03.06.09 Issue #365 Forward This Newsletter To A Colleague

Is Hygiene Pay Outpacing Production?
by Sally McKenzie CEO
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There you are sitting in your office across from the hygienist. She wants more money. You want to be fair. You believe in compensating your employees well. But you don’t want to send overhead into the stratosphere. You know she works hard; there are days when she doesn’t have a minute to rest her hands. Yet there are other days when she is kicking back in the break room with the latest issue of People magazine. How do you find a balance?

First, take a look at how you are compensating your hygienist currently. If hygiene salaries are beyond 33% of collections, consider paying the hygienist on a commission basis of 33%. If a hygienist is making $300/day, production/collections need to be three times her salary or $900 at a minimum. But remember, the hygienist doesn’t have total control of her schedule, and the scheduling coordinator needs to understand that she/he is responsible for keeping the hygiene schedule full.

Another option would be to pay a guaranteed base wage plus commission. For example, if the hygienist works10 days a month and makes $300/day her monthly earnings are $3000. She must produce $9,000. If she produces $10,000 for the month the doctor could pay her commission of 15-33% on the $1,000 over her monthly goal. Next year, if her performance warrants a raise, she would get a percentage increase on the commission, provided it’s less than 33%, which is the maximum.

Don’t let the dollars slip through during non-production time. The hygienist should be paid 50% of her production salary for staff meetings, continuing education, and other non-production activity. But don’t spring it on the individual. Ideally, this should be spelled out during the hiring process.

In addition, the practice should be continually monitoring hygiene supply and demand and adjusting for it. You want to ensure that you have an adequate supply of hygiene days so that new and existing patients do not have to wait weeks or, worse yet, months for hygiene appointments and you want enough patient demand to ensure that the hygiene department accounts for 33% of your total practice production and your hygienist is producing 3x her/his daily wage. Follow this formula to ensure that your supply meets demand:

  1. Count the number of active patients – those seen in the past 12 months for oral health evaluations.
  2. Multiply that figure by two, since most patients come in twice a year for  hygiene appointments.
  3. Add the number of new patients receiving a comprehensive exam 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.

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.

Keep in mind that your hygienist cannot do this alone. She/he is going to need assistance achieving the goal of 33% of practice revenue. That help comes in the form of a solid recall system and a trained patient/scheduling coordinator to ensure that the hygiene schedule is full. But this team effort doesn’t stop there.

As we’ve all come to realize, in these economic times more and more patients are very concerned about their financial situation, if they don’t perceive the importance of keeping their hygiene appointment, they won’t. Use your recall system to do more than just remind patients of a “regular check-up,” educate them and emphasize the importance good dental health and how it relates to overall health. And, most importantly, doctor, assistant, and hygienist need to stress the value and importance of hygiene care every time a patient sits in the dental chair for dental treatment or the routine hygiene appointment.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

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