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November 21, 2008

A sore point for many hygienists is how to acquire supplies and equipment we feel will work best in our hands and provide the best level of patient care. While some clinicians have their every wish granted, others have no success getting new equipment or products. Most hygienists' experiences fall somewhere in the middle.

The business owner, usually the doctor, is ultimately responsible for every facet of business operations. If the business is not thriving, then there is no money for new equipment, different supplies, or even a raise. Typically, a business operating on a marginal basis is not a pleasant place. Owners and employees are frequently fearful, and the opportunity for change is stymied.

Another barrier to a "yes" from the key decision maker is expecting him or her to be a mind reader and know your every desire. Whining or an attitude of entitlement also create confusion and resentment and will not move your case forward.

The question then becomes, how can we move our doctor or key decision maker towards a yes? If we think in a more business-like manner, the success rate will improve. This means we need to build a strategy from a business owner's point of view, which is often a more global stance than looking at the world from a dental hygiene perspective.

The moment you adopt a business-like approach you show your doctor you're serious and willing to help the business grow and become more successful.

Facts are a critical component of building a path to success. It is important to find out the initial cost, price differentials, and what companies make the same or similar technologies. The features and benefits of each product are important, as are the warranty or durability of a product or piece of equipment.

Is there any research that demonstrates a product's superiority? Have colleagues had clinical success with the product or equipment? It's important to get as much information as possible and not rely solely on a salesperson's recommendations. If the salesperson is not a clinician, it's often impossible for him or her to answer clinical questions with the same veracity as the clinician who uses a product or technology every day.

Remember, while firsthand testimonials about product efficacy, equipment reliability, repair issues, and customer service are important, they are limited. Reports can be fraught with misconceptions and the experiences of clinicians who do not read product directions or do not understand the subtleties of a particular technology.

Does the new procedure, technology, or service fit the current CDT codes for third party reimbursement? Many patients focus on accepting services that are eligible for some type of coverage. If you provide your practice with the appropriate coding as well as a brief sample narrative for services rendered, the path to yes will be faster.

While this is a busy time of year, it may very well be your golden opportunity to get the yes that you want. For a number of years, the IRS has allowed dentist/owners a special tax deduction for equipment purchases under section 179. This type of tax incentive, typically in the range of $250,000, prompts many dentists to purchase and take delivery of new equipment before the year-end. My doctor is always looking for ways to build his business via a legitimate tax deduction, and the practice has benefited from the acquisition of digital radiography, high-end ultrasonic scalers, intraoral cameras, ergonomic seating for clinicians and assistants, new magnification loupes, and headlights.

Now that you're armed with the facts, plan to meet with your doctor to discuss your requests. Don't try to catch the doctor while he/she is rushing out the door. Tell him or her that you want to arrange a 20-minute business appointment in the next seven to 10 days. Request to meet at a time that is not hectic. Offer three to four different times that work well with your schedule.

Once the date is set, make at least three copies of all the data. Provide the doctor and other key decision makers with copies. Make a copy for yourself and store one in your permanent records. Go to the meeting with a positive attitude. Be prepared to discuss the facts and potential alternatives with your employer. Remember to emphasize how your request will benefit the business' bottom line.

If your plan meets a brick wall, don't crawl off in defeat. Instead, ask the doctor if there's a problem with your request. Offer to provide more information within a specific time and request a definite date to revisit the plan. If this doesn't work, ask where your plan fits within the long-term business plan. If you feel strongly about the idea yet sense that your employer is putting your proposal at the bottom of the pile, then perhaps it's time to look for a practice that is more compatible with your professional philosophy.

Consider developing a special fund where the monies can be used to purchase new equipment. Years ago, I worked in a practice where the profits from the sales of power toothbrushes and home care fluoride were designated to purchase equipment for the dental hygiene department. The only flaw with that plan was not getting the agreement in writing. Somehow my numbers were never the same as the bookkeeper, but discrepancies like that are not as likely today since business transactions are computerized in most practices.

Smart business owners are always looking for ways to make their offices stand out from the competition. Dentists who want to grow their practices look for ways to provide better clinical experiences so their patients will say "wow." Getting a patient's attention in a positive way is the best form of advertising. Satisfied patients tell others about their great treatment, and the result is a thriving dental practice. An economically sound, flexible dental practice is a wonderful place to practice. Never underestimate your power to get a yes to create your personal professional comfort zone.

About the Author

Anne Nugent Guignon, RDH, MPH, is the senior consulting editor for RDH magazine. She is an international speaker who has published numerous articles and authored several textbook chapters. Her popular programs include ergonomics, patient comfort, burnout, and advanced diagnostics and therapeutics. Recipient of the 2004 Mentor of the Year Award, Anne is an ADHA member and has practiced clinical dental hygiene in Houston since 1971. You can reach her at anne@anneguignon.com or (832) 971-4540, and her Web site is www.anneguignon.com.

Four steps to get to yes

1. Get the basic facts — initial cost and consumables
2. Check out the options — comparable technologies or systems
3. Research the track record — durability, reliability, and customer service
4. Demonstrate how it will distinguish the practice with measurable goals

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