I need structural/hierarchical advice for smaller dentistry clinics.

  • 1-2 dentists (one of them the owner)
  • 0-1 dental hygienists
  • 1-3 dental assistants.

If you want to choose one setup of personnel I believe the data shows the most prevalent composition (in Denmark) is:

  • 2 dentists
  • 1 dental hygienist
  • 3 dental assistants

By hierarchical/structural advice I mean who would manage whom? Would you make the owner the manager of all. Or would you have the owner manage the dentists and dental hygienist and just one dental assistant - who would then be managing the rest of the dental assistants?
What would be the breaking point between the models, i.e. when would you choose to structure it differently?

Looking forward to your answers

Best regards
Philip Gredsted Garner
Copenhagen, Denmark

Kevin1's picture

Hi Philip,

My view would be that iIn your example, with at most 5 direct reports in different roles, the owner should be the manager of all of the staff.   

If the business grew, you may consider having one assistant as the team lead or senior assistant.

Hope that helps.


PhilipGarner's picture

Hi Kevin

Thanks so much for your response. That helps alot.

Best regards

Twycrokai's picture

Hey Philip,

I work with hundreds of dental offices across America and the most common structure I see for a 2-8 employee office is that the doctor owner is usually the sole manager with every position reporting directly to him or her.  However the employee make up would be slightly different here, with the blend being 1 host doctor, possibly 1 associate doctor, 1-3 hygienists depending on whether they do multiple part timers or one full timer, 1-2 dental assistants (DAs), 1-2 Front Desk who are also often billers or insurance coordinators.  This also depends on Practice style (high volume/long hours vs small team/family oriented).  Usually, although not always, the doctor's spouse will fill the role of de facto office manager (OM) and may be a fill in DA or Hygienist.  

Usually by the time an office hits 7 or 8 employees, the owner doctor doesn't have the desire or ability to manage and will hire a full or part time office manager, usually by promoting one of the DAs or Front Desk.  This may also depend on whether the Practice hires a Dental Office Consultant, who will likely make specific hiring, firing and efficiency recommendations.  

As it grows from there, usually around 15 or so, you will often see the OM promote a back office employee to act as Team Lead in the back and a Front Desk to act as team lead in the front.  By this point, specialization of labor has taken over and there is a usually a billing coordinator, treatment coordinator, insurance coord, etc.  This usually pulls in more doctors, who in turn pull in more assistants.  About this time, the Practice, assuming it is a general dentistry office, may look for an Endo, Ortho, or Prosti specialist to work as an Indepedent Contractor a few times a month so they don't lose their piece of the referral business.  That really depends on the Practice and what type of work is coming through the door.  Also on how much the Practice wants to invest in new toys.  

Anyway, not sure how much transfers over to Denmark, but that is the most common evolution I have seen over here.