Hygiene Production - More than Today’s Numbers
A hygienist is an expensive employee; which is why it is always important to consider his/her compensation against actual production numbers generated for the day. One third of the hygiene day’s production goes for compensation, two-thirds goes to the office. This formula can keep the hygiene department profitable. However, the true picture of what a hygienist can generate in terms of office production is not completely revealed by these numbers. For example:
Sam, age 60, is the owner of a small business, and as such does not have dental insurance. He comes in faithfully every six months, but has been adverse to addressing some of his dental issues. His attitude has been that since he is “old” his teeth don’t need to last too much longer. He has good home care and a nice smile. However, he is missing #19 and the teeth on either side are tilting, as well as some extrusion into the gap from above. His hygienist, Jennifer, has been telling him about implants during his last eight hygiene visits. Sam has said that an implant is too expensive, that the gap doesn’t really show that much, he is eating just fine, and besides that, “I’m too old!”
Not discouraged, Jennifer continues to let Sam know that getting an implant is an option. She explains that it will stop the adjacent teeth from continuing to tilt, the top teeth from continuing to extrude, and that the presence of the implant body will help keep the bone around the gap from deteriorating. Today Jennifer shows Sam a radiograph of the area (just as she has many times in the past) and talks more about the relationship between roots and bone. For some reason, today the explanation strikes a chord. Sam says that his father had a removable partial that he hated. He tells her that the partial got looser and looser, in addition to some of the anchor teeth deteriorating. His father ended up with an unsatisfactory denture. Sam does not want this to happen to him. When Dr. Smith comes in for his exam, Jennifer tells him what she and Sam have been talking about. Dr. Smith explains what Sam might expect with an implant procedure and how his treatment would be handled. Sam agrees to the implant and crown and Jennifer takes him to the coordinator to arrange for appointments and payment. Why was today different? Why did Sam “suddenly” agree to treatment?
Sometimes, repetition is the key to treatment acceptance. Other times it is introducing an aspect of care that perhaps had not been emphasized. Both seem to have been at play in this patient’s situation. Jennifer had told Sam many times about the value of implants and how they help preserve bone. However, today’s discussion about losing bone seemed to “click” and be important to his decision. All of our patients have their own primary concerns and when we address them, treatment acceptance will likely follow.
Joanie, 45, is a professional woman with a busy, busy life. She makes time for her recall appointments, but she is also “that patient” who never puts her cell phone down. Jennifer notices that two of Joanie’s molars are showing cracks in tooth structure adjacent to existing resin restorations. She talks about these while performing the prophy, and when finished, takes two photographs for Joanie to look at. Joanie can see the cracks in living color and huge detail on the television mounted in the treatment room. Jennifer tells Joanie it’s likely that Dr. Smith will recommend full coverage crowns for these teeth. Otherwise cusps can break and nerves can be exposed. While Jennifer talks about what might be recommended, she also explains that Dr. Smith will make that determination. When Dr. Smith comes into the treatment room, Jennifer tells him what she and Joanie have been talking about and shows him the photos. Dr. Smith confirms that full coverage crowns are recommended. At this point Jennifer interjects that Joanie is so busy…what might be done to expedite her time. Now Dr. Smith can explain that the office CAD/CAM capability will allow for a one-day prep and cementation for the crowns, a big plus for Joanie. She agrees to the crowns and schedules an appointment for next week.
A hygienist gets to know patients and often grows to understand what is important to them. Knowing Joanie’s time constraints enabled Jennifer to help Dr. Smith highlight the fact that crowns could be prepped and cemented in one day. This made it much easier for Joanie to say “yes” to treatment.
While both Sam and Joanie were scheduled for adult prophys, four bite-wings, and a recall exam, far more was accomplished during their appointments. Just for discussion’s sake, let’s say that the total logged into production was $215 for each appointment; ($100/prophy, $55/4 BWS attributed to hygiene production and $60/recall exam attributed to doctor production). While those figures show what was generated today, what about what will be generated next week? For example, $1200 for implant placement, $1000 for the implant crown for Sam. For Joanie, $1000 x 2 for two full coverage crowns is scheduled. Total production = $4200 for the office.
The hygiene department provides a valuable service by providing patients with preventive and therapeutic treatment. In addition, identifying concerns and possible solutions helps patients to receive the restorative treatment they need. Hygiene services plus input on necessary treatment makes the hygiene department very important to overall production. Hygiene production is not just about today’s numbers. It is about continuing to support and fuel general office success. For more information on how you can improve the hygiene department in your practice, view our Hygiene Performance Program HERE.
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.
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