If your practice is growing (or you want it to), three levers matter most: how you compensate hygiene, how often you huddle, and how you keep core values alive. This episode dives into all three with real-world scenarios you can swipe today.

1) Rethinking Hygiene Compensation (without blowing up payroll)

A multi-specialty perio owner asked about moving hygiene from hourly to a model that drives productivity and autonomy. My go-to: a hybrid plan.

How it works

• Pay a fair hourly base (regional market rate).
• Add % of adjusted production/collections (commonly 25–35%).
• Monthly true-up: hygienist earns whichever is higher—base or percentage.

Why it works

• Security for steady performers; upside for go-getters.
• Naturally aligns with case acceptance, perio diagnostics, radiographs, and schedule discipline—without compromising patient care.

Guardrails

• Aim for a 3.0× revenue-to-wage ratio (gold standard 3.3×; 3.0× is realistic in PPO-heavy markets).
• If you’re stuck at ~2.0×, diagnose the system, not the person: fees/PPO schedules, confirmation protocols, patient flow, perio under-diagnosis, or hygiene capacity.

Time discipline

• Close charts in ≤20–30 minutes after the last patient. If it’s regularly longer, coach time management—don’t normalize overwork.

2) “We Don’t Do Meetings” (…yet)

An office manager joined a 12-person, single-doc practice with no team meetings. The fix isn’t to argue for meetings—it’s to surface pain the doctor actually feels.

Make the case with outcomes

• Turnover risk: people leave when the “why” is fuzzy.
• Production vs. profitability: meetings expose supply/lab leaks and scheduling gaps.
• Calibration: same-day dentistry, hygiene checks, and handoffs improve when everyone sees the playbook.

Start small

• Propose 1×/month, 60 minutes, pizza included.
• Agenda: scorecard (adjusted production, collections, case acceptance, new patients, doctor hourly), one core system to improve, one recognition shout-out, next steps/owners.

3) Core Values That Don’t Live on the Wall

A newer owner asked how to keep core values from going dusty. Make them operational:

• Daily huddle touch: read one value, ask a teammate for a 60-second example.
• Public recognition: “Caught Living the Values” on your team chat or bulletin.
• Quarterly reviews: evaluate core values first, then role responsibilities (the “Rules of the House”).
• 90-day trial: tell the team it may feel cheesy for a month—then let results speak.

One-Page Practice Growth Cadence

• Quarterly: Re-commit to the vision (solo → add associate), capacity check (ops, people, demand), hiring avatar, capital needs.
• Monthly: Scorecard review (new patients, case acceptance, doctor hourly, hygiene ratio, key expenses).
• Weekly: System fix of the week (e.g., no-show prevention, same-day flow).
• Daily: Huddle + one core-value touch.

Key Takeaways

• Hybrid hygiene pay (base + %) rewards productivity and protects stability.
• Use meetings to solve known pain (turnover, margin leaks, misalignment).
• Make core values a habit—huddles, recognition, and value-first reviews.
• Run a simple cadence so dentistry, leadership, systems, and practice growth stay in sync.

Want the scripts, percentages, and sample scorecards we discussed? Listen to the full conversation on the Dental Lighthouse Podcast for more insights.