Reviews and Raises by Sandie Baillargeon

Reviews and Raises 

Keeping top-performing team members on staff is essential—especially in today’s job market

by Sandie Baillargeon

The landscape of the dental workforce has changed drastically over the past two years. The shortage of qualified personnel results in many employees jumping from office to office and demanding higher salaries. Orthodontists are being backed into a corner and, in some cases, feel forced to pay outrageous salaries just to attract and retain staff.

However, paying higher salaries doesn’t guarantee that the quality of work is commensurate with the pay. Many orthodontists are hiring out of desperation and tolerating poor performance simply because of the shortage. The best solution is to hire carefully and keep the good employees that you have.

As an owner, you are the chief executive officer and head of human resources of your practice. It is challenging to be the main provider, practice owner and leader! Your employees work for you because their job is an integral part of their career path, but employees are most interested in their own personal success. Where do you find the time to communicate with your team, delegate responsibilities, listen to feedback and have the flexibility to solve problems in an ever-changing workplace?

Orthodontic teams are generally self-directed, but they do require information and feedback to know what’s expected of them as far as daily duties. Guidelines and boundaries provide comfort and a sense of security to your employees while encouraging accountability for results.

Download three free review templates!

Author Sandie Baillargeon provided Orthotown with three templates orthodontists can use when creating performance review forms for their own offices. To find these free downloads, click here.

Performance reviews are essential

The performance evaluation process is a basic responsibility of good management, but you may not be comfortable with this part of your job as CEO of your practice. It’s not easy to play judge and jury over someone else’s work, especially if the assessment affects their salary and their future. Most people think they do great work. Many of them are right ... but not all of them.

Performance evaluations are scary for employees, too. From their perspective, the employer’s opinion is going to affect their future, and there’s no guarantee that the doctor or manager really knows the employee’s job and how well they do it. They may fear the rating will be based solely on how well you like them, and you’ll remember only the bad and forget the good. Even when you must provide feedback with the intent of correcting negative behavior or poor performance, it’s important to look for the good things the employee does and use those as motivation.

Employees often expect a salary increase with every performance review, but a performance review does not necessarily mean a raise will be given. Pay increases should be awarded only when the employee meets or exceeds the performance statements as outlined in the job description.

In fact, orthodontists can run into legal complications if they reward a poor-performing employee but then subsequently discipline that person. If the employee is terminated, he or she can go to an employment lawyer and claim wrongful termination: “I didn’t know I was doing a bad job. My boss gave me a raise and never provided any feedback. …” The employment lawyer or the labor board may ask to see the performance evaluations that were conducted, and if there’s no evidence of a performance review and the employee was given a raise in salary, that may indicate that the employer was happy with the employee’s performance; therefore, the employee was wrongfully terminated. (Labor laws will almost always side with the employee.)

The performance evaluation process

To provide fair and equitable employment practices, pay increases must be based on merit of individual performance and decided upon by the doctor. Employees often think they are entitled to pay increases annually and employers are obliged by law to provide an increase annually. That is not the case. Employers are not obliged to provide pay increases beyond the minimum standards under the state or provincial labor laws.

If an employee is eligible for a pay increase, it should not go into effect until he or she has worked at the practice continuously for one full year before the increase and there is no interruption of earnings. Wage adjustments may be provided annually, based on the results of the individual’s performance as well as the practice performance. You need to have enough money in the budget in place to ensure you can afford to provide salary increases!

If you’ve never conducted a performance review, here are some suggestions.
The first step is to provide the employee with a self-evaluation form, similar to the one at right. Give the form to employees two or three days in advance of the meeting, which will allow them enough time to reflect on their performance and to formulate some questions in preparation for the review. This process helps them develop an objective view of their own contributions to the practice, and is an opportunity for them to have a voice with their employer. In busy offices, there is very little time to have a one-on-one dialogue with each employee, which is one of the benefits of the annual review.

To help the employee prepare for the meeting, have them complete the following questions:
  1. Based on what you achieved this year, in what areas do you feel that you were very strong? Where did you think you could improve?

  2. Assign an overall rating to your own performance out of 10.

  3. What new or improved skills would help you in the coming year?

  4. What issues or blockages challenged you during the past year?

  5. What, if any, blockages must you overcome to achieve your goals this year?

  6. Describe your personal development plans for the coming year.

  7. Do you require employer support to achieve your goals? If yes, describe the type of support that would be most helpful to you.

  8. Do you have any constructive comments or suggestions that would help improve the quality of service that we provide?
At the beginning of the review, have employees read the self-evaluation out loud. Listen carefully to how they answer the questions, because the listener sets the tone for the meeting. Conduct the performance review in a quiet area where you won’t be disturbed. Stay objective and focused on the individual results as well as those of the overall practice.

Be specific when giving feedback, both positive and negative. Although you are reviewing past performance, focus on the future. Help the employee to realize their true potential by setting a career path and focus on long-term goals.

Discuss any issues or blockages that they experienced as well as the strengths in their job performance. Then begin your evaluation of their performance. It is helpful to have the employee’s job description and assign a rating to each duty that he/she performs based on what those duties are. This will help the employee to feel that they are receiving a fair and objective evaluation based on their actual daily duties.

Wage adjustments

A wage review should be a separate process that is conducted only after all the performance reviews have been completed. Wage adjustments should be based on the following criteria:

  • Results of the employee’s performance evaluation, which includes ratings on attitude, enthusiasm, punctuality, reliability, communication skills, etc.
  • Overall financial performance of the practice.
  • Everyone’s level of responsibility.
Should an employee not meet the expectations of the role, opportunities for improvement should be discussed and they should be provided with a time frame in which to display visible and consistent improvement, as well as written guidelines to follow. No pay adjustment should happen during this time of reevaluation, and progress should be closely monitored. A date should be identified when the orthodontist and employee can meet again to discuss any progress that has been made, and what should be included in the team member’s action plan.

Wage increase guidelines

Annual increases are not a right of the employee. If the practice is not doing well financially, it would not be wise to increase costs by granting increases. The best time to schedule performance reviews is before the end of your fiscal year, when you are setting your operating budget for the coming year.

You may wish to grant increases using the following guidelines:

No increase: If an employee’s performance is not up to acceptable standards, they should be advised that there are gaps in their performance and how they can be growth opportunities. You may wish to help the employee set goals and timelines for performance improvement. Once these goals have been met, a wage increase may be granted as of the improvement review date; however, backdating of increases should never be considered.

3%–4%: A 3%–4% increase may be given if an employee’s performance is usually up to expected standards. There may be minor inconsistencies in performance during the year, but these have typically been addressed through discussion with the employee and are not serious enough to warrant formally setting goals for performance improvement. This adjustment would provide for a cost-of-living increase.

5% or more: If an employee’s performance consistently meets expected standards and they demonstrate that they’re willing and ready to fill in and help wherever necessary, a 5% increase may be warranted. An increase of 5% or greater should be awarded to only top performers.

Alternate options: If an employee has reached the top of their pay range for your area, you may wish to provide a one-time bonus for a top performer. You may also wish to incentivize your employees by providing them with benefits such as a health care spending accounts instead of bonuses.


A good human resource infrastructure that has measurable performance objectives, role clarity and consistent performance feedback will help your employees feel valued and connected to you and the team. Conducting annual performance reviews helps you be involved enough with your team members that they feel not only your direction but also your support. Employees want to be treated as people first and workers second. Remember, happy employees affect your bottom line!

Employees who feel empowered perform better. Information about job performance is the path to employee empowerment.

To empower your employees is to do three actions:

  • Give them the freedom to get a job done.
  • Provide them with the right level of support to get the job done well— information, training, resources, etc.
  • Create measurable, objective targets to help them be accountable to produce the right outcomes.
Inspire your team to want to be part of this journey and help them to discover what they can do to create their own path forward. Help them do their job well by providing them with the time, tools, training and support that they need, then hold them accountable for the results and pay them accordingly.

Author Bio
Sandie Baillargeon Sandie Baillargeon, an authority on how to increase the effectiveness of dental business systems, is the owner and operator of Dental Office Consulting Services, which specializes in dental business planning, staff development, consulting and continuing education seminars.

Baillargeon is the author of the textbooks "Dental Office Administration" and T"he Canadian Dental Office Administrator." She created the first certificate course in dental practice management at the University of Toronto Faculty of Dentistry and offers webinars on the topic via the continuing education department of McGill University Faculty of of Dental Medicine and Oral Health Sciences.

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