Before You Hire Again: Fix the Work That’s Burning Out Your Team

By Sarah Beth Herman, MBA, Founder & CEO, Dentistry Support®

There is a sentence almost every growing dental practice eventually says: “We need another person.” The phones are ringing, insurance verifications are piling up, claims need follow-up, patients are waiting at the front desk, the schedule has holes, treatment needs to be presented, and team members are covering responsibilities that were supposed to be temporary. Everyone looks busy, everyone feels behind, and hiring another employee begins to feel like the obvious solution.

Sometimes it is. However, before adding another salary, another workstation, another software login, and another person who needs to be trained and managed, there is a more important question to answer: What exactly are you hiring them to do?

“Help everyone because everyone is overwhelmed” is not a job description. It is evidence that something inside the practice is creating more work than the current team can comfortably manage. The mistake is assuming that too much work automatically means there are too few people. Sometimes your practice does not have a staffing problem. Sometimes it has a work problem, and adding another employee to a broken system simply gives that system another person to overwhelm.

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Busy Does Not Automatically Mean Understaffed

Dental practices can become extremely good at making chaos look normal. The phone rings while a patient is checking in. An insurance company is on hold while someone is trying to schedule treatment. A claim that should have paid weeks ago needs another follow-up. Eligibility still needs to be confirmed for tomorrow's patients. Someone has a billing question, there is an opening in hygiene, the doctor needs an answer, and another patient has just walked up to the front desk.

In the middle of all of that, a treatment coordinator may also be expected to sit down with a patient and have a calm, focused conversation about a significant treatment plan. When this happens every day, it is understandable for leadership to conclude that the practice simply needs another front-office employee.

Maybe it does. But before making that decision, look carefully at where the work is actually living.

Could eligibility verification be handled differently? Could insurance accounts receivable and claim follow-up be removed from the same employees who are responsible for taking care of patients physically standing in front of them? Could phone coverage be structured differently? Are employees entering the same information into multiple systems? Are team members maintaining spreadsheets or reports that nobody meaningfully uses? Are your strongest employees constantly answering questions because critical information exists only in their heads?

Before increasing headcount, understand what is consuming the capacity you are already paying for.

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How a Simple Job Becomes Five Jobs

Most dysfunctional positions are not intentionally designed that way. They evolve slowly, usually through a series of decisions that seem perfectly reasonable at the time.

An employee may originally be hired for three clearly defined responsibilities. Over time, they perform those responsibilities well, so another task is added. Then someone leaves the practice, and the reliable employee agrees to cover a few responsibilities “temporarily.” Six months later, those responsibilities are still there. The practice grows, another responsibility is added, and a new software platform is introduced without completely eliminating the old workflow.

Then exceptions begin to appear. A patient needs something outside the normal process, so a workaround is created. Someone builds a spreadsheet because the current system does not capture a particular piece of information. Another team member creates a different tracker because the first spreadsheet does not contain exactly what they need. Eventually, the employee who was originally hired to perform three related responsibilities is responsible for ten completely different things.

Leadership may then become frustrated because accountability is unclear. But accountability for what? If that exact position were posted as a new job opening today, would one qualified candidate realistically possess the skills needed to perform everything that has gradually been assigned to it? Would all of those responsibilities even belong in the same role?

If the answer is no, the problem may not be the employee. The job itself may have become poorly designed.

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Your Best Employee May Be Hiding Your Worst Process

Most practices have at least one employee who seems to know everything. They remember what happened with a patient six months ago. They know which insurance company requires a particular document. They know where the spreadsheet lives, which password works, who to call, which report can be trusted, and which workaround is needed when the system does not behave the way it is supposed to.

These employees are incredibly valuable, but they can also unintentionally hide serious operational weaknesses. The practice appears functional because that employee is functioning at an extraordinary level inside a system that may not be functioning well at all.

Take that employee out of the office for two weeks, and suddenly the questions begin. Where is that information? Who handles this? What happens next? How do we submit this? Why do we do it this way? Who knows the password? Where is the report?

When one person's absence makes an entire process difficult to understand, that is not simply proof that the employee is valuable. It is information about the system. Your strongest employee may be compensating for something leadership should have addressed a long time ago.

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Stop Rewarding Competence With More Weight

There is another problem that often develops quietly inside growing practices. The employee who finishes quickly receives another assignment. The employee who solves problems gets every complicated problem. The employee who rarely complains becomes the person leadership assumes has unlimited capacity. The team member who always offers to help slowly accumulates responsibilities nobody intentionally assigned.

We often praise these employees for being dependable, flexible, and willing to do whatever it takes. Then, without realizing it, we reward that competence by giving them more and more to carry.

Eventually, they become exhausted.

When great employees repeatedly discover that doing excellent work only earns them everyone else's unfinished work, competence can begin to feel like punishment. That is a retention problem long before it becomes a recruiting problem.

The American Dental Association continues to report significant workforce pressure in dentistry, including ongoing difficulty recruiting and retaining qualified dental professionals. That makes protecting the capable people already inside your organization even more important. You cannot eliminate every stressful day or demanding season, but you can stop designing jobs that require extraordinary effort simply to remain functional.

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Before You Question Productivity, Look at Interruption

An eight-hour workday does not necessarily provide eight usable hours of focused capacity.

Microsoft workplace research found that many employees using Microsoft 365 were interrupted by a meeting, email, or notification approximately every two minutes during the workday. The same research found that nearly half of employees described their work as chaotic and fragmented.

That matters because interrupted time is not the same as focused time.

Inside a dental practice, an employee's day may be repeatedly interrupted by patient questions, incoming calls, insurance companies, internal messages, emails, doctor requests, coworker questions, approvals, schedule changes, walk-up requests, and the constant “Can you do this really quickly?”

Every interruption requires the employee to stop what they are doing, shift attention, respond, remember where they were, and restart the original task. Before deciding that an employee needs to “manage their time better,” leadership should examine how much uninterrupted time the practice actually allows them to manage.

Sometimes the fastest way to create additional capacity is not to hire another employee. It is to protect more of the capacity you are already paying for.

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Another Salary Is Bigger Than Another Salary

Hiring may absolutely be the right decision, but it should be treated as an investment rather than simply another name on the schedule.

The true cost of adding an employee extends beyond their hourly wage or salary. A practice may also absorb payroll taxes, benefits, workers' compensation, recruiting expenses, equipment, software licenses, training, management time, and the productivity cost of experienced employees who must help onboard someone new.

According to the U.S. Bureau of Labor Statistics, total employee compensation in private industry includes both wages and a significant additional cost for benefits. While those figures represent the broader private sector rather than dental practices specifically, they demonstrate an important principle: an employee costs the organization more than the number printed on the paycheck.

That does not mean you should avoid hiring. It means the reason for hiring should be clear.

Before approving another position, leadership should be able to complete this sentence:

We are hiring this person because ____________________.

A strong answer might be that verified patient demand has exceeded the team's available capacity. It might be that the practice is adding clinical capacity to support another provider. It could be that treatment coordination needs to be separated from administrative duties so patients can receive uninterrupted financial conversations. It may also be that duplicate work has already been removed, reasonable automation has been implemented, workflows have been reviewed, and genuine demand still exceeds capacity.

Those are very different explanations from, “Everyone is drowning.”

If everyone is drowning, first determine why they are in the water.

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Do Not Simply Move Work From One Person to Another

When an employee says they are overwhelmed, one of the most common leadership responses is, “What can we take off your plate?” That can be a helpful question, but it should immediately be followed by another one: Why is this on anyone's plate in the first place?

If five hours of work are removed from one employee and handed to another employee, the organization has not necessarily become more efficient. The work has simply moved. One person feels temporary relief, another absorbs the responsibility, and a few months later the second employee is overwhelmed too.

Before relocating a task, examine the task itself. Why do we do this? Who actually uses the result? What would happen if we stopped doing it? Can part of the process be automated? Does the information already exist somewhere else? Are two employees maintaining different versions of the same information? Are we creating reports nobody reads? Are employees manually entering data that already exists in another system? Are we holding meetings simply because those meetings have always existed?

Operational improvement begins when leadership stops asking only, “Who else can do this?” and starts asking, “Should we still be doing this at all?”

The goal should not be to become better at moving unnecessary work from one employee to another. The goal should be to eliminate unnecessary work.

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Technology Should Create Capacity, Not More Complexity

Technology belongs in this conversation, but not because every practice should be looking for ways to replace people. The more valuable question is whether technology can responsibly return time to the people you already employ.

Microsoft's 2025 Work Trend Index reported that 82% of leaders expected to use some form of digital labor to expand workforce capacity over the following 12 to 18 months. The important word is capacity.

Imagine that an administrative process currently requires six employee hours every week. If technology can responsibly reduce that process to one hour, the practice gains five hours of capacity. Those five hours can then be redirected toward responsibilities that require human judgment, communication, leadership, patient interaction, or relationship building.

Perhaps the treatment coordinator finally has time to coordinate treatment. The office manager can spend more time managing. The scheduling coordinator can focus on the schedule. Patient calls can be returned faster. Unscheduled treatment can receive proper follow-up. The front office can give more attention to the patients physically standing in front of them.

That is where technology becomes valuable.

However, technology should not be used to automate a bad process simply because automation is available. A process filled with unnecessary approvals, duplicate data entry, unclear ownership, and outdated steps does not become a good process simply because it happens faster.

Examine the work first. Then determine what should be eliminated, redesigned, delegated, outsourced, or automated.

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Managers Need Capacity Too

The person carrying too much may not be sitting at the front desk. Sometimes it is the office manager.

Managers are often expected to supervise employees, solve operational problems, train new team members, address performance concerns, manage schedules, answer patient escalations, approve requests, attend meetings, communicate with providers, monitor results, and step in whenever another position is short-handed.

Then, because they are capable and dependable, leadership adds another responsibility.

And another.

At some point, we have to stop asking whether a manager can technically carry more and start asking whether carrying more allows them to perform their actual job well.

Gallup's workplace research has repeatedly demonstrated the important role managers play in employee engagement and organizational performance. When managers themselves are overloaded, the effect rarely stays contained to one person. It spreads into communication, accountability, employee development, decision-making, and ultimately the experience of the entire team.

Being capable of carrying more does not automatically mean carrying more is good organizational design.

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Dentistry Cannot Afford to Hire Without Thinking

This discussion becomes even more important in an industry where finding qualified employees continues to be difficult.

American Dental Association research has shown that dental practices continue to experience substantial recruiting challenges, particularly for dental hygienists and dental assistants. Staffing shortages remain one of the significant operational concerns facing practice owners.

If finding employees is difficult and employing them is expensive, there is even more reason to understand exactly what work requires another employee before beginning the recruiting process.

Hiring should increase meaningful capacity. It should not simply give a dysfunctional workflow another person to consume.

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Look at the Work Before You Look at the Person

When a position consistently struggles, leadership naturally begins evaluating the employee. Are they organized? Are they productive? Are they prioritizing correctly? Are they moving quickly enough? Are they accountable?

Those are legitimate questions, but another set of questions should come first.

What does this position actually own? How many unrelated responsibilities have gradually accumulated? How frequently is the employee interrupted? How many systems are required to complete their work? How much information must they chase? How much duplicate work exists? How many tasks were added because another employee left? How many “temporary” responsibilities quietly became permanent?

The employee may need coaching. They may be in the wrong role. You may genuinely need another person.

But you will make a much better decision after understanding the work.

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Your Five-Day Work Audit

This week, choose one position in your dental practice that consistently seems overwhelmed. Do not choose five departments and do not attempt to redesign the entire organization at once. Choose one position and spend five working days determining what that person actually does.

For the moment, ignore the formal job description. Track reality instead.

Pay attention to where the employee's time goes, what interrupts them, what information they repeatedly have to search for, which tasks they redo, which meetings they attend, which responsibilities they inherited from former employees, and which jobs have been given to them simply because everyone knows they are capable.

Look for manual data entry, duplicate work, unnecessary reporting, overlapping systems, outdated processes, repeated questions, administrative tasks that could potentially be outsourced, and responsibilities that no longer logically belong to the position.

At the end of the five days, remove the employee's name from the analysis and look only at the work.

Then ask:

Should this work exist at all?

If the answer is yes, ask:

Is this actually the right place for the work to live?

Finally, ask one more question:

If this employee disappeared tomorrow and we had to design this position again from nothing, would we intentionally rebuild the job exactly this way?

If the answer is no, do not start recruiting yet.

Start there.

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Build the Job Before You Fill the Job

Hiring is not the enemy. There will absolutely be times when patient volume exceeds capacity, when growth requires additional support, when new providers require additional staff, or when a position simply needs another qualified person.

When the data tells you another employee is necessary, hire them.

But hire them into something worth joining.

Give them a position that makes sense. Give them responsibilities that belong together. Give them systems that support their work instead of creating more work. Give them clarity about what they own. Give their manager enough capacity to actually manage them.

Do not hire someone into years of accumulated workarounds and expect that person's presence to repair the system.

A new employee cannot fix a broken process simply by becoming part of it. Eventually, they may become another employee telling you they are overwhelmed.

Before increasing payroll, investigate the work. Before questioning productivity, investigate interruption. Before transferring a responsibility to someone else, determine whether the responsibility still needs to exist. Before celebrating your strongest employee for carrying everything, make sure their competence has not become the reason leadership keeps giving them more weight.

Growth does not require your team to remain permanently overwhelmed. Strong leadership is not measured by how much work your best people can survive. It is measured, in part, by whether you have created an organization where capable people can spend their time doing the work they are actually positioned to do well.

Sometimes demand has genuinely exceeded capacity, and the answer is to hire.

Sometimes the job has accumulated too many unrelated responsibilities, and the answer is to redesign it.

Sometimes administrative work is consuming employees who should be focused on patients, and the answer is to move it.

Sometimes technology can responsibly reduce repetitive tasks, and the answer is to use it.

Sometimes a process has survived for years simply because nobody has challenged it.

Challenge it.

Before you hire another person, look at the work.

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Coming Next on No Silver Spoons®

Once you start examining how work actually moves through your practice, another uncomfortable question tends to surface: What about the problem everybody already knows exists?

It is the process employees complain about, the issue new team members notice almost immediately, the problem leadership has discussed repeatedly, and the frustration everyone agrees should have been fixed a long time ago.

At some point, you do not need another meeting to identify a problem everybody can already see. You need to understand why the organization has continued allowing that problem to survive.

That is exactly where the conversation goes next.

Watch for the upcoming No Silver Spoons® Episode 144, where the focus turns to the problems everyone already knows about—and why real leadership requires more than simply acknowledging that they exist.

References

American Dental Association Health Policy Institute. (2026). State of the U.S. Dental Economy: Q1 2026. American Dental Association.

American Dental Association Health Policy Institute. (2025). State of the U.S. Dental Economy: Q4 2025. American Dental Association.

Gallup. (2026). State of the Global Workplace: 2026 Report. Gallup Workplace.

Microsoft. (2025). Breaking Down the Infinite Workday. Microsoft WorkLab, Work Trend Index.

U.S. Bureau of Labor Statistics. (2026). Employer Costs for Employee Compensation — June 2026. U.S. Department of Labor.

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Disclaimer:

To learn more about Sarah Beth Herman, the author of all free training content you can read her bio here. These materials are intended to provide helpful information to dentists and dental team members. They are in no way a substitute for actual professional advice based on your unique facts and circumstances. This content is not intended or offered, nor should it be taken, as legal or other professional advice. You should always consult with your own professional advisors (e.g. attorney, accountant, or insurance carrier). To the extent, Dentistry Support ®has included links to any third-party website (s), Dentistry Support ® intends no endorsement of their content and implies no affiliation with the organizations that provide their content. Further, Dentistry Support ® makes no representations or warranties about the information provided on those sites. You can view our privacy policy and terms and conditions by clicking those pages in the footer of our website