Hardly any issue currently preoccupies dental practices in Germany as much as the shortage of dental assistants. In the episode „Fachkräftemangel oder Führungsproblem?“ of the podcast Queens & Sons of Dentistry, the host, together with Dr. Nebo Stankovits, a dental entrepreneur with practices in Hanover and Bremen, puts forward an uncomfortable thesis: there are plenty of good dental assistants – they simply no longer wish to work under the conditions on offer. According to this view, the problem often lies not in the market, but in leadership, in structures and in the attitude of practice owners.
A shortage that affects every sector
In the conversation, Dr. Stankovits describes how the skills shortage is by no means confined to dentistry. Anyone driving once around the block will see, on almost every company vehicle, not messages about quality or speed, but always the same notice: “We are hiring.” Whether a skilled trade business or a medical facility – all of them compete for qualified staff, and this development has intensified further in recent years. Self-employed professionals therefore have to convince two groups in equal measure: patients on the one hand and employees on the other – because without staff, a certain order of magnitude is simply unattainable.
Just how tense the situation is becomes clear from a figure taken from his own practice with 35 employees: of the 30 applications that arrived during a few weeks of active recruitment, he rated only two as good. The shortage is “brutal”, and he knows of no dentist who is not preoccupied with the subject.
The legacy of the “little helper” image
Dr. Stankovits identifies a home-made problem within the profession as one central cause. In the 1980s and 1990s, the typical practice model consisted of one dentist with “two and a half employees”: a dental assistant in the treatment room who occasionally took on prophylaxis, a member of staff at reception for billing and the telephone, and a trainee who worked alongside them inexpensively. As a result, the occupation enjoyed little esteem – the members of staff were regarded as “little helpers”. Added to this were remuneration that was considerably poorer for a long time and a lack of appreciation; even the colloquial term “helper” conveys an image that does not do justice to the profession as it stands today.
What experienced dental assistants actually deliver
Dr. Stankovits contrasts this with reality: experienced dental assistants have long ceased to be auxiliary staff and are instead employees capable of organising a practice independently. They have to cover every area of practice operations – commercial tasks, communication with the payers, written and verbal exchanges with patients, elements of marketing and complaint management. On top of this comes the mediating role between dentist and patient, since dental assistants often build a more immediate relationship with patients than the practitioner does.
The podcast conversation also brings out that the dental assistant has considerably more points of contact along the entire patient journey than the dentist: from reception through the medical history form to appointment scheduling. Consistently, Dr. Stankovits takes the view that a dental assistant should be allowed to take on everything that is permissible within the legal framework – with the exception of anaesthesia, the preparation of teeth or the placement of restorations, for instance. Where members of staff are not permitted to perform these tasks, understandable frustration arises, because alongside financial recognition the appreciation of the work performed is then also missing.
Development paths as the key to staff retention
Amata, site manager of the Bremen practice, complements this view with the perspective of personnel development. She emphasises the variety of the occupation: prophylaxis, billing, practice management, continuing education – there are so many opportunities to develop. It is the task of practice leadership to find out, for each team member, what they particularly enjoy doing and are good at, and to foster these strengths in a targeted way – for example with the question of what someone needs in order to become better, and in which direction they would like to develop.
By his own account, when setting up his first practice Dr. Stankovits took his bearings more from the structure of a hotel than from the dental practice as it had been known until then: with a standing reception, encounters as equals and a division into reception, front office and back office. The conclusion of the episode is correspondingly clear: appreciation, trust, clear framework conditions and structures, clear leadership, listening and meeting as equals – these are what decide whether good specialists come and, above all, whether they stay.