Like most graduates, I enthusiastically looked forward to working in a dental office and was itching to put into actual practice all of the knowledge and skills I had acquired while at college. I soon realized that what I was taught at college and what actually is expected of us in a large number of dental offices is not necessarily the same. This became very obvious to me shortly after I accepted my first job.
I first worked full-time in an office in the Ft. Lauderdale area. The practice catered mainly to HMO and Medicaid patients. Although I admired and respected the dentist for his work and expertise, I could not adjust to the day-to-day operations and patient flow.
On a typical day, I was expected to see 14 patients or more in eight hours. This translated into less than one-half hour per patient. However, I was expected to spend only 15 minutes on Medicaid patients and 30 minutes on HMO patients. In order to meet the "production requirements," I worked through my lunch hour and after closing. Time and time again, I requested to be given as much as 45 minutes per patient but my request fell on deaf ears.
My college training and my belief in providing quality care were at odds with the office. Although I stuck it out for 18 months, I was determined that my career as a hygienist would be better than this. I did not realize at the time how the profession was affected by the shift to managed care. In order to remain profitable, some dental offices chose to pursue the path of sacrificing some quality care. I do not wish to suggest that the office I worked for did not take care of its patients; but I certainly did not see myself working in this type of office again.
My beliefs were strengthened when, on handing in my resignation, the dentist asked me to stay on and commented that I was the best hygienist he had ever employed. In addition, he then said he would allow more time per patient. However, it was too late, and I moved on.
From the frying pan into the fire
I did move on, and this time I was employed part-time by a general dentist with all fee-for-service patients. I began a new chapter in the type of office environment I was seeking ... or so I thought. I was allowed 45 minutes per patient, and all went well for the first week. Then came my rude awakening! At the beginning of the second week after a very short honeymoon, Dr. Jekyll suddenly became Dr. Hyde.
To refer to Dr. Hyde as being obnoxious is an understatement. He made me cry on a few occasions, and I later discovered from his receptionist that I was the 15th hygienist employed there over a five-year period. One hygienist lasted half a day (she went to lunch and never came back). His patients even feared him. I had no choice, and so I stuck it out for nine months. When I gave notice that I was leaving, the last week brought about a virtual transformation of Dr. Hyde back to the sweet Dr. Jekyll. Dr. Jekyll also commented that I was the best hygienist he had ever had. I was beginning to believe that I was.
I was in the "frying pan" on a part-time basis, but my other part-time job really landed me in the "fire." The "fire" was located in Pompano Beach with another general dentist. I only lasted three weeks in the "fire." I was so fried that I called up on Friday and said that I wouldn't be back on Monday.
His patients were mainly elderly. They were cantankerous and demanding, and I often thought to myself, "Like attracts alike." Unlike Dr. Hyde, there was no honeymoon, and I felt the tension from day one. I was now confronted with a dentist who wanted things done his way or "hit the highway."
There was one incident I must share. He did indeed allow me 45 minutes per patient. One day, I had a patient that took me 46 minutes to complete, and he was angry. He stormed in, removed my face mask, and shouted, "Have you ever had a tennis lesson?" I acknowledged that, yes, I had taken a lesson. "There is 30 minutes for a tennis lesson and, when the 30 minutes are up, then you are off the court! That is how this office runs. You get the next patient in."
I thought to myself, "Am I in hygiene hell?"
My luck begins to change
At this point, I had been working for more than two years. I wondered how long my baptism of fire would last before I would find my ideal dentist with the ideal office. I must admit that there were times when I wanted to change my profession. I had been rudely awakened to the fact that there was a vast difference between what I envisioned my career as a hygienist to be like and the reality of working in some of the dental offices in my area.
But I persevered. I knew in my heart that somewhere out there was the type of dental practice I was searching for and that we would find each other.
After leaving hygiene hell, I enlisted with a temp service. Unknown to me at the time, it would prove to be the path for a change of luck. I was directed by the service to work for a few days at an office in Ft. Lauderdale. At the conclusion of the temporary period, the office offered me a part-time position that I accepted.
I was given 45 to 50 minutes per patient. The dentist respected me not only as a professional, but also as a human being. More importantly, I was working in an office that I would not hesitate to recommend to my family and friends. My luck had indeed changed. I felt that perhaps I had now entered the pearly gates of dental-hygiene heaven after two years on the other side.
A year passed, and, finally, my dream did come true. I was offered a full-time position. I was honored, but events intervened and, within six months of accepting the position, I decided to relocate to Miami. My dentist did not want me to leave and even suggested that I commute. I gave some thought to his idea, but the distance was too far. Leaving this office to relocate was one of the most difficult decisions I ever made. It was made more difficult when I was told that no other hygienist had received as many compliments from patients as I had. Those compliments will remain with me forever, and I have made every effort to live up to that high standard in my profession.
A celebrated cleaning
I returned to temping, this time in North Miami. My luck continued to hold as I was offered a part-time position with a periodontist. I was very pleased to have landed this position, even though I had to travel several miles in traffic each day. My ego received another boost when the dentist who hired me commented that he only hires from the "cream of the crop." I tried not to let this go to my head, but coming from such a well-known and highly respected periodontist, I had my lapses.
Like the previous one, my new office had very high standards of care and allowed me 45 minutes per patient. In addition, I had the privilege of learning more skills from one of the other two highly qualified hygienists in the office. We also shared the patient load, and one day a well-known movie star was referred to our office for a prophylaxis. As luck would have it, I was the only hygienist available with an opening that day. He was booked for me to see him. For privacy and security reasons, no one outside the office was to know about the appointment. The patient was none other than that celebrated spy, "007, James Bond."
"James Bond? Which one?" I asked. I began to tremble a bit at the reply: "Sean Connery." Was this really happening to me? I willed my heart to be still. OK, he is just another patient, I told myself.
On the appointed day, I went to the waiting room and called out, "Sean Connery." The handsome, mature movie star approached me and shook my hand. "Hello, I am Sean," he said. I replied, "I am Suzanne, please follow me." With a coolness that belied my inner turmoil, I did the cleaning, and gave him his complimentary toothbrush and floss. We exchanged a few pleasant words about his stay in North Miami and the making of a new movie. It was a pleasure and a privilege to have him as a patient.
Besides working part-time with the periodontist, I also worked part-time with a general dentist in downtown Miami. This was mainly a private practice with some HMO patients. I got along well with everyone and enjoyed working there. I shared an operatory with another part-time hygienist who only worked on Saturdays. After almost a year, things seemed to be working out for me. The periodontist offered me a full-time position, but I reluctantly declined because the office was too far away from where I lived.
Then I got an unexpected surprise. Rumors began circulating that the "Saturday" hygienist was having an affair with the dentist. The rumor became fact when I was told that I was being let go and that she was being hired full-time. To add insult to injury, he said I could stay on until I found another job. I declined.
My luck holds
Once again, I was looking for a job. I called the local dental society and was immediately referred to a dentist in Coconut Grove. I interviewed with the dentist and was hired in three weeks. As an added bonus, the office was located about five minutes from where I lived - no more highway travelling!
I have been working full-time with this dentist for six years. His fee-for-service practice has a wonderful support staff. I am allowed one-hour appointments with patients who are very appreciative of my services, based on their comments and remarks. We have our differences and problems, but we always have been able to work through them.
A few years after I joined this office, we hired a new receptionist. I eventually discovered that she had worked for the same dentist who practiced downtown and had an affair with my colleague. The receptionist saw him later and mentioned that she now worked in the same office with me. Upon hearing this, he told her to tell me that he regretted firing me and that the "Saturday" hygienist had moved on. Revenge is sweet, but there are no hard feelings.
A friend of mine, a hygienist, referred me to a dentist in the south Miami area. He was searching for a part-time hygienist. I told him that I had no intention of leaving my position in Coconut Grove, but that I would work with him on Saturdays for a few months.
His practice allowed hour-long appointments, and it was a pleasure working with him and the staff. Of course, my other boss was aware of this and jokingly called me a "traitor." He said, "On Saturdays, you should be on the tennis court instead of working."
I have now been in the profession for 10 years. I have read much about burnout among hygienists. I will cross that bridge when and if it ever happens to me. I love my work and personally believe that I am providing a much needed service to the public. Their appreciation of my work will keep me at it for as long as my good health allows me to continue. The joys far outweigh the tears!
Suzanne Corbin, RDH, graduated from Miami-Dade Community College in 1990. She currently resides in Coconut Grove, Fla.