CCDS President, Dr. Keith Collins, reflects on the challenges that the pandemic has presented the dental workforce. With staff shortages, high demand, and inflated wages Dr. Collins looked into how working had changed in the past year. Dr. Collins used what he found to adjust his work culture and shares the "Lean Life" recommedations he used to boost morale, attract staff, and continue to provide essential health services to his patients. 

"Dear CCDS Members, 

The major issue our dental community faces moving forward is inadequate workforce. With high demand and many of us short on staff, patients are leaving practices with concerns like "they don't have a hygienist", or "they had to cancel my visit four times because of staff shortages."  Employers had trouble filling jobs in general before the pandemic; it seems worse now.  We are seeing dramatic inflation in wages, dental supplies, PPE and more with no commensurate improvements in fees from dental benefit plans.  Lower productivity when understaffed and higher overhead can easily reduce net income.  Add in the stress of the situation and more dentists are retiring or selling their practices.  Patients seem a bit worried about their access to care and many are showing great appreciation for us sticking it out to care for them.

The business news is covering significant changes in choices made by American workers. We already know that 93% of dental staff were laid off in March of 2020 when we were locked down by the pandemic.  Some other interesting figures:

• One in four workers changed jobs last year, and many did not return to traditional work.
• Over 40% of those aged 18 to 45 said they moved or planned to move since the pandemic started.
• Over 50% do not want to return to full time work, and many think three days a week is too much.  Many workers shifted to value family, health, reduced stress, and more time off far differently than before.
• Many would rather work from home for at least two days per week, citing time lost to commuting and a preference for home over the workplace.
• Workers are less inclined to think of working long term in one place as a career, favoring short term or day to day work that fits their immediate needs.

I am describing last year as "the great dislocation" and the current condition as "a transient workforce.” However, I found a new direction while commiserating on workforce problems with the manager at Qualident Lab, who said they are coping by adopting a "lean culture.”  He invited me to visit and study their effort, and suggested I read "2 Second Lean" by Paul Akers, which is free to download on Aker’s web site, as well as "Lean Life,” "Lean Health" and more. 

The lab has countered staff turnover and higher numbers of temporary workers with new organization of all their materials and processes.  They have a pile of Akers books in their meeting room, and they meet every morning to better standardize everything and pursue continuous improvement.  Now they can onboard new staff faster, waste less, and feel better as they work.  The lab was filled with labels on everything, and the staff were all smiling.  Wow!

I committed to adopting lean concepts in my own office and have enjoyed some enthusiasm from staff as we make a concerted effort to review all our materials, instruments, trays, tubs, supply ordering, storage, and routines to simplify and reduce wasted time. We have been updating our written office manual, sorting, standardizing, and labeling.  We can now onboard a new or temporary worker more easily, and morale is improving. 

Check out Aker’s "Lean Life,” which focuses on balance of family, health, and career.  This gave me the courage to try a shorter work week, which has been greatly appreciated by staff.  We work full days Monday and Tuesday, 10 to 5 Wednesday, and 8 to noon on Thursday.  What a difference in reduced stress and enjoyment of life this has made!  

I lost a key staff member to a practice that will not bill insurance for their patients; they simply charge their regular fees and hand the patient a claim form to submit on their own.  The staff member was burnt out on the grind of trying to help people determine their benefits, then chasing payment from some of the less cooperative benefit plans.  She was particularly offended by some patients who were cranky about their plans and asking more of us than was fair.  I am taking this as a key concern for attracting office staff in the future.  A patient who works as a paralegal was surprised to find that we don't charge administrative fees for all the time and effort we expend to help people with their insurance - this isn't fair.

In conclusion, we provide essential health services that many patients appreciate more than ever, but we need to get a leg up on reducing stress for ourselves and our staff.  Lean culture and adjusting our working conditions can help to attract staff and help all of us to enjoy work despite our tough times.  

You are invited to study lean culture from a dental perspective and connect to talk it over.

Sincerely,

Keith Collins, DMD
President, CCDS"