6.15.07 - Issue # 275 Forward This Newsletter To A Colleague

Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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The New Hygiene Department

It is not uncommon for new dentists to clean teeth in their practice when they are first starting. It is also not uncommon when those same dentists find their schedule getting so full with restorative work that they decide to hire a hygienist. When done correctly, this may be a very profitable venture, not only when looking at the doctor’s production, but also the hygiene production.

Starting a hygiene department is much more than hiring a hygienist. There are many different items that need to be considered such as, job description for the hygienist, forms that will be utilized, and office protocol to be determined.

Job descriptions help when the doctor is looking at doing performance reviews or evaluating who should or should not get raises. They also help when hiring new hygienists by allowing them to understand the expectations of the job description they are interviewing for and their willingness to accept the responsibilities before taking the position. This will hopefully prevent your practice from hiring people that are not willing to do the job needed, in order to be a part of your team, thus helping to cut down on the amount of turnover.

What forms are recommended when looking at starting a hygiene department? A daily hygiene monitor is recommended in order for the hygiene department to be accountable for monitoring their production and reporting it at staff meetings. A recall treatment form is recommended for the hygienists to share in the responsibility of reinforcing treatment the doctor has diagnosed on recall patients. Both of these forms help with employee evaluations as they help in creating accountability. We all know that the patient should sign an informed consent, particularly when any treatment is recommended.

There are many protocols that need to be determined when establishing a hygiene department.

Who is going to see the patient first?
What is going to be done at the initial visit?
What if the patient needs to have more extensive treatment other than the prophylaxis they are scheduled for?
What will the hygienist and doctor say to the patient?
Who will determine what the periodontal treatment plan will consist of?
How much time is needed by the hygienist in order to provide quality of care?
What will be done at each hygiene appointment?
How often does the doctor want x-rays?
Who will take the x-rays?
What x-rays does the doctor want?
How often will the doctor do a periodic exam?
Will the periodic exam be done in the hygiene area or will the patient be moved?
How often should the hygienist probe?
Is she/he expected to probe every patient?
What is to be done at a periodontal maintenance appointment?
What will be completed at a prophylaxis?
What should the daily hygiene production goal be in order to be a profitable department? 
Who will work recall?
What forms will be used to show accountability when working recall?
What recall notices will be sent to the patients?
Will appointments be made in advance?
How will the recall system be designed?
Will the recall system be supplemented with an outside company like Elexity?

Some of the answers to the above questions may vary depending on state laws.
These are just a few of the many protocols that will need to be determined for the hygiene department. Naturally every patient’s treatment will be determined based on his or her individual needs. However, there needs to be a starting point for the hygiene department in order for it to provide quality of care while maximizing its production.

What will the answer be when the patients start asking, “Why isn’t the doctor doing my cleaning any more?”  This may not be asked very often, but for those patients who do ask, verbiages will need to be created in order to have continuity throughout the office. The staff may answer, “The doctor has hired a hygienist and Sarah will take excellent care of you. She will now be providing all of your professional dental hygiene needs for you. Sarah’s degree in dental hygiene concentrates specifically in this area.”  Possibly the doctor would prefer the staff to say, “Sarah is an excellent dental hygienist and she will now be taking care of all of your professional dental hygiene needs. She has been highly educated when it comes to dental hygiene.” Every doctor has his or her own preference when it comes to answering questions patients may ask, and verbiages should be talked about and gone over at staff meetings.

Taking time to plan and organize the hygiene department at the start of your practice may pay off even more than you think.  Waiting until the practice is busy tends to lead to a hygiene department that is reactive instead of proactive and productive.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

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