Start setting goals today!

Jan. 1, 2002

If you want to have your own practice, all you need to do is hire a dentist. It's very simple. I know several hygienists who have done just that.

In 1980, I was offered a clinical-practice position in a general dental office, with an option for partnership buy-in. That dentist was way ahead of his time! I took the job, first, because I respected the dentist and shared his philosophy of practice, and, secondly, because he offered me more than just a job. As it turned out, I only stayed a year and a half (without actually buying into the practice) in Port Townsend, Wash., and then moved to the sunshine of Arizona. I still think about that offer and wonder about the potential opportunities of partnering with a dentist. Too bad Dr. Steve Scharf didn't want to start a practice in Tucson!

Had I known I still would be involved in dental hygiene more than 30 years after graduation, I would have made different decisions along the way. I would have had a plan rather than simply doing whatever came along. For those of you just embarking on your dental hygiene career, I have a couple of suggestions. As a matter of fact, I'm following this advice even now .These suggestions are helpful no matter where we are in our careers.

I know you've heard this one before and don't want to hear it again, but set goals! Set daily goals, one-year goals, five-year goals, career- achievement goals, financial goals, patient oral-health goals, and personal accomplishment goals. Set outrageous goals! Who cares if you fall a bit short sometimes; you'll still be farther ahead than if you never set any goals.

When I taught the expanded functions program in Tucson in 1980 (duties that are now a part of regular practice), I had the hygienists complete goal sheets on a regular basis. They set goals for each clinical session, as well as goals for implementing these new skills into practice. It helped me see what they wanted to accomplish, obstacles they faced, and if their activity moved them closer to those goals. I'm sure they learned from it, but they would never admit that. Setting goals was not their favorite part of the program.

One of the students, Cindy Chillock, became a good friend and business partner. During the expanded functions course, I began working out with Cindy and her husband in their well-equipped home gym. To my surprise, I was handed a goal sheet to complete when I arrived at the gym the first day. It was done in jest, as the entire class was getting tired of setting and achieving goals. To my surprise, we did set goals in the gym and we achieved those goals.

What are your goals? If your goal is to have your own practice, set that goal. By the way, you don't have to wait for the laws to change in your state to do that. If you want to have your own practice, all you need to do is hire a dentist. It's very simple. I know several hygienists who have done just that. Because of the political climate, there are no neon signs outside announcing: "Hygienist-Owned Practice." These are savvy business folks who have made an investment in their career and who will build financial equity with their investment. Hygiene isn't just a job to them!

Just the idea of independent practice can set some dentists off, as I'm sure you've noticed. I wonder if they really think that independent hygienists would set up "prophy parlors" on every corner or "pyorrhea palaces" in their garages?

Most hygienists don't want the headaches associated with an independent practice, but consider partnering with a dentist. This suggestion falls under the heading of invest in your career. If you've found a dentist you respect, work with well, and with whom you share similar philosophies, consider a partnership.

The model is there in law practice. Young attorneys work for a firm for a few years, and, if the match works, they are offered partnerships. The same can happen in dentistry, but the idea may have to come from the hygienist. Besides buying into the practice, actively promoting the practice and recruiting new patients will be part of that partnership, as well as sharing other responsibilities.

I recently spoke with a woman dentist who was selling her practice, but the potential buyer was having trouble coming up with the financing. I suggested offering the hygienist an investment opportunity, along with the new dentist. A hygienist in an established practice that is to be sold has a lot to gain by buying into the practice with the new dentist. The new dentist doesn't have to come up with as much cash, and the hygienist has an opportunity to invest in the practice he or she helped to build. It becomes a joint financial venture, and building the new practice also becomes a joint venture between hygienist and dentist.

Set measurable goals for your dental hygiene therapy:

  • What percentage of your patients do you want to keep disease-free?
  • What is your definition of disease-free?
  • What percentage of the children in your practice do you want to be caries-free?
  • How many are caries-free now?

Unless we set these goals, we can't accomplish them.

Many years ago, a patient asked me what the success rate was for my nonsurgical periodontal therapy. I didn't have the answer, so I ventured a guess, saying that approximately 80 percent of the pockets were reduced. That seemed to satisfy the patient, but I wondered how accurate my guess was.

To find out, I took a look at patient charts, analyzed the numbers, and found out some interesting things.

The success rate was actually better than 80 percent, when looking at pocket depths and bleeding points. For those patients who completed therapy and returned for follow-up, the pocket depths were reduced in 100 percent of the patients.

I've often wondered about research studies that report advancing disease in study patients undergoing treatment. That wasn't my experience in practice, and other hygienists I've questioned on this subject have reported similar success rates.

What do the numbers look like for your patients?

This is an area of dental hygiene that lacks research data. Nonsurgical therapy research is traditionally done by perio graduate students, not experienced clinical hygienists. It would be interesting to gather the data from hygienists on this subject. Take a look at your patient pool and see what your success rate is.

I set goals for each patient: to stop all disease progress, reduce pocket depth as much as possible, and get bleeding levels close to zero. Setting those goals changed how I approached treatment and how successful it was.

Patients enjoyed working toward those goals as well. It was definitely a partnership. If one approach didn't work, we would try another, until the goals were achieved. When necessary and for just a couple of patients, that meant two-week recalls, but it worked.

Start setting goals today for yourself, your patients, and your practice.

If I had more space here, I'd tell you about my latest goal, but you'll find out about it anyway on a future "New York Times Best Sellers" list.

Trisha E. O'Hehir, RDH, BS, is a senior consulting editor of RDH. She also is editor of Perio Reports, a newsletter for dental professionals that addresses periodontics. The Web site for Perio Reports is She can be reached by phone at (800) 374-4290 and by e-mail at [email protected].