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The hygiene department: A business within the business

Dec. 9, 2021
Kathryn Gilliam, BA, RDH, says becoming a business partner with your dentist/dental practice can maximize your professional satisfaction, elevate your value to your employer, and broaden your career possibilities.

I never thought about the business of dentistry early in my dental hygiene career. I prided myself in caring deeply about my patients and delivering the utmost skilled care to each person I served. My production and profitability never entered my mind. The only way I measured my value as an employee was that my patients’ health improved, they were happy with my care, and they requested to schedule with me for future appointments. Further, my teammates and employer liked me. But I was oblivious to my revenue generation responsibility to the practice.

When my employer hired a consultant to work with our team in 1990, my eyes were opened to the business side of dentistry. Initially, I was resistant to the idea that the financial health of the practice should be important to every member of the team. I clung tightly to my identity as a skilled and caring clinician, trusted patient advocate, and nonjudgmental educator, which I felt was far removed from the identity of business partner or owner.

I felt that it could be a betrayal of my professional oath and moral integrity to focus on the financial aspects of dentistry, as if that might lead to questioning the ethics of my treatment recommendations.

More about the hygiene department:

Oral-systemic connection is a perfect fit

At this same time, approximately 30 years ago, I was learning more details about the connection between oral health and whole-body health. The term “oral-systemic link” was not yet being used in our literature, but there was research beginning and a growing awareness. I knew that it was in my patients’ best interests to treat periodontal disease early, to conserve as much of the attachment tissues as possible. Early intervention has always been recommended, but somehow, watching and waiting had been the norm.

Interestingly, while our consultant was teaching me the importance of viewing the dental hygiene department as a business within the business, I was committing myself to early intervention in periodontal disease to reduce my patients’ oral and systemic health risks. It was a perfect fit.

Our consultant explained that the financial health of the dental practice is vital for being able to provide this level of care to our patients. We needed a certain level of productivity and profit to be able to pay the rent on our building, keep the lights on, afford the supplies necessary to do our jobs, purchase and maintain new technology, and regularly attend advanced continuing education courses. This was basic business education that I had not received in my four-year undergraduate studies nor in my two years in dental hygiene school. It was a real eye-opener to learn about supply and demand, profit and loss, my personal profitability, and other business basics. I became keenly aware of my position as a business partner to my owner-dentist. I felt a responsibility to produce at least three times my compensation and create a profit so we could cover the expense of my assistant, as well as be able to afford the microscope and laser we wanted to implement to treat our patients at a higher level.

How the hygiene department became fun

Once I fully understood the value of running the hygiene department as a business within the business, it became fun. I never strayed from my core values of ethical clinical practice, nor did my employer ever ask me to. I expanded my identity as a dental hygienist and health-care practitioner to include business partner. I felt even deeper ownership in the success of the practice. Now my intention wasn’t only about how well I served my patients, but also how well I served my entire team and the practice.

I paid closer attention to the supplies I ordered and how I used them. I was on the phone immediately when my patient was late, or when someone tried to cancel an appointment with me. My open time decreased when I made it clear to patients how important it was that they respect my time and their commitment to their scheduled appointments with me, and I worked very hard to respect their time as well.

Our hygiene team developed standard protocols for periodontal care so all the hygienists were aligned in our philosophy of care and all patients would receive a consistent level of care. Our patients received a higher level of individualized treatment and achieved better health, and the practice enjoyed higher profits. The hygienists and doctors met regularly to review restorative cases and foster closer alignment in our codiagnosis.

As our confidence grew in knowing what our dentist was most likely to recommend in each situation, treatment acceptance increased, and practice productivity grew. I found myself taking even more intraoral photographs of old amalgams, enamel fractures, and other dental conditions that needed restoration. I made sure my radiographs were of the highest quality, and I always took as many radiographs as necessary, regardless of the patient’s insurance coverage. I spent time clearly explaining treatment needs and helping patients accept treatment. The trusting relationships dental hygienists build with our patients put us in a perfect position to support our doctor’s treatment recommendations, which in turn helps patients receive the care they need and helps the practice to grow.

Another habit we expanded as a team was to compliment one another’s work to our patients. Admiring the assistant’s temporary crown with excellent margins, the doctor’s stunning veneers, and the vastly improved periodontal condition thanks to the great teamwork between hygienist and patient should be regular occurrences.

As I began to feel more like a partner in the practice, I made sure I always had my business cards with me to hand out whenever someone complimented me on my smile or mentioned needing a dentist. It was surprising how often the topic of finding a good dentist came up at my sons’ school, sports events, and religious activities. I’m always proud to recommend our practice because I know the excellent level of care people receive in the hands of our team members. I began asking all my great patients to refer their family, friends, and coworkers to both build our practice and expand the number of people in our community receiving outstanding dental care. Now we ask our wonderful patients to share their reviews on social media for us too.

The expansion of my professional identity from high-performing hygienist to include that of business partner to my dentist has increased my professional satisfaction immensely. I take pride in seeing our practice grow, and I enjoy the financial benefits of increased production and productivity in the form of bonuses as we exceed our goals. When owners share the wealth, it’s a win for everyone. Including the financial health of the practice in my focus has not diminished my attention to my patients’ health in any way. I continue to derive enormous pleasure and pride in partnering with my patients to improve their oral and systemic health.

I encourage my client teams to develop this mindset as well. This commitment can maximize your professional satisfaction, elevate your value to your employer, and broaden your future career possibilities. 

Editor's note: This article appeared in the December 2021 print edition of RDH.