What to Consider When Paying Hygiene a Guaranteed Salary
You treat your hygienist, Katie, just like any other employee. You pay a guaranteed hourly rate, a structure that seems fair to you. Not only do you know exactly how much you’re paying her each month, she never has to wonder how much her paycheck will be – no matter how much, or how little, is produced during the pay period.
And that’s the problem. When you pay your hygienists a guaranteed hourly rate, they don’t have much motivation or reason to improve their production numbers. You limit the amount they can earn, so instead of working to grow their income and your practice’s productivity numbers, they become perfectly fine settling for the status quo, especially if they know they can count on a yearly raise, no matter what.
In my more than 30 years as a dental consultant, I’ve found that many practices follow this payment method and don’t even realize how much it’s hurting their practice. Most dentists are reluctant to make any changes because it’s a payment structure their hygienists like, so they continue to offer guaranteed wages while their bottom line suffers the consequences.
How can you fix this? I suggest you start treating your hygienists like the producers they are, instead of as a typical employee. Instead of paying a guaranteed salary, make sure wages are no more than 33% of what the hygienist produces. Hygienists really should be in the same category as associate dentists. That’s right, associate dentists. And associate dentists are typically paid 25-35% of what they produce.
Still not convinced? Let me give you an example. Let’s say your hygienist makes $25 an hour and works 8 hour days. That’s $200 a day. If she produces $600 a day - or three times her salary - then you’re golden. The hygienist gets one-third in compensation, you can apply one-third to hygiene department expenses, and the last third comes back to the practice as profit.
Sadly, this isn’t how it plays out in most practices. If your practice doesn’t have a Scheduling Coordinator trained to make sure your hygienists are scheduled to produce three times their salary, or if no one is accountable for the recall system that feeds the hygiene schedule, guess what? You’re going to have plenty of days when hygiene just doesn’t meet that goal. While this isn’t the hygienists’ fault, you’re still not meeting production goals. In fact you’re losing money, yet you have to pay your hygienists that guaranteed salary.
Now you might be thinking you can task your hygienists with calling recall patients during down time to help boost those production numbers. That’s sure to get more patients in the chair. There are dentists who go this route, but I don’t recommend it. Think about it. Do you really want your $50 an hour hygienist dialing for dollars? No, you want him/her producing.
Again, you should look at your hygienists much as you would an associate, and I bet you’d never ask an associate to work the phones. When producers are tasked with recall, your practice actually sacrifices more patient activity than it gains, so resist the temptation and make a designated business operations employee accountable for the recall system.
Let’s get back to your hygiene salary. When it comes to hygiene wages, I believe the best system to consider is paying hygienists a guaranteed base plus commission. This gives them the base pay they want, while still providing incentive to boost their productivity numbers. And when it’s time to hire a new hygienist, I recommend playing this up in your advertising. Why? It will attract candidates who understand the benefits of this model, and who will work hard not only to increase their income, but to boost practice production numbers and revenues as well.
If you’re considering making this change with your current hygienists, I bet you’re worried they may be resistant. After all, they’re used to making the same amount no matter what, and switching to this two-tier system may make them nervous. My advice? Explain how this model benefits the hygiene team and the practice. Before, earning potential was limited. This model leaves room for income to grow. The more that is produced, the more can be earned, which is good for both hygiene and the practice.
Bottom line: If hygiene isn’t producing three times their salary, it’s hurting your practice. To improve hygiene production numbers and increase your revenues, consider ditching the guaranteed salary structure and switching to a system that will help you meet practice goals.
Next week: Why a two-tier hygiene salary may work best
For additional information on this topic and more, visit my blog: The Lighter Side
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