Last week: the fastest ways to find great people, from renaming the job to screening with video. This week: keeping them.

Orthodontists at AAO 2026 Said Keeping Good People Is a Top Challenge. Here’s the Culture Fix.

When orthodontists at AAO 2026 were surveyed on their biggest challenges, retaining and supporting their team made up nearly 11% of everything they named, on top of the 25% that went to hiring. Finding great people is hard enough. Watching one walk out the door right after you finished training them is worse.

Pay matters. Culture matters more. MIT Sloan Management Review studied attrition across hundreds of the largest U.S. employers and found a toxic culture was 10.4 times more powerful than compensation at predicting which companies lost people. Those were big companies, and I’ve watched the same thing play out in small ortho offices for years.

Culture is what happens when you’re not in the room

I’m the culture guy, so you knew this was coming. Your culture is how your team treats a nervous parent, each other, and the new Smile Stylist while you’re in the back with a patient. Three moves keep it strong:

1. Live your core values out loud. Use them in your huddle, your reviews and your praise. When someone nails one, say which value they just lived. Values that only live on a wall stop meaning anything.
2. Ask why they stay, before they leave. An exit interview tells you why someone quit, a few weeks too late. A stay interview asks your best people why they stick around while they still do. Try these three questions: What do you look forward to when you come to work? What would make you think about leaving? What’s one thing I could do to make your job better? Then act on at least one answer.
3. Show them a path. The same MIT research found lateral career opportunities were 2.5 times more predictive of retention than pay. In a small office, that could mean a Smile Stylist learning to run consults, a Director of First Impressions moving into insurance and billing, or your best assistant training to become a Rainmaker.

Take the weight off with an AI receptionist

Burned-out people leave, and the front desk burns out fast. Phones ring while a parent is checking out, voicemails pile up over lunch, and the same insurance question comes in a dozen times a day.

An AI receptionist answers your calls after hours, during lunch and when every line is lit up. It can book new-patient consults, answer routine questions like your hours and location, and text back anyone who hangs up. Your Director of First Impressions gets to focus on the person standing in front of them.

Say out loud that this is support for your team. The first thing your front desk will wonder is whether they’re being replaced, so answer it before they ask. Three rules for a smooth start:

1. Start with after-hours and overflow calls only.
2. Let your front desk help write the scripts, since they know every question patients ask.
3. Choose a vendor that will sign a Business Associate Agreement, because it will handle patient information under HIPAA.

Crazy Enough to Work: “Learn AI Here”

Plenty of young workers wonder what AI means for their future. So answer it for them. Train your whole team on the AI tools you use, give everyone a certificate when they finish, and put “Learn AI skills here” right in your job ads. The job down the street probably isn’t offering that. You get a growth path for your team, a reason for them to stay, and a line in your ad that stops the scroll.

Something new is coming

Every idea in this issue comes back to one person on your team: the one you want to keep, the one who needs a path, and the one quietly wondering if AI is coming for their job. I’m building something for that person.

For 9 weeks, live with me every Tuesday, one person already on your payroll learns to build AI systems inside your practice. We’ll cover everything from today’s issue and a lot more: SOPs, a dashboard you’ll actually open, a Practice Brain that keeps your values, policies and voice in one place, and plenty beyond that. Everything they build stays with you.

There are some special perks and discounts for the first practices in. And if the person you train ever moves on, I’ve built in a way to make sure you’re not left starting from scratch.

It drops soon. Watch your inbox next week for the details.

Next week: why most new hires still feel lost a month in, and a training coach that never gets tired of the same question.

P.S. If candidates keep ghosting your interviews, start a free ScreenHire trial at screenhire.me.