Get down to business

Talk about the business of hygiene and most hygienists shrink away like a fading flower. After all, that's why we went to hygiene school.

Aug 1st, 2004

by Janet Hagerman

Talk about the business of hygiene and most hygienists shrink away like a fading flower. After all, that's why we went to hygiene school. There was no math and we could focus on what we love, which is helping people.

Hygienists are social creatures. We like to get to know our patients, and most of us develop friendly, often deep, relationships with the patients we come to care for over the years. We are also a compassionate group. We worry and fret over our patients, and everything about them, from their periodontal disease to their kids to their pocketbooks.

Business just isn't our thing. There was not one business class in college, unless you count practice management, which still makes it only one. Great — no math, no accounting, no statistics. So it made sense to enroll in a profession that didn't require any business skills — just people skills.

We became hygienists, because we preferred to focus on our patient relationships and clinical care. I used to feel that as long as I was doing a good job clinically, the numbers should just take care of themselves. The business part was the doctor's end of the practice and the responsibility of the administrative team.

That's the way it used to be. However, times have changed and so has they way we do business, including the business of dental hygiene. Clinical skills, no matter how extraordinary, are not enough. Today's successful hygienist must stay focused on the business of the hygiene department while simultaneously maintaining clinical expertise. It is no longer sufficient to let "business" take care of itself.

What I have found is that monitoring production is really a reflection of patient care. With the miracle of modern computers and dental software, accessing production reports is as easy as your closest keyboard. I used to resent having to keep up with all of these numbers. I thought it took away from patient care. Now I know that, with a little practice, analyzing the numbers of hygiene production is actually the quickest and easiest way to monitor the care that patients are getting, and to quickly correct areas that need improvement.

Basically, what this means is that you must know how to create and maintain profitability for your department. But, you don't have to do this all alone. A great appointment scheduler and office manager are your best friends and you need to work together to stay focused on hygiene productivity.

The administrative team can make or break hygiene productivity! Partner with your office manager to maximize your numbers. How do you do that? I asked my friend and business associate, Dawn Vanderlinden, this very question. Dawn is a regional vice president for our company of over 100 dental offices, and Dawn manages 28 of them. She has been a peak-performing office manager in many dental practices and has trained others to mirror her success. Dawn told me that there's no secret to maintaining high production if you do five things. But you must do these five things regularly and relentlessly! Here they are.

1) Morning huddle and chart review — The biggest mistake people make about morning huddles — second to not having them at all — is they drag them out too long. A morning huddle should only take about 10-15 minutes. This is not a staff meeting, nor is it a forum for problem solving (that's for the staff meeting). The purpose of the morning huddle is to identify specific patient concerns or challenges, including patient pre-meds and other medical red flags, as well as patient financial balances.

In order for the morning huddle to be productive, and happen in a timely manner, charts must be reviewed beforehand. This can be done in the morning, prior to the huddle, or the previous afternoon. Hygienists review their patient charts and assistants review the doctor charts. Look for medical alerts, outstanding financial balances, and unscheduled pending treatment, including restorative, cosmetic, and overdue hygiene.

The office manager is typically the logical team member to facilitate the morning huddle. The office manager should first review the production presently scheduled for the day comparing that to the daily office goals, as well as for each department. Strategize ways to maximizing patient care and productivity. The front office is notified to discuss any outstanding patient balances before the patient is treated. Everybody is made aware of all the day's patient concerns. Look for opportunities to find restorative needs in the hygiene department, and overdue hygiene from the doctor's restorative patients. Finally, finish your morning huddle with a positive and optimistic "thought for the day."

Do not skip morning huddle because one or more of your team, including the doctor, is not present! Have them anyway with whatever staff is present. Fill in for each other and support your absent team members as they will do for you when you have a time challenge. (Set up a fun system to return the favor.) When you are the absent team member, it is your responsibility to obtain morning huddle information.

Morning huddles give everyone on the team the opportunity to be prepared during the day. Without them you can count on your day being chaotic and stressful. Dentistry is inherently stressful enough. Prepare for success daily with the morning huddle.

2) Doctor-hygienist-office manager huddle — This abbreviated huddle (immediately after the morning huddle for three to four minutes) is totally focused on filling any open time in the schedules of your two office producers, the doctor and the hygienist, by finding outstanding treatment. The hygienist actively looks for restorative treatment from that day's hygiene patients and alerts the doctor. The doctor notes any restorative patient that is due for any hygiene treatment and alerts the hygienist. The office manager assists with coordinating the two, so patients can be seen the same day for additional needed treatment.

3) Print and post throughout the office the schedule for the next three days — All day long the team is required to pay attention to the next three days of schedules and look for opportunities to fill them with patients' needs. Make this fun by attaching prizes or rewards (movie/restaurant gift certificates) to motivate the team.

4)Everybody leaves with two appointments — Pre-appoint all patients. Every patient should leave with two appointments, their restorative appointment and their hygiene appointment. Any patient with unscheduled treatment goes into a "Quick Call" book, which is then used to fill open time.

5) Daily goals, all day long — The office manager visits all departments throughout the day (three to four times) to inquire about, and update, current production. Any team member, at any time, needs to be able to know where their production is. Questions to ask include:

• "What is your need for today?" (How much production do you need to fulfill your goal?)

• "Where are you at?" (Where are you in relation to your production goal?)

Dawn tells me "if it takes longer than two minutes to get an answer, then they don't know. That tells me they're not focused on their day."

If this seems like a lot to keep up with, it is. But, you don't have to do all alone. The best leaders never accomplish their success by themselves. They depend on great teams to support them. Show this article to your office manager, doctor, and other team members to share how your office can maintain predictable profitability.

The hygienist of today is no longer just a clinician. You must become a business person to lead your department to profitability as a reflection of comprehensive patient care. So get down to business, step up your leadership skills, partner with your office manager, and doctor and become the business leader you never knew you could be.

Janet Hagerman, RDH, BS, is a speaker, writer, and the director of dental hygiene for Coast Dental. She can be reached at jhager man@bellsouth.net.

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