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9.26.08 Issue #342 Forward This Newsletter To A Colleague

Angie Stone RDH, BS
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Hygiene Practice Enrichment Program

McKenzie Management received a call from an office manager, Suzie, who was aware the hygiene department in her practice needed improvement.

Because she had read many McKenzie Management E-Newsletters she was aware of what the hygiene production numbers should be. She also knew their numbers were not on target. In fact, their numbers had been declining for several months and she was concerned. Though she was able to make a basic assessment, she did not possess the knowledge required to make the numbers go the other direction.

She recognized she was going to need all the solid information that she could get because the doctor she worked for was not in favor of consulting services. He thought things were going along just fine, but Suzie knew the facts did not support his thoughts.

Another concern was the manner in which one of the hygienists, Heidi, was practicing. She did not attend any continuing education courses unless she absolutely had to and was not abreast of current methodology. She was a friendly, “chat and polish” hygienist concerned with how the families of the patients were doing and where Johnny was going to college and if Sara was getting married. This type of information exchange certainly can develop patient relations, but the conversation cannot stop there. Dentistry needs to be brought into the conversation. After all, isn’t this why patients have their teeth professionally cleaned and examined? If dental situations, particularly periodontal conditions, are not evaluated and discussed it is irresponsible and not in the patient’s best interest.

On top of this the doctor had fallen into the same pattern as Heidi the hygienist. He too had more of a social focus and less of a dental focus during the examination. He was relying upon the hygienist to let him know what she found. Oh, she did fill him in on the patient’s latest personal news, but when the doctor did not hear any dental concerns from the patient or the hygienist, he dismissed the patient with a casual, “See you next time!” There was never any talk regarding periodontal disease, pocket depths, etc. Heidi did not feel comfortable enough to bring up the issue of periodontal disease. She had been seeing these folks for years and had not discussed anything other than personal issues while cleaning their teeth. How was she supposed to tell the patients they have periodontal disease?

Luckily for Suzie and the entire dental team, her concerns were addressed. She received information and support from the McKenzie Management team, so she was able to convince the doctor to participate with  McKenzie Management utilizing their Hygiene Enrichment Program . The following is the practice analysis data.

There were 2,004 patient charts in file cabinet, but only 1,154 active recall patients. 850 patients had not been retained over two years.

  • The practice was operating on a net loss of 24.5 patients per month because of an ineffective recall system.
  • There were approximately 1.5 hygiene hours a day not scheduled, which resulted in $47,232 lost annually from openings in the hygiene schedule. This loss did not include the additional treatment that would have been diagnosed from the hygiene department.
  • Hygiene production to office production was 13.04%. Industry standard is 33%.
  • Periodontal production to hygiene production was 5.3%. Industry standard is 33%.
  • Daily average hygiene production for the year previous to consulting services was $1,151.
  • Daily average hygiene production needed to be increased to $1,488 per day to cover hygiene salaries and benefits, which were running at 39.16%. Industry standard is 33%.
  • Average monthly hygiene production = $32,320
  • Hygiene production for 4 months pre Hygiene Enrichment Program = $129,280

Post-consulting data (for the 4 months following consulting program):

  • Daily average hygiene production = $1,262 (an average increase of $112 per day per hygienist)
  • Average monthly perio production = 22% (an increase of 17%)
  • Hygiene to practice production = 18% (an increase of 5%)
  • Average monthly production = $44,781 (an increase of $12,461 per month)
  • Hygiene production for 4 months  = $179,089 (an increase of $49,809 over 4 months)

The numbers tell the story of success but the most important improvement came from the patients. Because the doctor, hygienists and the rest of the team learned how to change the systems affecting patient care, a measurable difference in patient acceptance and compliance took place.

Need help with implementing new systems in your Hygiene Department to ensure patient acceptance and compliance? Email
Interested in having Angie speak to your study group or at your next seminar? click here.

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