The job market and general economic climate in communities will drive establishing a realistic pay scale for your positions. The most common manner of employing clinic personnel is salaried positions. Some programs may only be able to afford part-time staff who are paid by the hour. Terms of employment usually include a salary and benefits package for more than half-time positions, which may include all or some of the following: vacation, holiday and sick leave, malpractice insurance, continuing education time and financial support, health insurance, disability insurance, 401-K contributions. Salary may be based on an hourly wage, a monthly or annual salary, remuneration in a base salary plus a percentage of billings or collections, or any number of other formulas. If you intend to pay dentists and hygienists with a base salary plus bonuses based on productivity, make sure the productivity levels that trigger the bonuses are attainable and reasonable. Unattainable goals will hinder staff retention if the base salary is not competitive for your region. When personnel are employees, the clinic will be responsible for all State, Federal, and local tax withholding, Workers' Compensation insurance, and any other such expenses required by law or regulation.
When establishing a salaried dental position, remember that the dental community is oriented to private practice. It is, therefore, important to not focus on salary alone but discuss total compensation, which includes salary and all benefits. Benefits often are 40% of the salary, which makes the gross compensation considerably more attractive than salary alone. Be prepared to educate dentists who are looking for their first position after dental school. Often they have unrealistic expectations for compensation, confusing gross income from a private dental practice as being the dentists' net pay.
If you can offer loan repayment, be sure to emphasize that up front. Unfortunately, providers who receive loan repayment often will leave the position or the area after their loan is paid. A number of states are beginning to offer their own repayment programs rather than relying on federal loan repayment programs through NHSC or other programs.
Contracting with professionals is another method to obtain personnel. Contracting commonly is done with professional staff (i.e., dentists and dental hygienists), but less so with dental assistants, receptionists, or office managers. This type of hiring involves drawing up a legally binding contract between an independent provider and the sponsoring agency or program. The contract will specify hours the provider will work, the rate of pay (usually per hour or per day), etc. An independent contractor is essentially self-employed, does not receive a benefits package (e.g., health insurance, malpractice insurance), and is responsible for paying all State, Federal, local, and payroll taxes. For this reason, the program must expect to pay a higher hourly or daily rate for a contractor than for an employee. Internal Revenue Service criteria distinguishing between a contractor and an employee can be viewed on the IRS Web site.
Many charitable and non-profit mobile clinics provide a portion of services through the work of volunteers. Consider the following tips for using volunteers.
Things to consider about using volunteers