Ask Kara RDH: What should I do about doctor cutting my pay?

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I’ve been a hygienist at my current office for two years now. When the doctor hired me, he told me he would pay me $30 per hour ON ONE CONDITION: he said I must have at least five patients per day. If I have less than five, he cuts my pay down to $16 an hour. I agreed only because I was desperate to leave the office I was at before, and he led me to believe this would only be temporary. Luckily, most days I see an average of 7-10 patients a day, so it doesn’t matter, but every now and then we have really slow months like right now, and I constantly feel stressed worrying about if I’m going to get paid enough to make ends meet. It’s frustrating because when he cuts my pay by that much, it makes me the lowest paid employee in the office (even less than the receptionist) even though I’ve got the second highest education besides him. I work so hard to call recall patients and fill the schedule, not to mention I’m the highest producing hygienist in the office. Also, this rule only applies to me. The other hygienists get paid their regular salary no matter what. I guess I’m just wondering if anybody else has had to deal with this and what I should do about it?

This is a tough situation to be in because it feels like the doctor took advantage of you and is now holding you to an unfair pay structure, especially when nobody else is held to it. That said, it’s a little unclear if the $16/hour is for only the hours you are seeing less than 5 patients, or if you are still getting paid for the full 8 hours. If you are still getting paid for the full 8 hours, I could see the doctor justifying his offer because he’s paying you about half as much when you are seeing half the patients of a full schedule. That said, it’s ridiculous that he is only holding you to this and no other hygienists in the office.

Since we can’t go back in time and not agree to the terms, your best bet is to have a conversation with the doctor and express your concerns like you have here. You’ve put in 2 years, so it’s not like you are an unproven, new employee. Let him know how hard you work at calling recall patients, and that you will always continue to do that when you’re not seeing patients, but sometimes you just can’t get 5 in for the day. Side question here: why is the front desk not trying to fill the schedule? Explain that when times are light like they are now, it can be very stressful financially because you value stability. I know it can be hard to admit, but it emphasizes to him that you don’t just want a raise and that it’s affecting you personally. After explaining how you feel, ask him, “What can you do to help with this situation?” It’s important to ask WHAT he can do and not IF he can do anything because you want him to be thinking towards solutions, not providing him with an easy cop-out by saying there’s nothing he can do.

If he doesn’t seem willing to budge on improving the situation, ask him, “So you don’t have the power to make this happen?” While he may not show you at the time, that question will get him thinking because no boss wants to give the impression that they don’t have the power to do something. He may even change his tune right there. If it’s clear he’s not going to change anything, I think it’s time to start looking for a new office where the doctor values his employees and doesn’t try to shortchange them.

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Kara Vavrosky, RDHEP, is a Co-founder and Chief Content Officer of Today’s RDH, a digital media company for dental hygienists, encompassing a daily publication, podcast, virtual continuing education events, and self-study continuing education. Kara is recognized as one of the largest social media influencers in dental hygiene, with a following of over 200,000 dental hygienists and other dental professionals. Additionally, Kara was recognized in 2020 as one of the top 100 women in media for her entrepreneurship as a Co-founder of Today’s RDH. A graduate of the Oregon Institute of Technology, Kara has a deep passion for spreading knowledge about the importance of oral health and its relation to systemic health. Kara’s passion extends to helping other hygienists understand the latest protocols, products, and research – all with the goal to push the dental hygiene profession forward. Kara currently lives in Vancouver, Washington, just outside Portland, Oregon, with her husband, Ben, and their four Chihuahuas. In her free time, you will find Kara on her quad riding the Oregon Dunes, spoiling her Chihuahuas, and cherishing every moment with her family and friends.