Advocating your position

By  Anne Nugent Guignon, RDH, MPH

The November 1999 issue of RDH published a feature article written by California hygienist, Carol Coady. Carol had gotten injured and was struggling to make sense of how and why this happened. Determined to make a difference, she created the Hygienists' Pain Network, a safe place for hygienists to dialogue about workplace musculoskeletal disorders (MSDs).

Last November, a woman with a big, genuine smile came up to me at the beginning of a course in Chico, Calif. Thinking that I would not know who she was, Carol introduced herself to me. Thirteen years ago her article was the tipping point for me. Her story fueled my passion for workplace safety and was the genesis of this column.

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What an honor it was to meet Carol and everyone she practices with. Because she made critical changes to both her lifestyle and how she practiced, Carol has been able to continue to provide patient care for over four decades. Please join me in saying thanks to Carol for making a difference for so many!

Decades ago it was rare for hygienists to purchase their own equipment, but a growing number now consider ownership an expression of professional freedom and accountability. More and more academic institutions either require or encourage students to have their own scalers, magnification, illumination, and disposable supplies. New graduates are now more mentally prepared to make purchases than those of us who graduated years ago.

Many things need to be taken into account. Purchasing and owning equipment should be a successful, low-stress adventure. Before considering any product, remember this basic ergonomic principle: The equipment needs to fit the user, not the other way around. This goes for everything, from magnification loupes to gloves. Your best friend may like a certain saddle stool design or a particular loupe's frame, but make sure the design really fits your body build or your facial geometry.

Once you have narrowed down the product choice, carefully review the options using the seven points listed below. Consider this a lesson in business ownership. Once you begin purchasing your own equipment, you will view your professional career from a very different vantage point.

Dental dealers vs. direct sales -- There are two distribution models for all products. Most dental products are purchased from dental dealers that sell thousands of different items. Dental supply companies can be national, regional, or local and are used to taking orders for multiple products over time. This is a relationship typically based on how a dental office makes purchases. Other companies that sell products such as custom magnification loupes sell directly to clinicians. Companies that sell directly are often more inclined to do business directly with dental hygienists.

Financing and special deals -- Some companies only take lump sum payments. Others offer interest-free payment plans for specified periods of time, with payment guaranteed by a credit card on file. Special offers can be found in exhibit halls, hygiene-focused conferences such as RDH Under One Roof, via ADHA membership, or by bundling multiple purchases into one order.

Product warranty and trial period -- Carefully review the fine print. Ask questions if the information is not clear. Understand the time limits and don't fall for an off-hand comment that brushes off your concerns, such as "there is nothing to worry about." It is your hard-earned money at stake, so be smart about the details.

Custom orders -- If you order a nonstandard color or some other custom feature, understand that most companies will not offer a refund. There might be a hefty restocking fee, if they even agree to take the item back.

Ownership -- Co-owning equipment with a doctor is fraught with potential problems. If, for some reason, you leave the practice, then who owns the equipment that you purchased together? Ownership needs to be spelled out in writing. There are creative ways to prevent disagreements. For example, some hygienists have negotiated for custom magnification in lieu of a raise, so the loupes are considered their property from day one. Others have agreements that confer ownership after a specified time period, such as two years, or when a particular service has been rendered, such as treating family members.

Consider this variation on the ownership theme. What if you and your doctor split the cost of a saddle stool and the doctor decides it is okay to let your colleague use the saddle on your days off? There has to be a very clear understanding on issues like this. Remember your dollars went toward the purchase because you thought the equipment was important to your ability to practice, not your coworker's. I'm not advocating selfishness, just asking you to put the situation in perspective.

Maintenance, repairs, and consumables -- This is another sticky wicket. Think about these options. Since the equipment is being used on the patients in the practice, have a written agreement that the doctor pays for all repairs or that you have an increase in financial compensation because you are supplying certain pieces of equipment.

Due to normal wear and tear, parts will eventually need replacement, so who covers that cost? Ultrasonic scaling inserts are a perfect example of a consumable product. From a purely business standpoint, it does not matter who pays for the parts, but it does matter if there is an agreement.

Tax benefits -- Everyone's tax situation is unique, so it is important that your accountant review your specific situation to determine if a purchase can be deducted as a business expense.

While our clinical journeys are varied, it is important to make wise purchase decisions. Each of these topics deserves careful consideration. Ignoring any of these steps can result in unexpected outcomes that can rock your comfort zone. Ensure the joy of taking charge of your career by taking a methodical approach to owning equipment.

ANNE NUGENT GUIGNON, RDH, MPH, provides popular programs, including topics on biofilms, power driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 ADHA Irene Newman Award, Anne has practiced clinical dental hygiene in Houston since 1971.

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