Every practice owner I speak to at the moment is having some version of the same conversation. They can’t find the right people. The candidates aren’t what they used to be. The market is impossible. The salary expectations are unrealistic. The team they have is stretched, and the gap they’re trying to fill has been open for longer than anyone is comfortable admitting.

The instinct, understandably, is to look outward. To blame the market, the platform, the area, the generation. And there’s truth in some of it. The dental recruitment market is genuinely harder than it was five years ago.

But in nearly every practice I walk into, the real issue isn’t the market. It’s much closer to home.

Recruitment and retention problems are usually leadership problems wearing a recruitment costume. The job ad isn’t the bottleneck. The interview process isn’t the bottleneck. The bottleneck is what happens before the vacancy ever opens, and what happens in the weeks and months after the new person arrives.

Consider what most candidates actually walk into when they accept a role in a practice. A vague job description that doesn’t quite match the day-to-day reality. A handover from someone who’s leaving in a hurry. A principal who’s still secretly doing half the role themselves. A team that’s been understaffed for months and is too tired to onboard anyone properly. Standards that are spoken about but not consistently held.

Then, six months later, when that new person is struggling or has quietly left, the conversation turns to whether they were the right fit. The practice goes back to market. The cycle repeats.

The practices that are quietly recruiting and retaining well in this same market aren’t doing anything clever. They’ve done the slower, less visible work upstream. Roles are clearly defined. Standards are explicit. The principal has stepped out of doing everyone else’s job, which means there’s actual space for someone new to land in. The team has the bandwidth to support them, because the leader hasn’t allowed them to be permanently underwater.

When that work is in place, recruitment becomes much easier. The job ad almost writes itself. Good candidates respond to it. New hires bed in within weeks rather than months. Retention follows naturally, because people stay in places where they can do good work without friction.

When that work isn’t in place, no amount of cleverness in the recruitment process will fix it. You can pay more, advertise harder, and interview better, and you’ll still lose people within a year because the system around them was never built to hold them.

This isn’t a comfortable message, because it puts the work back inside the practice rather than outside it. But it’s also good news. The things that are within your control are the things that actually move the needle.

A useful starting point is to ask, honestly, what someone joining your practice next Monday would actually walk into. Would the role they were hired for match the one you described in the interview. Would there be someone with the time and authority to lead them properly through their first three months. Would the standards they were promised be held consistently across the team, or quietly bent depending on who was involved. Would the principal be available to lead, or absorbed in doing.

If the honest answer to any of those is no, that’s where the work is. Not in the advert. Not in the salary. Not in the candidate market.

There’s a temptation, when recruitment gets hard, to push harder on the recruitment itself. To run more ads, lift the salary, drop the standards, accept the first reasonable candidate. All of that is understandable, and all of it tends to make the underlying problem worse over time.

The harder, slower path is to use the vacancy as a prompt to look at what the role actually needs to be, and whether the practice around it is structured to make that role succeed. That work doesn’t fill the gap this week. It does start to break the cycle.

Most recruitment problems in dentistry right now aren’t really about recruitment. They’re about the conditions people are being recruited into. Fix the conditions, and the recruitment looks after itself.