Never Stress AGAIN When An Employee Leaves!

I use my blog as an opportunity to share real and practical advice-things that we actually do in our practice. This particular blog is about something that I got burned on over and over before I wised up and made a change.

If you do nothing else that I recommend, please do what I’m about to tell you. It has saved us from a lot of heartache and stress. I only wish I had thought about it 20 years ago instead of about 3 years ago.

When we were a young and scrappy office in the 90’s and early 2000’s, we didn’t have a good way to find, hire, and train new team members. In particular, I was not very good at finding reliable people. We certainly hired our share of terrible employees over the years. We were often forced to hire quickly and to get them working quickly, which was often a disaster in itself. There was virtually no time to train them adequately.  Back in the day, we were really small, and sometimes only had one dental assistant. If that assistant decided to quit, or worse yet just stopped showing up, we would be completely screwed. Do I have to go into the gory details about how hard it was to answer the phones, send claims, schedule patients, and do all of the assisting at the same time? You get the idea. It was awful. It wasn’t only me who suffered, but more importantly, it was the BUSINESS that suffered. It’s REALLY hard to see patients when you don’t have adequate help to see them.

Anyway, I’m sure you can relate. Unfortunately, dental offices are often left scrambling when and employee leaves the practice. I HATED that stress of being short handed until the next new employee was interviewed, hired, and trained. During those times, I would overextend MYSELF so that the other team members wouldn’t feel stressed out. I didn’t want them to be stressed and quit, too.  I often worked extra hours before and after them to make sure that things would continue to run as smooth as possible. I was trying to  keep the doctor happy, because he deserved to stay busy and profitable.  I was trying to keep the patients happy because they wanted to be seen. I was trying to keep the rest of the team happy because I needed them to stay. This grand plan often backfired on me because the rest of the team had no idea what I was doing to make their lives easier and in turn, I was burning out.

Over the years, our practice grew. Our staff grew. Our business grew.

I grew up, too.

About 3 years ago, I made the decision to never be in that stressful position again. I just had to figure out how.

Stephen Covey says to “begin with the end in mind.”

I knew that I wanted the end to look like an office that went through smooth employee transition times.  I didn’t want the doctor, the other team members, the business, or myself to suffer. I realized that in order to never feel short handed, I couldn’t allow us the opportunity to BE short handed.

Here was my solution.

I always have someone in training.

We created an entry level floater position 3 years ago. This person goes through an extensive training period in our office. I’ve created so many tools for this person, even if she doesn’t have ANY dental knowledge, to establish a GREAT foundation in dentistry. I’ve made videos of our office, systems, and equipment and have also written a pretty extensive manual that describes every procedure and system we do in great detail.

Training this person is the responsibility of EVERYONE in the office-not just me. But since everything is spelled out, listed, and photographed, it’s pretty easy. Basically, the floater learns to be responsible for stocking rooms, sterilizing, assisting the assistants and hygienists, turning over treatment rooms etc. The floater also goes through a lot of procedural materials and instrument study. After the floater masters those things, we start to teach her four handed assisting. I can transition her from floating into actual assisting when she is ready and not just throw her in because I need a warm body. Everyone wins. The new employee has the time to learn basic level skills, office systems, and CONFIDENCE!  This allows us to build a nice skill set before we have them assist on a live patient. The doctor doesn’t have to miss a beat because the floater is doing “background” things like stocking and sterilizing, and so his patient schedule isn’t affected. I am happy because it doesn’t all fall on my shoulders.

Now, if this person leaves, it’s not a terrible blow to the business because they were not responsible for working on patients. The goal is to have them eventually work on patients when they are ready.

This system has worked out beautifully for us time and time again. Most recently, we had two assistants and a floater, Denise, who was hired at the end of July. She had no previous dental office experience. Denise spent the first 2 months or so learning the floater responsibilities. In about October, we began to introduce her to four handed dentistry. When one of our assistants moved back to NYC in December, we were ready to comfortably transition Denise to full time assisting.  We hired a new floater, Rachel, in December, who also had no dental office experience. It’s been about 5 weeks and she has already mastered many of the floater duties and is beginning to assist. Because she has been extensively studying procedures, as part of her floating training, she is quickly becoming a competent and confident assistant. Interestingly enough, Denise is doing a lot of her training because SHE was trained so well! If one of the other two assistants leave, Rachel, the new floater, will seamlessly move into full time assisting and I will find another floater.

Because we don’t have to scramble anymore when someone leaves, I am able to REALLY take my time when it comes to hiring the right person. Basically, I’m looking for a poised individual who isn’t afraid to learn. I have all the tools here to teach the skills, but I need the right person who is willing to do the work. Side note, I’ve had a LOT of luck with hiring people without any dental knowledge. Don’t be afraid to hire outside of dentistry-just be willing to train them!

So, gone are the days of the mad scramble when we lose someone. We have a great system in place to protect the business and my sanity.

Got a question or comment for me? Let me know in comment section below!



About Missy


  1. GREAT READ!! “begin with the end in mind” = wisdom!

  2. Thanks for writing this! We just had an employee leave last week.
    I do digital marketing for a highly acclaimed periodontist in Michigan Dr. Joe Nemeth. I was wondering if you would be willing to do some back linking to help boost SEO for both of our websites? This will be mutually beneficial for our pages. If you’re interested please shoot me an email.

    [email protected]


  3. After reading this, I will never stress AGAIN at the loss of an employee!

  4. Wow, great detail, did you delegate the sections of the manual out to team members when you put this together ? It’s a task I’ve been wanting to do but feel overwhelmed and not sure how to organize it or start compiling it, thanks!

  5. It took me 4 years to write our manual-so I understand that overwhelming feeling! I wrote it myself. Recently, I created a front desk version with a friend of mine and we made it available for purchase. We are currently working on an assistant version that should be ready in a few months. You can see that front desk manual/planner at

  6. I have the front desk planner…and NEED the assistant one, too! I’m looking forward to the release. My only assistant was out today because she hurt her back, so my office manager stepped in to assist. It was a difficult day for all, but we made it!

    On another note – how do you justify paying someone to learn “just in case”? I’d love to hear more about staff payroll percentages with this model.

  7. Hey there! Glad you like the Front Desk Survival Guide! We are working hard on the assistant guide!
    I don’t look at this like I’m paying someone “just in case”. My goal is to create a capable and contributing employee that I can promote to another position when they are ready. I am investing in someone from the ground floor.

  8. I guess I am finding this a little too late, but I am considering buying the guide for our next hire.

  9. I wrote a front desk guide (The Dental Office Survival Guide: 2018 Front Desk Edition) with Mary Beth Bajornas. It’s a GREAT tool that helps your FD get through EVERY single day of 2018. We are currently working on an Assistants Edition that will change the world. You can visit my other site at

  10. Hi Missy,

    I first hear about you through Dental Hacks Nation. I opened my dental practice about 8 months ago; My front desk girl, who pretty much did everything left without notice and now I am in the exact position you described in your blog, podcast etc. I have been putting in over 12 hours a day just to keep us afloat. Ive have my RDA helping in the front, however shes not the right person for the job. I am taking my time to find the right person. Hiring someone without ANY dental knowledge as the main, lead person for the practice seems daunting to me. I have been working on my own Front desk Office manual for the last week (specific to our Patient Management system). Any tips or pointers would be amazing.

  11. I’m sending you an email right now!

  12. Dianne Boles says

    Thank you for the information, I will pass it on to our doctor.