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Jan. 1, 2019
He`s telling me to change my technique and coddle my patients so they`ll want to come in for their appointments.

He`s telling me to change my technique and coddle my patients so they`ll want to come in for their appointments.

Dianne Glasscoe, RDH, BS

Dear Dianne,

I`ve been practicing dental hygiene full time for 20 years, and I absolutely love what I do. Last year, I landed a job in a wonderful practice. The doctor manages his office and staff well, and we are paid higher than the average for our area. We have the most modern technology at our disposal, and the staff members are all professional .

However, the way I`ve always practiced dental hygiene just doesn`t seem to fit in this practice. I`ve always approached my work with professionalism and intensity.

When I talk to patients about their periodontal condition with intensity, I am emphatic in my own way about how the disease is affecting the patient, the consequences of inaction, and what kind of treatment regimen is needed. Patients always are amazed and sometimes say, "No one has ever told me like that before." This honesty and intensity on my part and the changes in patients` oral health has worked for me all these years.

A big problem is that my schedule has been falling apart. My doctor has taken me aside several times and gently admonished me that perhaps patients are canceling because I`m not coddling them like the other hygienist does. He thinks I should accept his original hygiene diagnosis, even when I feel he is not aggressive enough in diagnosing periodontal disease. He wants me to simply be their friend first, and then, in six months, gradually bring up the issue of periodontal disease and how to treat it.

This position used to be a two days/week position, but I have turned it into a four days/week. The front-desk assistant or hygiene assistant does not seem to sense any urgency in keeping my schedule full, although the other hygienist`s schedule is always full.

There is a huge problem with broken appointments/cancellations. When I`ve tried to make suggestions about how this could be remedied, the office manager gets testy with me.

The office staff is a very close-knit group, and I often feel snubbed. The doctor wants to blame the problem on me. He`s telling me to change my technique and coddle my patients so they`ll want to come in for their appointments.

This has bothered me so much that I`ve actually considered leaving hygiene completely. Can you help me get a new perspective?

Round Peg in a Square Hole

Dear Round

What I see here is a classic paradigm shift. You were used to doing things a certain way in a former practice, but those same techniques do not seem to be effective in this new practice. I suspect your former practice took a more aggressive approach in detailing conditions, treatment, etc. In your dilemma, you are swimming against the current.

The fact that you are more intense is creating ripples in the otherwise tranquil dental pond. The doctor, who is most likely nonconfrontational, has taken you aside "several times." He says quite loudly that he is concerned, even worried, and that you are turning patients off with your intensity. My guess is that the doctor has received complaints from patients. Otherwise, he wouldn?t have taken you aside at all.

Having been in the practice for only a year, you still are the Onew kid on the block.O

Your statement, ONo one has ever told me like that before.O says that patients have been used to seeing a hygienist who never mentioned anything about periodontal disease or who probably never admonished them about their home care. So, they think everything is Ohunky-dory.O Then, along comes this new girl who tells them all kinds of bad things are going on in their mouths. This does not create a good feeling, and patients can become defensive. I can see why the doctor would tell you to make friends with patients first before dropping any periodontal bombshells on them.

It is quite possible that the doctor has not been aggressive enough in diagnosing periodontal disease. However, it also is possible that you are being overly aggressive. Even if you don?t agree with him, please remember that this is his practice. He has the right to operate it in any fashion he so desires. He must be doing many things right, because you described it as being OwonderfulO in the opening paragraph. Being paid exceptional wages and having access to modern technology tell me that this doctor has been quite successful in building a thriving practice.

You mentioned that two extra hygiene days were added when you came on board. This probably is at least part of the reason why your schedule is often not full. It takes from 12 to 18 months for this situation to stabilize, unless there is a serious shortage of hygiene time at the outset. It could be that there simply is too much hygiene time available for the number of active patients in the practice.

However, the issue of broken appointment/cancellations needs to be addressed and remedied with a set protocol. Good verbal skills and even dismissing certain repeat offenders from the practice often is necessary. I teach my offices to call patients two days before to confirm appointments. For those who have a history of no-show/late cancellation, the call should sound like this: OMrs. Jones, this is Ann from Dr. Davis? office. We have reserved time for you on Tuesday, May 3, at 10 a.m. Please call our office at 123-4567 by noon tomorrow so that I may confirm this reserved time.O Some will call, some won?t. But it does improve the chances.

Every practice has its own distinct personality. The problem is that you have come into an office where the status quo is just fine with everybody ... except you! You see where things could/need to be changed for the better, but no one wants to listen to you or take your advice. Other staff members see you as Orocking the boatO too much.

Here?s my advice to you. Just relax! Accept the fact that this office has a different dynamic than what you had before. If the doctor has told you what he wants, then do it. Don?t try to fit this office into any kind of predetermined mold that you have in your own mind. Become part of the flow, instead of swimming against the stream. Do excellent hygiene, make friends with the patients, be warm and caring with both co-workers and patients, and give this thing some time. After all, one year is not very long to have worked anywhere.

Obviously, you have come on as Ogangbusters.O It?s time for you to change your approach. I learned a long time ago that the only person I can change is me! And, please don?t leave hygiene ? we need good ones like you!


Dianne Glasscoe, RDH, BS, is an adjunct instructor in clinical hygiene at Guilford Technical Community College. She holds a bachelor`s degree in human resource management and is a practice-management consultant, writer, and speaker. She may be contacted by e-mail at [email protected], phone (336) 472-3515, or fax (336) 472-5567. Visit her Web site at http://www.professionalden