Chapter 11: Commissioning Employees (Treatment Coordinators & More)

Commission vs. Base Salary: What Works Best?

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.