Nine years since last raise: Hygienist seeks bump in salary

Dec. 16, 2015
Hygienist seeks a salary increase after nine years. Dianne Watterson offers advise on asking for a bump in wages

Dear Dianne,

I have been reading RDH magazine for a very long time, and I always enjoy reading “Staff Rx.” I have an issue that I have been struggling with for a while and would greatly appreciate some insight and advice. I have been a dental hygienist for 16 years now and have been in my current practice for almost nine years. During this time, I have not received an increase in pay. My current rate of pay is $34 per hour. I work four days a week, which is full-time. I do receive two weeks of paid vacation and two weeks of paid sick time. I also have a 401(k) plan and receive quarterly bonuses, which are approximately $450 each, as well as a $500 Christmas bonus. The median wage in my area is about $38 per hour, but I do realize that I get benefits that other hygienists may not receive.

I could really use a cost-of-living increase, as my expenses are continually increasing. I really do like this practice and would like to stay here long-term, but I am afraid that I may not be able to afford to stay if my wages never increase. Am I off base in wanting a wage increase? If not, do you have any advice as to how to effectively broach the subject with the dentist I work for? I have always had very good reviews with my doctor, and he says that he and the patients are happy with my performance. Any suggestions would be greatly appreciated.

Rita, RDH

Dear Rita,

Wow, no increase in nine years! That is a long time. I wonder how long the doctor would be willing to stay in a job with no pay increase for that many years.

Without knowing any of the practice’s business stats, it is difficult for me to make judgment calls though. The reality is that many dental practices are not growing, and some are even in decline. So not receiving a pay increase may be a function of a declining business. Or maybe not. I believe it was George Carlin who said, “Most people work just hard enough not to get fired and get paid just enough money not to quit.”

Most doctors raise their fees once a year, and I can’t imagine that your boss has not raised his fees in nine years. Typically, I recommend that doctors raise their fees on January 1 and award any salary increases they feel appropriate on April 1.

Broaching the subject of a pay increase can be most uncomfortable. One doctor I worked with never gave wage increases unless the staff member asked first. Without a doubt, it was the most humiliating thing I’ve ever done. When I left that practice, I vowed I’d never ask for a raise ever again. I reasoned that if my boss didn’t think enough of me to raise me at appropriate times, then I’d find another job.

Hygienists can possess an important intangible value if they have the ability to connect with people and promote the doctor’s restorative dentistry. Are you good at presenting elective dentistry? If so, you need to track that too; i.e., what you present and what patients schedule.

Depending on the circumstances, the doctor could reply is a variety of ways. The answer could be “yes,” “no,” or “maybe.” You need to be prepared for any of the following possibilities:

  • Why do you think you deserve a raise?
  • I can’t talk about this right now. Could we schedule a later time?
  • The practice is not growing, so I cannot give any increases now.
  • How much do you think you should get?
  • What are others in the area making?
  • Yes, I’ve been working on that. Let’s see what we can do.

In today’s employment climate, longevity alone is not a great basis on which to feel raise-worthy. Many states have saturated dental hygiene markets, because there are simply too many hygienists for the number of available jobs. This tends to drive wages down.

A recent article on by Aaron Gouveia listed nine things to avoid saying in salary discussions:

  • I know timing isn’t great, but . . .
  • I haven’t had a raise since . . .
  • I’m doing the work of three people . . .
  • I’ve been here for a year now . . .
  • I’ve done everything I was supposed to do . . .
  • I need a raise because I’m having personal problems . . .
  • I want 100 billion dollars . . .
  • I just found out Sally makes more than I do . . .
  • If I don’t get a raise, I’m outta here . . .

My advice to you is this:

  • Monitor your production every day and determine your salary/production ratio to see if it falls within the industry standard.
  • Instead of boldly asserting that you need (demand) a raise, talk with the doctor unemotionally and privately armed with facts.
  • Ask the doctor to provide feedback about your job performance and if there is anything he or she feels you need to be doing that you are not currently doing.
  • Determine the value of your current benefits package, because that counts too.

I wish you all the best as you build your case for a wage increase. Go in armed with facts!

Stats to know when asking for a raise

If you feel it’s time for a wage increase discussion, you need to gather some data first to build your case. Do you track any of your stats? You need to know:

  1. What you have produced (and collected) each month for the past three months. The reason you need to know collections attributable to your production is because if you are in a high PPO practice, there could be a big difference in production and collections because of write-offs.
  2. Your salary/production (S/P) ratio. The industry standard is that the hygienist will produce three times his or her wages, which means S/P ratio will be about 30%–33%. Divide your gross salary by your production and move the decimal two places to the right. Example: Salary = $15,188; Production = $45,565; $15,188/$45,565 = .33 or 33%.
  3. Downtime tracking. Downtime should be at 5% or less of available time. a.) Tally all the available units of time that the hygienist is available to see patients in one month. If the practice is on a 15-minute time increment, there will be four time units in an hour. An 8–5 day with an hour for lunch would mean 32 time units per day. If the office is on a 10-minute time increment, there are six units in an hour. An 8–5 day would have 48 time units. b.) Tally all the open time units in the schedule. Do not count lunch as open time. Also, do not count time that has been blocked off for training or staff meetings. c.) Divide the available unit total into the open time unit total (big number into the small number). Move the decimal two places to the right. This is the downtime percentage. Round up anything that is .5 or higher.
  4. Breakdown for the past three months of procedure by code. This tells you how many of each procedure you have done over the period. It is desirable to see about 30% of procedures with periodontal codes; i.e., D4341, D4342, D4910. (You might need to get someone at the front desk to run a production/collection or the production by code report for you.)

DIANNE GLASSCOE WATTERSON, RDH, BS, MBA, is an award-winning speaker, author, and consultant. She has published hundreds of articles, numerous textbook chapters, an instructional video on instrument sharpening, and two books. For information about upcoming speaking engagements or products, visit her website at Dianne may be contacted at (336)472-3515 or by email [email protected].