Staff Pay Issues – Part 1 of 2


Staff Pay Issues

This is a very touchy topic that is filled with many conflicting opinions and ideas, and in many cases, it is a matter of a lack of communication, agreements and understanding on both “sides” that causes the difficulties.

On the one hand, staffs often want more pay and feel they should get a raise every year no matter what, they want sick days paid for, they want overtime pay, they want Christmas bonuses, more vacation time, and so on. They have financial needs and pressures. (It is a fact that you will always need more, no matter how much you make, by the way!)

On the other side of the coin, the owner of the practice can be caught between a rock and a hard place with the overhead of the practice to consider. This may include student loans, start-up or practice purchase loans, rent or mortgage payments for the office, equipment leases, renovation loans, insurance payments, licensing fees, salaries for the team and of course, they deserve to have take-home pay for all the work they do, as well as for going to school for 6-8 years to get their degree, and also for being the owner of a business as an additional responsibility and set of functions.

For Starters

For starters, there should not be “sides” that one may take regarding the running of the business and the staff remuneration. There are criteria that do however have to be considered and understood all parties concerned.

So how DO you get everyone on the same page and make it mutually beneficial for everyone?

The First Agreement

So the first thing to agree upon is that you are all on the same team with the purpose of the practice being to deliver high quality care to your patients. If you do just that, the practice will be successful.

What we find is that the highest paid teams are generally those working in the most productive and efficient practices.

The Second Agreement

The owner of the practice needs to head up and lead the team effectively to deliver the highest quality of service possible since a well run practice means enough income for it to thrive on. The owner is usually on a straight “bonus system” of whatever is left over after all else is paid. So as the top level exec of the practice as well as the practitioner, they should be well remunerated if they do a good job of leading.

The Third Agreement

It needs to be understood by the staff that while they do not own the practice, their pay too is dependent on how well they help grow the practice and inspire patient referrals and so on. If the team slacks off or does the irreducible minimum on their positions and no more, then the result is that the practice may not grow or may even go down. And when the income doesn’t go up, there is no room for raises and bonuses. If the patients or clients do not perceive the quality of care or attention they feel they should receive in exchange for their hard earned dollars, they will not refer others to the practice and may even decide to move on to another practice. This then means no growth.

Bonus Systems

An effective way of leveling the playing field a little in terms of remuneration for all team members is a well designed bonus system (in addition to regular pay). The owner of the practice is almost always on a straight bonus system of whatever is left over after the bills and staff are paid. So when the whole team or a part of it drops the ball and the stats go down, the staff still get their pay but the practice owner doesn’t. With a bonus system properly designed for the practice, the income often goes up because the team has a game to play which encompasses more and better service to the patients. If the income goes up, there are bonuses for everyone; if it goes down, there are not.

Sick Days

Again, a touchy issue. If any of the staff including the owner of the practice takes a day or 2 off due to illness, it is hard on the whole practice and the patients of the practice as you are running short staffed. In some practices, the staffs get paid for their sick days up to a certain number. (Notice that the owner does not and that practice owners are sick far less often than the other team members as a general rule because of this.)

In many practices, there is no pay for sick days because the focus is on taking very good care to get enough sleep and eat healthy so that the team is all present every day to deliver perfect service to the patients. In most practices, a missing staff member is devastating in terms of a reduced level of care, not to mention income.

Some practices will pay up to 7 sick days per year, but if you do not use them, you can get paid for the unused days at the end of the year or in terms of time off at a convenient time for the practice. The intention here is for people not to use their sick days unless absolutely necessary.

Watch for Staff Pay Issues – Part 2 (overtime, vacations, etc.)


For executive training and one-on-one customized coaching, call us at:

416-466-6217 or click here


Creative Commons Attribution: Permission is granted to repost this article in its entirety with credit to The Art of Management Inc. and a clickable link back to this page.



Book free Practice Assessment

Scroll to Top


Fill in your information to book a Free analysis of your practice

christmas decoration

WAIT! We are offering
from now till December 20th!




You have nothing to lose –
except an opportunity to enrich
your practice!