Satisfied with the money...

If a dentist collects 10 resumes for a hygiene job, here`s what he could think - at least from a businessman`s perspective - when he studies the applicants from across the conference table:

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...not as pleased with the benefits.

RDH survey reveals the `fringes` are hard to get.

Mark Hartley;

data compilation by

Julie Harris and

Vicki Cheeseman

If a dentist collects 10 resumes for a hygiene job, here`s what he could think - at least from a businessman`s perspective - when he studies the applicants from across the conference table:

- Six of the hygienists might go to work for him at an hourly rate somewhere between $16 to $25 an hour.

- Two of the hygienists might accept an offer for a daily rate in the neighborhood of $180.

- One of them just might join the dream dental practice for a mere $34,950 - but it`s got to be a fixed annual salary.

- The last hygienist in the room wants to work on commission. She`ll be negotiating for 30 to 40 percent of production.

Which one will be hired? Apparently all of the income scenarios are acceptable to dental employers, since the averages referred to above surfaced in RDH`s salary survey. It was the magazine`s second consecutive year to conduct the survey. The bad news is that the overall average income for a dental hygienist has slipped - from $37,619 to $34,076.

RDH tabulated the responses of 1,767 hygienists. The readers completed a questionnaire printed in the May 1997 issue. The lowest annual income reported was $2,000; the highest was $103,000.

Regardless of how you personally may feel about the income levels stated above, most readers like them. Seventy percent said they are "generally satisfied" with their income.

As with the case in the 1996 survey, however, a majority of readers are not "generally satisfied" with the benefits they receive from employers. More than likely, the sentiment is derived from the facts that:

- 28 percent receive no paid vacation.

- 34 percent do not receive paid holidays.

- 66 percent do not receive health insurance (although 16 percent of these responses said they were covered by the health insurance of another family member).

- 51 percent do not have an opportunity to participate in an employer-provided pension plan, 401(k) program, or profit-sharing program.

Oh, to be an ADHA member in the big city!

The percentage of readers earning in excess of $35,000 a year, based on experience, is:

- 1-5 years, 53 percent.

- 6-10 years, 47 percent.

- 11-20 years, 42 percent.

- 21-25 years, 41 percent.

- More than 25 years, 36 percent.

The percentage of readers earning in excess of $50,000 a year, based on experience, is:

- 1-5 years, 7 percent.

- 6-10 years, 9 percent.

- 11-15 years, 7 percent.

- 16-20 years, 10 percent.

- 21-25 years, 6 percent.

- More than 25 years, 6 percent.

The numbers speak for themselves. Experience apparently is not a relevant factor in determining a hygienist`s income.

The type of practice apparently is not relevant either. General dentists, specialists, and the public health services pay only 43 to 44 percent of their hygienists more than $35,000.

However, practice location and membership in a professional association do appear to be relevant:

Only 30 percent of rural hygienists earn more than $35,000. The city dwellers fare better - 45 percent of suburban and 47 percent of urban readers take home more than $35,000 annually.

The highest paid hygienists also live in the city. Nine and 10 percent of suburban and urban hygienists, respectively, earn more than $50,000 annually. The percentage drops to four for rural readers.

The professionalism implied through membership in a professional association also may be relevant:

- 49 percent of ADHA members earn in excess of $35,000 annually; 10 percent earn more than $50,000.

- 48 percent of ADA (auxiliary) members earn in excess of $35,000; 10 percent earn more than $50,000.

- 41 percent of readers who said they were a former ADHA member earned more than $35,000; 8 percent earned more than $50,000.

- 36 percent of those readers who said they have never belonged to an association earned more than $35,000; 6 percent earned more than $50,000.

Hygienists who work part time are more likely to be "generally satisfied" with their income (74 percent). Full-timers are happy too - just a lower percentage (67) of them. But it is worth noting that:

- 71 percent of hygienists who work more than 40 hours a week earn in excess of $35,000; 23 percent earn more than $50,000.

- 65 percent of hygienists who work 36 to 40 hours a week earn in excess of $35,000; 15 percent earn more than $50,000.

- 53 percent of hygienists who work 31 to 35 hours a week earn in excess of $35,000; 8 percent earn more than $50,000.

Finally, how does income tie into production? If it does, it`s very inconsistent. Income based on the number of patients treated each day is:

- Five or fewer patients - 21 percent earned more than $35,000; 8 percent earned more than $50,000.

- Six patients - 29 percent earned more than $35,000; 4 percent earned more than $50,000.

- Seven patients - 42 percent earned more than $35,000; 7 percent earned more than $50,000.

- Eight patients - 46 percent earned more than $35,000; 9 percent earned more than $50,000.

- Nine patients - 39 percent earned more than $35,000; 6 percent earned more than $50,000.

- 10 patients - 42 percent earned more than $35,000; 7 percent earned more than $50,000.

- 11 patients - 47 percent earned more than $35,000; 11 percent earned more than $50,000.

- 12 patients - 60 percent earned more than $35,000; 11 percent earned more than $50,000.

- 13 or more patients - 45 percent earned more than $35,000; 10 percent earned more than $50,000.

Stay healthy!

Health insurance for hygienists and their dependents, as indicated above, is scarce. When the benefit is offered, dental employers appear to be evenly split between managed care plans (48 percent) or traditional insurance programs (52 percent).

But hygienists who work at least 30 hours a week apparently have a much better chance to receive health insurance, and they are grateful for it. The survey recorded 1,082 readers who work at least 30 hours a week, and only 420 (39 percent) have no coverage at all. On the other hand, 675 readers said they work fewer than 30 hours a week. Sixty-six percent of this group lacked health insurance benefits.

Fifty-eight percent of the hygienists working under 30 hours a week were not "generally satisfied" with their benefits. In comparison, the percentage of unsatisfied hygienists was less for those who work more than 30 hours (45 percent).

But most hygienists are not protected. Job experience is frequently a factor when considering the accruement of benefits. However, with health insurance, it appears that work experience is not relevant, since 56 percent of the hygienists without coverage have more than 16 years experience. And a majority of this group of veterans indicated they were not "generally satisfied" with benefits.

Fewer urban readers were without health insurance than their counterparts (44 percent compared to 52 and 51 percent for rural and suburban hygienists, respectively). Not surprisingly, urban hygienists were the only group where a majority were "generally satisfied" with benefits.

Among the states with at least 50 responses to the survey, Ohio (64 percent), California (64 percent), Illinois (61 percent), Michigan (54 percent), and New York (53 percent) reported trends where more than half were not covered by any health insurance plan.

Conversely, North Carolina (26 percent), Pennsylvania (37 percent), Massachusetts (38 percent), Florida (40 percent), Wisconsin (48 percent), and Texas (49 percent) indicated that at least half of practicing hygienists had insurance coverage.

North Carolina, Pennsylvania, Wisconsin and Texas were the four states (which submitted at least 50 responses) where a majority of readers were "generally satisfied" with benefits.

Hygienists paid by a fixed annual salary are more likely to receive health insurance. Only 22 percent of salaried readers were not covered, as opposed to 49 percent of readers on an hourly rate, 54 percent for those on a daily rate, and 59 percent of those on commission.

Etc., etc., etc.

Most readers (67 percent) said they work full time for a general dentist (87 percent), and most (74 percent) work out of just one office. Twenty percent, though, indicated they work out of two dental practices, and even smaller percentages worked out of three (4 percent) or four or more offices (1 percent).

Among the 33 percent who work part-time, 78 percent are 36 years old or older.

Other work settings besides general dentistry practices included the specialists (8 percent), government or public health (5 percent), and self-employment (1 percent).

Overall, most readers work in suburban settings (55 percent). The remainder drives to urban (24 percent) or rural (21 percent) practices. A slightly larger percentage of suburban hygienists are more likely to work part-time (37 percent) than their peers in urban and rural settings (27 and 30 percent, respectively).

Readers were asked if they work with other hygienists in the office:

- 36 percent said they work with one other part-time or full-time hygienist.

- 30 percent said they work by themselves in the practice.

- 16 percent said they work with two other part-time or full-time hygienists.

- 14 percent said they work with three to five other hygienists.

- 4 percent said they work with more than five other hygienists.

Most hygienists estimated they treat an average of eight (27 percent), nine (17 percent), or 10 patients (20 percent) a day. Twelve percent indicated they treated seven patients or fewer, and 24 percent revealed workloads of more than 11 patients daily.

As expected, women hygienists dominated the survey responses. However, 17 males did respond. Although it is impractical to compare 17 men vs. 1,735 women (15 readers chose not to announce their gender), the statistics did reveal the following:

- 54 percent of the male hygienists receive employer-provided medical benefits compared to 38 percent of the women.

- 59 percent of the men earned in excess of $35,000 a year, compared to 34 percent of the women.

Most readers said clinical hygiene was their sole source of income. However, 22 percent said they earn income from additional sources, primarily out of the profession (76 percent). The other "occupations" within dentistry were:

- Part-time dental education (15 percent).

- Full-time dental education (4 percent).

- Part-time employee for dental manufacturer (2 percent).

- Full-time employee for dental manufacturer (1 percent).

The average annual income from the other occupations was $14,174 (70 percent of the readers said under $15,000). The range of nonclinical income varied from $200 to $120,000.

Despite the proliferation of sideline incomes for almost a quarter of the profession, most (92 percent) of the dual-career hygienists indicated that they still practice clinical hygiene at least some of the time.

Most (65 percent) of the 391 readers who said they earn income from sources other than clinical hygiene practice part-time out of "personal desire." A few said they were working dual careers out of financial necessity (26 percent) or still practicing while in transition to another career (9 percent).

Among the 69 readers who indicated they no longer practice clinical hygiene, the following reasons were offered for "retirement:"

- Occupational injury, 14 percent.

- Burnout, 18 percent.

- Other opportunities too enticing to pass up, 19 percent.

- Financial necessity, 5 percent.

- Problems obtaining licensure, 2 percent.

- Parenting duties, 9 percent.

- Unhappy with dental employer, 14 percent.

- Issues involving cross-contamination of diseases, 6 percent.

- Other, 13 percent.

The survey also asked if readers are assisted by dental assistants during hygiene appointments. The question was also asked during the 1996 survey, and the different responses were notable. In 1996, 61 percent said they "never" work with a dental assistant. This year`s survey recorded a 47 percent response - a 14 percent decrease. In 1996, 21 percent indicated an assistant "occasionally" assists them; the percentage increased to 28 percent in 1997.

Another possible answer to the question was, "Only to record probing scores." In 1996, 13 percent checked off this answer. A year later, the answer was checked off by 21 percent.

However, the percentage of hygienists working "full-time" with an assistant dropped from 5 percent to 4 percent.

In general, the trend of assistants in the hygiene operatory seems to be more prevalent among younger hygienists. A majority of hygienists who have been practicing for more than 20 years "never" work with an assistant. On the other hand, hygienists with fewer than five years experience "occasionally" (34 percent) treat hygiene patients with a helping hand.

Average annual income for RDHs

$15,000 or less 7 percent

$15,001-$20,000 6 percent

$20,001-$25,000 11 percent

$25,001-$30,000 15 percent

$30,001-$35,000 16 percent

$35,001-$40,000 18 percent

$40,001-$45,000 11 percent

$45,001-$50,000 7 percent

More than $50,000 9 percent

We asked, you answered

Approximately how many hours a week do you personally practice?

Under 11 hours 3 percent

11 to 15 hours 2 percent

16 to 20 hours 9 percent

21 to 25 hours 11 percent

26 to 30 hours 13 percent

31 to 35 hours 29 percent

36 to 40 hours 26 percent

More than 40 hours 6 percent

Other 1 percent

Of which professional dental associations are you a member?

I`m a former ADHA member 42 percent

I`m an ADHA member 36 percent

I have never belonged to an association 17 percent

Other 3 percent

ADA (auxiliary membership) 2 percent

How many weeks of paid vacation do you receive each year?

None 28 percent

1 week 16 percent

2 weeks 31 percent

3 weeks 19 percent

4 weeks or more 6 percent

What portion of licensure renewal and continuing education does your employer pay for?

- Pays all fees for licensure renewal 6 percent

- Pays some fees for licensure renewal 3 percent

- Pays all fees for continuing education 30 percent courses

- Pays some fees for continuing 39 percent education courses

- Pays all CE travel expenses 9 percent

- Pays some CE travel expenses 14 percent

- Does not pay any expenses related 29 percent to licensure or continuing education

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