How Many Patients Should The Hygienist See?
Cultivating a productive hygiene department is a priority for most dental practices. But the best way to accomplish this can be elusive. Let’s look at some of the strategies employed by many offices and how they might impact the practice’s financial health.
Should a productive hygiene department see more than the “average” number of patients? How many patients is average? For many practices this is at least 9 patients per day. (8 hours = 480 minutes divided by 50-minute appointments = 9.6 patients.) But are 50-minute appointments enough time? For many hygienists, trying to effectively take care of that many adult patients every day can make them feel they are truly on a treadmill. If these hygienists are also trying to provide perio charting plus schedule the patient’s next appointment, time actually spent on patient care can dwindle to 40 minutes or less. If the patient needs x-rays, patient care time can further dwindle to 35 minutes, and if possible perio or restorative treatment is identified and explained, it can go down even further. What about cleaning up after the last patient and setting up for the next patient. Can that be accomplished at the speed of light?
What actually happens in many practices is the hygienist always runs late; irritating patients waiting in the reception room, and causing stress and unhappiness to the hygienist, doctor, and the rest of the staff. Another possibility is patients receiving “just the basics” without a chance for possible appropriate perio or restorative treatment identification and recommendation. Neither is good for patients or the practice’s financial health.
Can a hygienist effectively treat up to 12 patients per day? If 9 standard adult prophys can be stressful, 12 can only be worse. At 12 patients per day, a hygienist has only 40 minutes to accomplish all related tasks plus provide the actual prophy. The addition of a hygiene assistant might make this schedule feasible, but one person working alone faces burn-out, exhaustion, and a feeling of futility. Plus, without adequate time to identify possible patient perio or restorative needs, the practice’s financial health will likely suffer.
Is moving patients through the hygiene department quickly the only way to justify the cost of the hygienist’s wages? Hygienists are typically the highest paid practice employee. Dentists often worry that without short appointments and high patient volume, they may not be getting their “money’s worth.” A dental office is an expensive business to run. Unlike a physician’s office, a dental practice is a “mini-hospital.” Rent or mortgage, utilities, supplies, equipment, disposables, computers, and staffing make the overhead of a practice a constant concern. Looking at a packed hygiene schedule can provide a feeling of security. The patients are coming in and the expensive hygienist is busy. But there is another way to look at it. What if a hygienist has more time, say, at least an hour for a standard adult prophy?
Hygienists who identify possible perio and restorative treatment, and who have the luxury of time to explain to the patient and discuss findings with the dentist when s/he comes in for the recall exam, affect appropriate patient care and the financial health of the practice in a very positive manner. Scaling and root planing needs can be identified and scheduled, providing necessary treatment for patients and increased income for the practice. Subsequent periodontal maintenance ensures lasting patient health for those who need it at double the fee of a standard prophy. When added to the fact that perio maintenance is often required four times a year, the financial impact is significant. Non-perio patients who are identified as needing more frequent prophys can also be important. Although most insurance plans only cover two prophys annually, patients who need to come in more often can be counseled and encouraged to accept a more frequent schedule. Just 50 patients who go from twice a year (at $80) to three times a year can add $4000 to the practice’s bottom line!
When a hygienist identifies necessary restorative treatment, it is important to have time to go over what has been found with the patient before the dentist comes in. When the dentist arrives, s/he can confirm the findings. From the patient’s point of view, two pairs of eyes have seen the problem, lending credibility to the need for treatment. If the hygienist has also had time to take a photo as illustration, patient acceptance is further enhanced. If only 50 patients a year accept necessary crown restorations (at $1,100 each) $55,000 can be added to the practice’s bottom line.
Given adequate time, there are many other ways a hygienist can bolster positive patient care and practice finances:
While each dentist must decide how many patients their hygienists should see each day, there is a great potential for increased office revenue when adequate appointment times are employed. The financial impact of the hygiene department can extend far beyond what they produce directly at the chair.
Carol Tekavec RDH is the director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office”. Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
Carol is also a speaker on hygiene efficiency and profitability for McKenzie Management. Interested in having Carol speak to your dental society or study club? Click here
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