole teams, and making sure the culture is there where it needs to be. That's the most important thing we can do on a day-to-day perspective to really retain our employees [and] recruit more because our most important recruiting tool is really our engaged workforce, because they're going to be our advocates out there in the workplace. If we don't have people who are happy to work at Aspen and they're looking for another job and not being our advocates out there, how are we going to be able to recruit? At the end of the day, we really try to make sure we are also asking for our employees' feedback and addressing any gaps we may have to make sure we are addressing their needs so we can not only retain them, but recruit more.