09.29.06 - Issue # 238 Forward This Newsletter To A Colleague

How to Establish Hygiene Goals…and Reach Them!
A McKenzie Management Case Study


Nancy Caudill
Senior Consultant
McKenzie Management
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Dr. Sam Snyder - Case Study #246

Dr. Snyder contacted our office and was upset because his hygienist wasn’t busy.  He wanted to know how to motivate her to work.  This article is devoted to establishing a daily hygiene goal for his hygienist…and the process will work for you, too. 

Salary Based Goal
The industry standard on hygiene net production is 3 times their daily salary.  Here is how it works:

  • Helen the Hygienist makes $325 a day.
  • Her net production goal is $325 x 3 = $975

There are a couple of factors that must be considered:

  • Helen does NOT get production credit for the exams – the doctor does.
  • When scheduling is done, it is based on gross production – not net production.  This means that the Hygiene or Schedule Coordinator does not have factual information pertaining to how many production dollars will be adjusted as a result of PPO adjustments, senior citizen courtesies, cash courtesies, etc.

Scheduling goals must be based on GROSS production numbers and not NET production.  In order to determine the gross production you must run a computer-generated report that reflects the production adjustments for the past 12 months and use this as a guide.

For example:  your report lists all the adjustments that were posted last year.  Some adjustments effect the production and some adjustments effect the collections.  Production adjustments are items such as bad debt write-offs, PPO write-offs, courtesies, professional adjustments, etc.   
The total production adjustments are $25,000.
The total production for the practice is $500,000.
$25,000/$500,000 = 5%

Add 5% to the initial production goal of $975 = $1,024 for the daily GROSS production goal

How To Schedule to Meet a Hygiene Goal

Building a “perfect” hygiene schedule is like creating a puzzle.  It only fits together correctly with the right pieces.  To determine what the right pieces are, we need to calculate the hourly schedule goal of the hygienist:

            $1,024 divided by # of hours worked per day (8) = $128/hour

We also need to determine the hourly value of the hygiene procedures.  For example:

Adult Prophy fee is $85.  If the hygienist performs this procedure in 50 minutes, the hourly rate for this appointment is $85/50 x 60 min = $102/hr.  If she needs 60 minutes, then she is producing $85/hr.  This is a $17 difference.

Adult Prophy and 4 BWX is $130.  This appointment is also scheduled for 50 minutes.  The hourly rate for this appointment is $130/50 x 60 min = $156/hr.

Child Prophy, 2 BWX and FL is $113 and is performed in 30 minutes.  $113/30 x 60 min = $226/hr!  Did you realize how profitable a child Prophy is?  How your hygienists will be begging for the kids!

2 quads of SRP @ $215/quad and performed in 90 minutes is $215 x 2 = $430/90 x 60 min = $287/hr.

Now that we know what the value is of these procedures, it is easy to see that if the entire day is comprised of adult prophies and no x-rays, the daily goal will not be met.  However, if all the patients needed x-rays, we would.  But we know that only 50% of the patients are going to need x-rays since they are usually taken once a year so this isn’t likely to be scheduled.

The difference between reaching goal and not reaching goal is in the diversity of the appointments.  Let’s look at this example:

1.5 hours of SRP @ $430
3.0 hours of adult prophies with BWX @ $390
3.0 hours of adult prophies w/o BWX @ $255
0.5 hours of child Prophy, BWX and FL @ $113
TOTAL GROSS PRODUCTION = $1,188

Imagine how much more productive Helen would be with more children or more periodontal therapy!

Now that Jane has some facts, she realizes that she can’t fill her hygiene day with just prophies…she must leave room for other procedures.  She must orchestrate her day the way that she wants it in order to achieve her goal.  Give your scheduler the tools she needs to reach the hygiene goal.

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email info@mckenziemgmt.com.

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McKenzie Management
A Division of the McKenzie Company, Inc.
3252 Holiday Court Suite 110
La Jolla, CA 92037
Email info@mckenziemgmt.com
1.877.777.6151
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