The most common manner of employing clinic personnel is through salaried positions. Terms of employment usually include a salary and benefits package, vacation and sick leave, and specific work hours. 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.
Contracting with professionals is another method for employing personnel. Contracting commonly is done with dentists and dental hygienists but less often with dental assistants, receptionists, or office managers. This type of hiring involves drawing up a legally binding contract between an independent oral health professional and the clinic. The contract will specify hours the professional will work, the rate of pay (usually per hour or per day), and other details. An independent contractor is 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 clinic must expect to pay a higher hourly or daily rate for a contractor than for an employee. Internal Revenue Service criteria distinguish between a contractor and an employee.
Contracting with private sector dentists can be an important approach for increasing access to oral health care services for underserved populations. The Children’s Dental Health Project’s document, Increasing Access to Dental Care Through Public/Private Partnerships: Contracting Between Private Dentists and Federally Qualified Health Centers, has information about why and how a federally qualified health centers (FQHC) might consider entering such contracts. This publication is specifically for FQHCs.
Many charitable and safety net clinics provide a portion of services through the work of volunteers. Staffing through volunteers can be an economical way to provide services. The use of volunteers was introduced in Unit 1 and revisited in Unit 3 in relation to reducing personnel costs.
Considerations that Affect Volunteering |
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Why Do Oral Health Professionals Volunteer? |
What Makes Oral Health Professionals Wary of Volunteering? |
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Reprinted, with permission, from Hanson SA, Goldin M, Goldin GL, 2002. Using Volunteer Dental Professionals to Provide Services to the Underserved: Types and Characteristics of Model Programs. [Presentation by Volunteers in Health Care at the American Public Health Association Annual Meeting Philadelphia, PA.] |