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1.11.08 Issue #305 Forward This Newsletter To A Colleague

The Hygiene Schedule: What You See Isn’t Always What You Get!
by Sally McKenzie CEO
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Many of us are experiencing our share of post holiday buyer’s remorse. In the insanity of the holiday season, we spent more than we should, but there were so many great deals at the time. And the specials, oh the blockbuster specials, the list of “must haves” just grew and grew.

For example, that special offer on the cell phone for your teen. What a great buy, until you add on tax, activation, handling, license agreements, warranty charges, battery pack, etcetera. Or that satellite radio deal for your significant other, the special offer was so good you just couldn’t pass it up. Then your credit card bill arrived and you weren’t charged that reduced fee after all, no, it was double that. Surprise! The car rental best buy you found online for your winter holiday getaway wound up costing you $400 not $200 as you had bid through that wildly popular Internet site – those taxes, insurance, and special fees certainly add up. No, things aren’t always as they seem, are they?

And that jam-packed hygiene schedule isn’t as booked out as it looked to be earlier, nor is it bringing in the revenues you think it is. Patients, well, they can’t get a hygiene appointment for months. But the looming question remains. If hygiene is so darn busy, why isn’t that translating into production? Why isn’t hygiene production bringing in a greater share of the practice profit?  No one is considering the law of supply and demand. Practices insist that they schedule to meet perceived rather than actual patient demand.  

Let me explain. It’s a delicate balance determining the number of hygiene days the office needs to ensure that patient demand is met, as well as ensure that the hygienist produce 3 times her/his daily wage and bring in 33% of total practice production. So how does a practice achieve that balance? Follow this formula.

  1. Count the number of active patients – those seen in the past year for oral health evaluations.
  2. Multiply that figure by two, since most patients come in twice a year for oral hygiene appointments.
  3. Add the number of new patients receiving a comprehensive diagnosis per year. For example: your practice has 1,000 active patients + 300 new patients = 1,300 x 2 = 2,600 possible hygiene appointments.
  4. Now take that number and compare it to the hygienist’s potential patient load. If the hygienist works four days a week, sees 10 patients per day, and works 48 weeks a year there are 1,920 hygiene appointments available.
  5. Subtract that total from 2,600. You are losing nearly 700 appointments per year – 680 to be exact – or 14 patients per week. In this scenario, the hygiene department should be increased 1.5 days per week.

If your practice schedules patients when they are due rather than pre-scheduling appointments, examine how far ahead patients are booked for appointments. If there are no openings in the hygiene schedule for a solid three-week period and some patients are being bumped into the fourth week, begin increasing the hygiene department’s availability in half-day increments. If you find there is more hygiene time than necessary develop a patient retention strategy and focus greater attention on filling those extra days.

Next, look at the hygienist’s percentage of production. She/he can’t achieve 33% of practice revenue without some help, namely a solid recall system and a trained patient coordinator to ensure that the hygiene schedule is full.

An effective recall system is more than a postcard reminder; it’s a necessary education and marketing tool for the practice that should emphasize the importance and value of every oral hygiene appointment. Send professionally printed recall notices that fit into an envelope with an educational brochure that informs them about a new or existing service that they may want to consider. In addition, explore other patient reminder/patient communication options, such as those offered through Elexity.

Finally, the practice should have a clear policy regarding cancellations and broken appointments that is shared with all new patients and regularly mentioned to existing patients.

Take a few steps to ensure that your hygiene department is as productive as it is busy, and you’ll find that the reality pays far greater dividends than the illusion.

Interested in speaking to Sally about your practice concerns? Email her at
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