To staff or not to staff. That is the question.

4 years ago, when I started my practice,  I had one team member. She was my my phone answerer, my TC, my assistant and pretty much everything else. Thankfully, we grew and I found some great team members to help our practice expand along the way.
Like many of you out there, I still have a younger, growing practice. I tend to add team members when I feel I must and I watch with mixed feelings as I see my peers post images of their teams that include 10,15 or even more employees.
On one hand, I tend to relate the number of team members to success. After all, no sane person would simply hire folks to take up payroll without a need, right? So, when I see a large staff, I naturally equate that to healthy practice. I think of all of those extra marketing, lab and clinical efficiencies I wish I had in my younger practice. But, extra team members come with a few costs, right?
Of course, the payroll costs go  up, along with optional costs of things like medical expenses, bonuses, uniforms, etc and anyone who has practiced for even a few months knows that the more team members, the greater the chance for friction among personalities.
But, more team members also has benefits when properly implemented. You can run so much more efficiently, apply individuals to specific tasks that might be underserved with a smaller team and more can be delegated.
However, if we’re in business to serve our patients AND make a living, every penny paid to a team member is a penny out of our pockets, so it’s wise to keep an eye on staff salaries as they relate to overhead.
There are those out there who recommend being slightly overstaffed when a practice is young so that it is always ready to embrace the next phase of growth. Others believe that overhead is key and that you shouldn’t employ the next new employee until you’re “bursting at the seams”.
There are metrics by which one can measure their team size versus efficiencies, but for growing practices whose numbers are rapidly changing and often unpredictable, it can be tough for an inexperienced orthodontist to know when is the right time to add someone.
I don’t know if there’s a right answer to how many team members one should have but I believe it all comes back to the written plan for the practice. How do you feel about overhead control, efficiency, patient experiences, in-house marketing, etc? Let your written plan guide your decisions.
The good news is that if you’re a younger practice and feel like you need to add a team member, it probably means that you’re growing and that’s not a bad thing.
All the best,
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