Labor protections just got stronger. What does this mean for your dental practice?

The Department of Labor (DOL) kicked off 2024 with a significant rule, which will make it more difficult for employers to classify their workers as independent contractors. What does this mean for dental practices and organizations, which have historically relied on temp workers and a flexible gig economy? In light of this rule, how can dental leaders mitigate financial and legal risk?

February 7, 2024

The Department of Labor (DOL) kicked off 2024 with a significant rule, which will make it more difficult for employers to classify their workers as independent contractors.

What does this mean for dental practices and organizations, which have historically relied on temp workers and a flexible gig economy? In light of this rule, how can dental leaders mitigate financial and legal risk?

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"Dentists often remind me that they “never signed up for this."

—Joe FoggCEO, Founder of onDiem

 

By “this,” of course, they’re not talking about delivering essential and critical oral care. They’re referring to the complicated skills and tasks required to run a business smoothly and effectively: the human resources paperwork, the compliance research, the office management, the marketing and outreach, the financial planning, the payroll taxes, the vetting, the credentialing, and so much more.

“I wanted to focus on caring for an underserved community,” one of our clients told me. “I didn’t realize I would spend so much invaluable time fixing employee classification issues at my organization.” Another dentist said, “I signed up to become a dentist, not a compliance expert. I had no idea I had to become both.”

Concerns like these are why we’ve always been proud to be the first fully W-2 compliant and nationally available dental staffing platform. We’ve known, from very early on, that it was the right thing to do. Being a W-2 platform means our dental practices and DSO partners don’t need to worry about expensive legal risks, and that they get to focus on patient care and new business growth instead of the tedium of compliance. It also means our professional community—our dental hygienists, assistants, and front-office staff—enjoy vital W-2 benefits and protections while enjoying all the perks of a flexible lifestyle.

“I signed up to become a dentist, not a compliance expert. I had no idea I had to become both.”

These concerns are also why we pay close attention when governing bodies and legislators alter laws that would affect our dental community.

A Landmark Ruling

On January 9th, the Department of Labor (DOL) announced a final ruling that would make it significantly more difficult for companies to classify their employees as independent contractors. Among the significant things to know:

  • The “Employee or Independent Contractor Classification Under the Fair Labor Standards Act Final Rule” goes into effect March 11, 2024. It overturns the 2021 Independent Contractor Rule in order to be more consistent with “longstanding judicial precedent,” reduce misclassification risks, and provide greater clarity and consistency for businesses that rely on contractors. 
  • The goal of the Fair Labor Standards Act (FLSA) “Economic Reality” test remains the same: to determine whether the worker is “economically dependent on the employer for work or is in business for themself.” The factors in the test: 
    • (1) opportunity for profit or loss depending on managerial skill
    • (2) investments by the worker and the potential employer
    • (3) degree of permanence of the work relationship
    • (4) nature and degree of control
    • (5) extent to which the work performed is an integral part of the potential employer’s business
    • (6) skill and initiative
  • Each of the factors will now be considered equally to determine worker status—making it harder to satisfy the test. Employers will need to think of the FLSA test as a “totality-of-the-circumstances” test—where no factor is prioritized over the other. Employers must also now consider six factors (previously five), including investments by the worker and employer—and understand an updated analysis on how scheduling, supervision, price-setting, and ability to work for others affects the “nature of degree of control” factor.
    • For context, the previous 2021 rule placed greater weight on the two “core factors” of control and opportunity for profit or loss; limited the consideration of “worker investments and initiative,” and did not allow consideration of whether or not the work performed was central to the employer’s business.

While some opponents have already announced their intent to challenge the ruling, existing state dental practice acts, IRS criteria, and DOL regulations have long affirmed strict and indisputable guidelines for classification.  

“Under applicable IRS and Department of Labor regulations, it is improper to classify most hygienists who work at dental practices as 1099 contractors, even when they are only working part-time or as a temp,” affirmed Brian A. Colao, DSO Industry Group Director at Dykema. “The regulations are very clear, and there can be significant consequences for misclassification of employees as independent contractors …  In my experience, many practice owners across the industry are needlessly exposing themselves and their staff to significant legal risk by misclassifying employees as independent contractors." 

When I meet with dental practice owners, DSO leaders, or state dental association leaders, I tend to ask, “Does your state dental practice act allow hygienists to have independent practices?” The answer is almost always “No,” because with very few exceptions, state dental practice acts state that hygienists must work under direction of control or direct supervision. That means hygienists cannot be independent contractors—and that any employer who hires them as independent contractors is doing so illegally.

We don’t need to look too far to find misclassification and W-2 (non)compliance horror stories in dentistry and beyond. For the professional, misclassification often means a lack of access to basic labor protections. For the dental practice or organization, misclassification can lead to (and has led to) costly and timely classification corrections at best—and multi-million dollar lawsuits and criminal penalties at worst. 

But in a world complicated by legalese and fearful repercussions, what are the solutions? What can a dentist, office manager, or DSO leader do to stay compliant and on the right side of the law—all while quickly and reliably filling dental chairs in the midst of an industry-wide labor shortage?

onDiem: What Dental Practices and Organizations Deserve

The simple answer: Using a W-2 compliant service like onDiem removes your legal and compliance risks, allowing you to focus on other aspects of patient care and business growth.

The longer answer: Dentists come to onDiem with a variety of concerns and asks, and they tend to to fall into the following four themes:

  • I need dental staff now. “Can you provide dental hygienists, dental assistants, and front-office staff today?”
  • I want to connect with the most qualified talent. “I’m done hiring unreliable workers with questionable credentials. Can you give me access to professionals who are qualified, vetted, certified, and ready to work?” 
  • I want my dental team to perform better. “Can you provide temps that seamlessly integrate with my existing team to enhance our performance?”
  • I want to grow revenue and production. “Can you keep my seats filled, so I can finally maximize production and think about growth?”

Traditional dental staffing solutions tend to focus on addressing urgent, temporary staffing needs—which isn’t necessarily wrong, but can often be shortsighted and lead to costly hiring blunders and compliance issues. In light of the DOL’s new rule, it’s more important than ever for employers in our industry to choose a workforce management solution that’s capable of addressing all four concerns legally and safely.

 

Rather than provide a temporary band-aid to temporary staffing, onDiem’s dental staffing platform gives practices and DSOs a workforce management solution that not only fills empty seats, but increases the value of their business through staffing. It all starts by seeing issues like the DOL ruling as less of a “restriction,” and more of an opportunity to create a mutually beneficial employer-employee relationship. Here’s how we do it, in a nutshell:

 

  • We provide dental staff now. We give employers access to the largest W-2 compliant dental professional community in the country.
  • We connect practices with the most qualified talent. We vet and qualify all dental professionals on our platform, saving invaluable time. We do all we can to make hiring simple by taking care of all the compliance and classification headaches.
  • We provide complementary staffing for dental teams. Instead of seeing our job-seekers as just “temps,” we invest in them as potentially key and integral members of your dental team. Every single job-seeker on our platform enjoys W-2 perks and protections that keep them stable, happy, and ready to work. We work with you to complement your existing team with hygienists, assistants, and front-office staff who are among the most reliable in the industry.
  • We work with practices to identify new growth opportunities. We collaborate with dentists to transition to a “staffing for production” model, which allows practices and DSOs to open new columns, open on weekends, and take advantage of other methods to improve revenue and production.

All of this, from providing qualified staff to unlocking new business growth, is possible precisely because we see classification and compliance requirements as positives—not barriers—for our industry. Every single professional on our platform enjoys W-2 benefits and protections. And because they enjoy benefits like PTO, flexible scheduling, health insurance, wellness reimbursements, workers’ compensation insurance, association membership discounts, and more—our dental professionals are more dependable, reliable, eager to work, and able to flex to our practices’ needs. Our dental practices and DSOs, in turn, can post jobs and hire for greater production and revenue, because we take care of all the hiring, payroll, benefits and compliance work at a controlled cost.

“All of this, from providing qualified staff to unlocking new business growth, is possible precisely because we see classification and compliance requirements as positives—not barriers—for our industry."

Our team is always happy to sit down with dental leaders to provide more detail—and to gain new insights that help us tailor our solutions. We’re also more than happy to share more thoughts on the DOL ruling, and work together to help your business mitigate any financial and legal risk. As rules shift and change, we’ll continue to educate our community, and make all necessary modifications to our dental staffing service to give our dental practices the ultimate peace of mind.

Dental practices and DSOs might be feeling the squeeze from the labor shortage and from stricter labor rules, and perhaps that feeling of “I didn’t sign up for this” is stronger than ever. Luckily, onDiem did sign up for this. Everyday, we’re providing and improving upon the only workforce management solution that gives our industry the thoughtfulness, insight, and effectiveness it deserves.