I was speaking to a client about this recently and an often quoted phrase came to me which is that the single biggest reason as to why people leave their job is their manager/boss.

It got me thinking, well where did this phrase come from in terms of the evidence to back this up and what is the latest? A great deal has happened in recent years and there is considerable focus currently on the cost of living, shortage of staff and as a result levels of pay.

It is difficult to find the original evidence for the statement that the single biggest reason for people leaving is their manager. It may have came from the Harvard Business Review Article Why People Quit Their Jobs which states that in general, people leave their jobs because they don’t like their boss, don’t see opportunities for promotion or growth, or are offered a better gig (and often higher pay) and that these reasons have held steady for years. However, I don’t see a reference for that in the article and it quickly moves on to say they also studied when people leave and they found it is often associated with certain moments and times in life when people typically take time to reflect, compare and assess where they are in their lives. This can be significant birthdays or events and of course the COVID epidemic really gave people that moment to sit back and assess, hence the great resignation that occurred there after.

There was a second article in the Harvard Business Review entitled Why People Really Quit Their Jobs which was based on some research done at Facebook. This stated that people do quit a job (not just their Manager) because they don’t like the work, their strengths were underused or they weren’t growing in their careers. The point they make though, is that the person responsible for this is their manager.

What is interesting in more recent surveys, such as carried out in the US in 2022 by Flexjobs, they found that the number one reason people quit their jobs was a toxic work culture at 62%, closely followed by low salary and poor management. A further more extensive analysis published in the MIT Sloan Management Review also found that toxic work culture was the number one reason why people quit and it being 10 times more powerful than how people viewed their compensation. What is a toxic work culture? They say there are 5 different areas which are the culture being disrespectful, noninclusive, unethical, cutthroat and abusive. Again, who is responsible for this? The manager or the overall leaders and leadership of the practice. People are no longer willing to put up with this type of culture and will leave if it exists.

I still liken this both to Maslow’s hierarchy of needs and Herzberg’s hygiene versus motivation factors. You have to fulfil the basic human needs and provide good enough working conditions. Pay is for sure a part of this and people do need to be paid to a certain level, but it is probably not as important as most people think and not as likely to cause somebody to leave as a toxic work culture which in essence is the equivalent to poor working conditions, which previously were physical many years ago, but now are more mental in terms of the psychological environment. When these things are satisfied then it is showing that what people do makes a difference and that there is opportunity for growth and development in their role which helps keep people.

Within dentistry roles can be very specific but there is still plenty of opportunity to recognise that their work matters and to provide growth in other areas. You have to work on the culture of the team and the whole practice. This is about looking at your own leadership skills in order to create the right culture for your practice. How aware are you of the culture that exists? What behaviours and beliefs exist in your practice? This isn’t just about your direct interactions but also the interactions between team members and outside stakeholders. All this can be worked on in order to develop your culture and improve your levels of retention.

This finally leads me onto an important point, which is that you have to be able to measure and analyse your levels of retention. I find it is often more anecdotal. Perhaps a popular person in the practice is leaving and this causes a response which leads to a story being created of low retention levels. This can be misleading. Instead, measure exactly how many people are leaving as a percentage of your total team on a rolling basis. Track how it is moving and see what the trend is. Analyse the leavers and the potential reasons. Doing good exit interviews to understand the real reason is vital. Is there a difference between different employees? Is it newer or older employees? How else can you segment your employees? What themes does this show in terms of the challenges and reasons for people leaving that are specific to your practice? For example, it could show that it is female nurses between the ages of 25-35 who are leaving. What is the reason for that? When you have this information you can create a plan to overcome these issues.

Ultimately it is down to the leader as to why staff leave. This can be in terms of how that person is treating that individual directly or it can be due to the broader culture the leader has created.