Dental and Medical Counsel Blog

When establishing or expanding your dental practice, a pivotal aspect to consider is the recruitment of personnel. You'll encounter two primary paths: hiring staff as employees or engaging them as independent contractors. Each approach carries its own set of pros and cons, and selecting the best fit hinges on your unique circumstances and practice model. 

What works well for one dental practice may not necessarily suit yours. It's essential to carefully weigh the advantages and disadvantages of each option before making a decision. Don't hesitate to seek guidance from a professional who specializes in dental practice management. At DM Counsel, we're dedicated to assisting you in navigating the staffing options tailored to your dental practice. Explore further below, and connect with us to arrange a consultation. 

What is the Definition of an Employee?

In dentistry, an employee is an individual who commits to working part-time or full-time under a contract of employment. They operate within the parameters set by the employer, covering aspects such as working hours, job tasks, and methodologies. As employees, they are bound by the responsibilities outlined in their job description and in return, receive compensation in the form of wages or salary. 

Remuneration for dental employees is subject to tax withholding, and they are entitled to a range of employment benefits. These benefits often include provisions such as sick leave, paid vacation time, health insurance coverage, retirement contributions, and more. Legally, employers typically bear responsibility for their employees' actions during their designated working hours within the dental practice. 

What Defines an Independent Contractor?

An independent contractor is an autonomous professional who operates as a self-employed entity, rendering services to clients based on a predetermined contract or verbal agreement. They usually exercise greater autonomy over their work methods and tools, affording them a level of flexibility that may surpass that of traditional employees. 

Independent contractors do not enjoy the same array of employment benefits typically extended to employees, nor are their tax obligations managed by the dental practice. Instead, they assume responsibility for their own tax payments and other financial considerations. However, to compensate for these factors and associated risks, independent contractors often command higher fees for their services. 

Unlike with employees, the dental practice generally holds less liability for the actions of independent contractors. Deciding which arrangement best suits your needs involves careful consideration of the advantages and disadvantages inherent to each option. 

Employee: Pros and Cons

There are several benefits to consider when hiring an employee. A few of the top benefits include:  

• Employees can provide consistent and reliable service to your practice's patients. 

• As the employer, you maintain control over the work hours, job duties, and quality of service. 

• Hiring an employee can contribute to team cohesion and a consistent practice culture. 

• Employees can be trained to follow your specific procedures and protocols. 

• Your practice's reputation and brand can benefit from long-term, dedicated staff. 

• An employee could potentially grow with your practice, leading to long-term retention. 

• Employees require regular wages or salary, irrespective of your practice's cash flow situation. 

• You're obligated to provide employment benefits, which can significantly add to costs. 

• You'll have to manage payroll taxes and other employment-related regulatory obligations. 

• Employees can require substantial training and supervision. 

• Termination procedures can be complex, often involving legal considerations. 

• Employees may not provide the same level of flexibility as independent contractors. 

Independent Contractor: Pros and Cons

There are several potential benefits to hiring an independent contractor. They include: 

• Independent contractors can offer high flexibility, ideal for handling peak periods or temporary needs. 

• You may save costs by not having to provide employment benefits or manage payroll taxes. 

• Independent contractors often bring a wide range of experiences, potentially enhancing service quality. 

• Contract termination can be simpler than employee termination. 

• You can easily scale your practice up or down based on demand by hiring or releasing contractors. 

• Contractors can provide specialized services that your regular staff may not be able to. 

• Independent contractors may not be as available or dedicated as full-time employees. 

• They may work with multiple clients, potentially causing conflicts of interest. 

• You may have less control over the quality and consistency of the service. 

• Contractor rates may be higher than an employee's wage to offset their lack of benefits. 

• Building a cohesive team can be more challenging with independent contractors. 

• Legal and regulatory issues can arise if an independent contractor is incorrectly classified. 

Navigating Worker Classification in 2024

In California, stringent regulations, particularly Assembly Bill 5 (AB 5) enacted in January 2020, have made it increasingly challenging for employers to classify workers as independent contractors rather than employees. A new U.S. Department of Labor rule, effective from March 11, mandates a complex multi-factor analysis for employers across the U.S., potentially resulting in fewer workers being classified as independent contractors. Despite California Dental Association (CDA) securing exemptions for California dentists under AB 5, the definition of an independent contractor remains ambiguous, prompting caution when classifying workers. Employment law experts anticipate increased scrutiny from the Franchise Tax Board after the implementation of the federal rule.  

The Department of Labor's final rule emphasizes that workers dependent on employers for work are not independent contractors. Employers must assess six factors outlined in the rule, including the opportunity for profit or loss, degree of control, and the extent to which the work is integrated into the employer's business. Despite the federal rule, California employers must still comply with AB 5's ABC Test, which almost always classifies dental assistants, hygienists, and front-office workers as employees. Worker misclassification can lead to significant liabilities for employers, emphasizing the importance of accurate classification under state and federal laws, a responsibility solely borne by practice owners. 

Accurate classification of workers as employees or independent contractors is crucial for dental practice owners to avoid legal repercussions and financial liabilities. Misclassification can lead to penalties, unpaid taxes, and violations of labor laws, putting the practice at risk. Understanding and complying with state and federal regulations not only ensure legal compliance but also promote fair treatment of workers and maintain the integrity of the dental profession. 

When to hire an employee 

The decision to hire a dentist as an employee might be right for your practice in several scenarios. If you're seeking to build a consistent and reliable team to manage everyday tasks and create a cohesive practice culture, hiring an employee might be the best option. Employees are typically more dedicated to your practice and can provide a stable workforce. 

If you're looking for someone to work during specific hours, then an employee could be the ideal choice. Having control over your workforce can help in managing the patient load and ensuring quality service. Moreover, if you want to invest in the long-term growth and development of your team, then hiring an employee could be the most beneficial path. 
 
When to hire a contractor 

On the other hand, hiring a dentist as an independent contractor could be the right decision if your practice needs specialized services that your current staff can't provide. This might include advanced diagnostic procedures or specific dentistry-related tasks. Contractors can also be an excellent choice if you need additional help during peak times or to cover staff absences. 

Independent contractor dentists can offer the flexibility to scale your practice's workforce up or down based on demand. If you prefer to avoid the administrative burdens and costs related to employment, such as payroll taxes and employee benefits, then a contractor might be the most cost-effective choice. 

Balancing Employees and Independent Contractors

It's worth noting that your dental practice might benefit from a mix of employees and independent contractors. A blended workforce can offer the best of both worlds, providing the stability and consistency of employees, coupled with the flexibility and specialized skill sets of independent contractors. 

Balancing the two categories can ensure your practice always has the required staffing while also being able to accommodate special needs or fluctuating demand. It's crucial to understand the legal implications and differences between these two types of workers to maintain a compliant practice. 

Contact DM Counsel for Help With Your Practice 

Whether you decide to hire employees, independent contractors, or a mix of both, DM Counsel is here to help guide your decisions. We specialize in legal support for medical, dental, and optometry practices, ensuring you can focus on providing excellent patient care while we take care of the legal complexities. 

Hiring a dentist as an employee or independent contractor can both offer unique benefits. The best choice will largely depend on your practice's specific needs, resources, and long-term plans. Don't navigate these complex decisions alone; reach out to DM Counsel for expert advice and guidance. Your practice's success is our priority. 

Frequently Asked Questions

Q: What are the two primary paths for recruiting personnel in dental practices? 
A: Dental practices can either hire staff as employees or engage them as independent contractors.

Q: What factors should be considered when deciding between hiring employees or independent contractors? 
A: The decision should hinge on the unique circumstances and practice model of the dental practice, as each approach carries its own set of pros and cons.

Q: What are the benefits of hiring employees in dental practices? 
A: Hiring employees allows for consistent and reliable service, control over work hours and quality, contribution to team cohesion, customized training, enhanced practice reputation, and potential for long-term growth and retention.

Q: What are the drawbacks of hiring employees in dental practices? 
A: Drawbacks include the requirement for regular wages, obligations to provide employment benefits, management of payroll taxes and regulatory obligations, need for training and supervision, complexity of termination procedures, and potentially limited flexibility compared to independent contractors.

Q: What defines an independent contractor in dental practices? 
A: An independent contractor is an autonomous professional who provides services based on a predetermined contract or agreement, enjoying greater autonomy over work methods and tools. 

Q: What are the benefits of hiring independent contractors in dental practices? 
A: Benefits include high flexibility, potential cost savings, diverse experiences, simpler contract termination, scalability, and specialized services. 

Q: What are the disadvantages of hiring independent contractors in dental practices? 
A: Disadvantages include potential availability and dedication issues, conflicts of interest from working with multiple clients, less control over service quality and consistency, higher contractor rates, difficulty in building a cohesive team, and legal and regulatory risks. 

Q: How do California regulations, particularly Assembly Bill 5, impact worker classification in dental practices? 
A: AB 5 and related regulations have made it increasingly challenging to classify workers as independent contractors rather than employees, prompting caution and legal scrutiny. 

Q: What are the implications of the U.S. Department of Labor's rule on worker classification for dental practices? 
A: The rule mandates a complex multi-factor analysis for employers nationwide, potentially resulting in fewer workers being classified as independent contractors and increasing legal obligations for compliance. 

Q: Why is accurate worker classification crucial for dental practice owners? 
A: Accurate classification ensures compliance with state and federal laws, avoiding legal repercussions, financial liabilities, and risks to the practice's reputation and integrity. 

At Dental & Medical Counsel, PC, we understand navigating the legal process can be tricky. We believe every doctor deserves the best advice and service so doctors can do what they do best, treat their patients. We make their lives easier by providing expert guidance, so they can focus on their personal and professional aspirations.

About Ali Oromchian, Esq.

Ali Oromchian, JD, LL.M. is the founding attorney of the Dental & Medical Counsel, PC law firm and is renowned for his expertise in legal matters

In addition to practicing law for almost 20 years, Ali is also a renowned speaker, throughout North America, on topics such as practice transitions, employment law, negotiation strategies, estate planning, and more! Ali has helped hundreds of dentists realize their professional goals and looks forward to aiding you in navigating the legal landscape.