The Hygiene Profit Center
In most general practice offices, the hygienist is a “stand-alone” member of the team. This person often works alone in a treatment room and is responsible for radiographs, periodontal charting, local anesthesia, non-surgical periodontal treatment, prophys, fluoride treatments, sealants, oral hygiene education, and maintenance of instruments. In some offices, the hygienist may provide even more services such as laser disinfection of pockets and biological testing.
While hygienists are undoubtedly members of the team, their responsibilities mean that they function somewhat differently than the rest of the staff. Business personnel provide vital support, systems structure and finance implementation. Assistants provide invaluable supporting clinical services and back-up for the dentist. Hygienists, however, provide services that both support the practice and constitute a separate production and profit center for the practice. Hygienists function as separate treatment providers.
What does this mean? For most offices, this means that the hygienist’s production has a dramatic impact on the financial health of the practice. Couple that with the ability of the hygienist to identify and support patient treatment during the course of a “recall” appointment, and it can easily be seen that a healthy hygiene department encourages patients to receive the treatment they need - therefore greatly enhancing a practice’s bottom line.
For some hygienists, thinking about their services as a “profit center” goes against the grain. Why is this? Many hygienists are drawn to the profession because of a desire to be of service to patients. They may be aware and strongly supportive of patient care and treatment, but somewhat less cognizant about the relationship between what they do and what the office “makes.” Some may not be comfortable with any idea regarding patient treatment that they associate with “selling.”
This does not have to be the case. Core functions of a dental office include identifying and treating dental disease, plus providing information and tools to patients to prevent further deterioration of their health. These are the services patients need, and these are the services for which an office is paid. Therefore it follows that identifying, treating, and providing tools need not be perceived as selling. These activities are merely part of the function of the practice. With this in mind, there are many ways that a hygienist can truly help patients while also enhancing practice profitability.
1. New patients need to receive a complete periodontal evaluation - which may minimally include radiographs, periodontal charting, the hygienist’s assessment (either at a first or subsequent appointment) and the dentist’s exam. If periodontal disease is revealed, it should be explained and treated. The hygienist’s role in the evaluation and patient education process is essential. Despite the fact that dental insurance only provides payment for basic treatment (which may mean two prophys annually) patients should not be receiving “cleanings” when they really need periodontal scaling and root planing. Hygienists can help patients understand and encourage them (sell them on the idea) to accept complete treatment even if insurance doesn’t pay for it.
2. At recall appointments, the hygienist can identify potential restorative needs the patient has, show them to the patient, and reveal these concerns to the dentist when he or she first enters the treatment room for the exam. This sets the stage for patient acceptance of restorative treatment. The hygienist sees it, the dentist “confirms” it, and the patient feels comfortable going ahead with care because from his point of view, two pairs of eyes have identified his needs.
3. The hygienist can help identify and support patient recall intervals. While many patients expect the traditional six-month recall (and most insurance plans only pay toward this) their individual issues may require more frequent treatment. The hygienist can explain why certain intervals are recommended and encourage patients to accept an individualized schedule.
4. Certain home-care products or tools may be made available at the office for sale to patients. While some “give-aways” such as floss or toothbrushes may be a standard, other items may be set up to be purchased from the practice. The hygienist can help identify which products are beneficial, and subsequently promote their purchase and use.
Next time - Coding for Hygiene Services.
Carol Tekavec CDA RDH is Co-Director of McKenzie Management’s Hygiene Division, a speaker on dental records, insurance coding and billing, and patient communication for McKenzie Management.
Interested in having Carol speak to your dental society or study club? Click here
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