Staff Management

Increasing Commitment: Four Keys to Retaining Valued Employees

By Melanie J. Denton, OD, FAAO,

and Paul Johnson, MBA, PhD


Retaining and developing valued employees is critical to delivering superior care–while losing employees and having to rehire and retrain is costly. Follow four steps to building the commitment level that ensures employee retention.


INVEST IN EMPLOYEE DEVELOPMENT. It pays to financially and emotionally support employees’ continuing education and attainment of certification.

HAVE STAFF RETREATS. Bond with employees over fun activities and sharing a brainstorming session.

RECOGNIZE UNHAPPY EMPLOYEES. Look for absenteeism and negative attitudes, which lead to hostile patient interactions.

Retaining good employees–those who exhibit a high level of commitment to your practice–is criticalto providing consistent quality care and in capturing the profitability that stems from that. Losing employees, then shouldering the added costs and time commitment of recruitment and training, is a profitability killer. On average, the additional costs incurred by a business to replace an employee is about 40 percent of their initial salary, or as much as $15,000, for the employee lost. Recruitment, selection, training, and the lost productivity associated with new employees learning their jobs cuts into your profitability.

For example, a front desk employee who makes $30,000 annually costs $12,000, on average, before they are hired and fully trained to do their job. This isn’t to say that you should have no turnover. Some employees cost more to keep than to replace, but you need to motivate the good employees to stay with your practice. How do you do this? The first step is to understand what commits a person to your practice.


For detailed metrics on staffing size, turnover rate and salaries, consult pages 38-41 of Key Metrics: Assessing Optometric Practice Performance from theManagement & Business Academy, sponsored by Essilor.

Are Your Employees Staying Just Because They Have To?

Many people stay on a job just because they need the money. Unfortunately, employees coming to work because they have bills to pay is a bad way to be motivated and engaged in their job.

Key characteristics: Employees who experience commitment based on financial needs fulfill the basic requirements of their job, but no more. They’re OK, but not your extraordinary workers. For example, this is the pre-testing technician who follows a checklist of tests to conduct for each patient, but won’t bother to engage the patient in the conversation that would reveal visual issues to pass along to the doctor. Or they may pick up on an issue through casual conversation with the patient, but then not care enough to bother to note it in the patient’s record or otherwise communicate it.

What to do: Pay a competitive wage considering the cost of living in your area. Do you offer benefits or a contribution toward obtaining them? An employee staying someplace based on need only will switch to another position as soon as a better opportunity presents itself. Sites like will give you an idea of average salaries in your geographic area, and Jobson Optical Research’s 2014 ECP Compensation Survey will give you a sense of optical industry averages.

Are Your Employees Staying Because They Feel Obligated?

Sometimes employees feel like they are obligated to stay with your organization because you did something extraordinary for them. An employee could feel this way because you’ve gone above and beyond as an employer to accommodate their school schedule, their childcare schedule or to help them out in some other way that was meaningful to them.

Key characteristics: This is the employee whose training you have invested in such as the optician you paid to attain an ABO, or the staff member who became a certified para-optometric assistant with your help. Both financial coverage, as well as emotional support from the boss, leads to an employee who doesn’t want to let her employer down by leaving.
What to do: Have a training and development plan for each employee that engages them with you and your practice. When an employee is first hired, you can discuss with them a development plan, including various certifications they would like to pursue and other forms of continuing education. You can also touch on the new employee’s desired career path–for instance, whether they are happy staying an optician, or whether they might eventually like to become an office manager.

Do Your Employees Genuinely Want to Be There?

The best form of commitment to an organization is when people want to be there. Employees who want to be at work result in patients who feel well cared for and satisfied with their experience. Emotions are contagious. Patients can quickly pick up on the emotional state of your staff, and it affects their perceptions of you.

Key characteristics: These employees come to work each morning because they’re happy, not because they need to pay bills or because they feel obligated. A strong, positive attitude toward your practice creates stronger ties than money. This is the office manager who gets to work early and stays late just to do the little extras that make a difference like making sure the glass frame display cases are smudge-proof, the frame board is in order and there are no patient eyewear or contact lens orders remaining to be processed. On the other hand, an employee who doesn’t want to be there may be curt with patients, snapping “What do you want?” whenever a patient approaches for help.

What to do: To encourage employees who genuinely want to be there, help them feel a connection to their work, colleagues, you and your practice vision. You can encourage this with activities that create friendship bonds between employees and makes the workplace interesting and fun. For instance: A one-day or even half-day retreat a couple times of year in which employees bond doing an activity like cooking a meal together or taking part in an outdoor sport or activity followed by a practice growth brainstorming session.

Increase Employee Commitment: Four Keys

Listen to your employees. Most people like to exert influence over their environment, so give your employees their voice. Set aside a regular meeting time, such as a weekly staff meeting, at which team members can convey their suggestions, concerns and frustrations. It’s important to ensure these meetings are safe, inviting events for employees to bring up their thoughts. You don’t have to act on these, but you should respond thoughtfully. Also, use this time to celebrate successes and accomplishments of your employees and the practice. An added benefit is that you may learn something about the operation of your practice that could enhance efficiency or the patient experience.
Make your office a place people want to be. Concentrate on making the office environment a welcoming one. Be cognoscente of how your employees build relationships, both with patients and their co-workers, and help them succeed at both. You don’t want your employees socializing at the expense of your patients, but you do need them to develop a mutual like and respect with one another and patients. For example, if you notice employees and patients are both enthusiastic social media users, have staff members participate in promoting the practice on Facebook and other social media sites.
Compensate them well for their hard work and dedication. Know your area and what competitive wages are for each job. Be fair. Consider offering benefits if you can. You can bet your employees have friends who work at a dentist’s or lawyer’s office, and they will compare notes.
Recognize withdrawal behavior and address it promptly. If a valued employee starts to show signs of detachment from your practice such as absenteeism or a negative attitude, act to recommit them. Have a conversation about what you’ve noticed in their behavior and what you can do to help them be happier at work. Sometimes it isn’t your practice that is causing their unhappiness, but rather family or money problems. Showing concern for their well-being often makes them feel valued.

By increasing your employees’ commitment to your practice, you can experience lower levels of turnover, higher levels of profitability, greater patient satisfaction and a better work experience for yourself, as well.

Related ROB Articles

Lessons for the Optometric Practice from Ritz-Carlton

Front Desk Training: Prepare Staff for Challenging Conversations

Comprehensive Training: Prepare Every Employee to Deliver Superior Service

Additional Resources

One Foot Out the Door: How to Combat the Psychological Recession That’s Alienating Employees and Hurting American Business

How to Retain Staff and Increase Profits: Article and Video with Eight Tips
Culture Matters: RetainingEmployeesand Increasing Profitability

Melanie J. Denton, OD, FAAO, practices at several locations in the Asheville, NC, area. To contact her:
Paul Johnson, MBA, PhD, is an assistant professor in the Global Management and Strategy Department of Western Carolina University inCullowhee, NC. To contact him:

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