Commission vs. Base Salary: What Works Best?
When structuring pay, orthodontists often debate between straight salary, full commission, or a hybrid model. Let's break down the options.
1. Base Salary Only (No Commission)
Pros:
Provides financial stability for the employee.
Easier to budget payroll expenses.
Eliminates concerns about aggressive sales tactics.
Cons:
No direct incentive to increase case acceptance rates.
May lead to lower motivation for performance-based roles.
Best for: Front desk staff, assistants, or employees who don't directly drive revenue.
2. Full Commission (No Salary)
Pros:
Motivates employees to perform at a high level.
Aligns their success with the practice's success.
Eliminates overhead from fixed salaries.
Cons:
Can create inconsistent income, leading to stress for employees.
May encourage pushy sales tactics that hurt long-term patient relationships.
Not ideal for positions requiring stability.
Best for: Highly experienced treatment coordinators who are confident in their ability to close cases consistently.
3. Hybrid Model (Base Salary + Commission/Bonus) – Recommended
Pros:
Provides financial security while rewarding performance.
Encourages higher case acceptance and same-day starts.
Balances motivation without feeling like a "hard sell."
Cons:
Requires careful tracking and payroll management.
If structured poorly, employees may lean too much on base pay and not push for results.
Best for: Treatment coordinators and key front-end staff who directly impact revenue.
Example Hybrid Model for a Treatment Coordinator:
Base salary: $45,000 - $60,000 per year.
Commission: $100 - $250 per same-day start (varies by case value).
Bonuses: Additional quarterly or annual bonuses for meeting overall revenue or start goals.
This model ensures the TC has financial stability while still being motivated to close more cases.