By Andrew M. Goldsmith, DDS, DICOI, FIALD
I am not a dental hygienist, but I work with three every day. I do not have to deal with the stress of managing a hygiene schedule, but I have witnessed the frustration and have often been the reason for the angst that many hygienists feel every day. I am a dentist and we are on the same team. Not only are we on the same team, I see the hygienist as one of the keys to a successful dental business.
Viewing your dental office as a business is essential for the long-term survivability of the team, and one of the primary functions of the business is marketing. Marketers refer to "touch points" in a business, which are the times at which a customer interacts with a business. Dental hygienists are the primary marketing touch point for the dental practice. They should be supported to perform every aspect of their job with excellence.
Dental hygienists perform many of the absolutely essential services that drive our practices and serve our patients. Patients have a loyalty to their hygienists and look forward to seeing them two or more times per year. Sadly, the primary complaint I hear from hygienists is that they just do not have enough time to get it all done.
From this point onward, hygienists are going to get some time back.
A bandit called time
While growing up in the Sierra Nevada mountain range, I experienced beauty and history on a consistent basis. I would often venture into the mountains with a sleeping bag and a few supplies for the weekend when I was only 13 years old.
One of my favorite discoveries as a young hiker was when I came to a spot on a trail that had two parallel ruts. The ruts were deep enough that, when I stood in them, the tops were higher than my hips. Imagine two ditches running side by side that look like tire tracks from a monster truck. The trail I was on was one of the routes used by the Pony Express over 100 years ago. The ruts were a bygone reminder of when they would deliver mail and later supplies with wagons over the mountains through mud, rocks, rain, snow, and the threat of violent attacks from bandits and the American Indians who called the land their home.
When I closed my eyes, I could imagine the difficulty they had in the cold rain with wagon wheels stuck in the mire of goo, and the horses that wheezed steam out their nostrils as they heaved with all their might, muscles rippling against the load and slippery surface. The men in drenched clothes pushed against the wet, muddy wheels, unable to find traction and yelling at one another and their horses to push harder-anything to move the wagon faster.
During those times, the riders received bonuses if they could get the mail delivered faster and often were penalized if they could not get the mail delivered on time. The Pony Express riders constantly struggled against their biggest foe-a bandit named time. Those riders never imagined what we can do today, that we would be able to send a letter from our phone to another person on another continent who would receive it almost instantly. It is wonderful how advancements in delivery methods can change everything.
As I get further along in my career, I realize that I am battling the same bandit as those courageous riders. So when I walk the floors of the dental conference exhibit halls, I am constantly looking for ways to wage battle against time. About a year ago, I found a product that did just that. At the time, I was working as the chief dental officer of Smile Source, a group of over 350 dental practices dedicated to preserving independent practice dentistry. Part of my job was to find ways to help our offices be more productive and profitable while maintaining the highest standard of care.
Monitoring efficiency
At this conference, I was introduced to Mr. Thirsty One-Step by Zirc Company. I was intrigued by this product. I had tried similar products in the past, but this one had a lot of promise. What I like about this product is that it provides single-use isolation, retraction, and suction with no upfront investment, no installation, and no maintenance. After using the product, I have found that it makes me more efficient, and I am able to finish procedures faster. But simply saying that is anecdotal and subjective.
Therefore, in 2015, I produced a study that proved that this unique product does in fact reduce the time of dental procedures by an average of 35%. Since introducing this product into our practice with three locations, we have found more ways to utilize Mr. Thirsty One-Step for implant procedures, quadrant dentistry, CEREC restorations, and we will no longer do sealants without it.
We have found this delivery method has saved our team time and allowed them to provide a higher level of care in a more efficient and productive manner. Our goal with our most recent investigation was to see if Mr. Thirsty One-Step would also save time for our hygienists by performing a time-and-motion study.
Our time-and-motion study was carried out over three different locations and 10 hygienists, measuring the time required to perform routine hygiene procedures without Mr. Thirsty One-Step versus the time required when using the product. What we found in our study will amaze you.
We measured the amount of time scheduled for prophylaxis (D1110), limited scaling and root planing 1-3 teeth (D4342), and scaling and root planing one quadrant (D4341). We tracked the amount of time the hygienist was working on the patient, the amount of time the dentist spent in the room, additional time remaining, and patient satisfaction as well as hygienist satisfaction (on a scale of 1-10).
• For prophylaxis procedures (D1110) scheduled for an average of 60 minutes, we noted a 39% decrease in the time of the procedure. This means that, when the hygienists used Mr. Thirsty One-Step, they finished an average of 18 minutes sooner.
• For limited scaling procedures (D4342), the hygienist completed their appointments an average of 15 minutes faster-an 11.5% reduction in appointment time when using Mr. Thirsty One-Step.
• For scaling and root planing (D4341), we saw a decrease in procedure time of 26%. The average time scheduled among all hygienists participating in the study for scaling and root planing was 105 minutes, and on average they finished 29 minutes faster when using Mr. Thirsty One-Step.
To determine satisfaction levels with Mr. Thirsty One-Step, we used the Net Promoter Score (NPS) assessment tool. The NPS metric was first introduced by Fred Reichheld in his 2003 Harvard Business Review article, "One Number You Need to Grow." The NPS is a measurement of customer loyalty and ranges from -100 to +100. A positive NPS number is generally considered to be "good" while a score of +50 or higher is considered "excellent."
Across the three procedures, we measured an increase in satisfaction by both the patient and the hygienist when utilizing Mr. Thirsty One-Step, and the changes to the NPS were significant.
• During prophylaxis appointments, the NPS for patients not using Mr. Thirsty One-Step was a respectable +60. But when using Mr. Thirsty One-Step, the NPS went to a perfect +100.
• For quadrant scaling and root planing, the NPS scores improved from +10 for hygienists and -40 for patients to +70 and +40, respectively. Essentially, quadrant scaling and root planing went from a negative experience for patients to a near excellent experience.
• When Mr. Thirsty One-Step was utilized for limited scaling and root planing, the NPS score increased from +20 to +80 for hygienists and from 0 to +50 for patients.
Once again, utilizing Mr. Thirsty One-Step improved the experience for patients to the excellent level. To put the NPS scores in perspective, if a U.S. company were to receive a Net Promoter Score greater than +65, it would be in the top 10 of all companies in the United States for customer satisfaction. In a recent analysis of the top 10 NPS leaders, the No. 1 rated NPS score went to USAA Insurance with a score of +80, followed by Costco at +78. Even an NPS score of +36 landed Trip Advisor the leading score in the category of travel websites. Therefore, the improvements in NPS scores witnessed when using Mr. Thirsty One-Step proved to be significant.
Mr. Thirsty One-Step offers a new delivery method that increases patient satisfaction and decreases treatment time during hygiene procedures. Imagine yourself being happier, your patients happier, and having an additional 29 minutes more than what you normally would have after a scaling and root planing.
This additional time certainly gives you options: to properly educate your patients, to see more patients, to turn over your room, or maybe just eat lunch. No matter what you do with that extra time, I hope that you discover as we did the time savings of utilizing this product for isolation, retraction, and suction. There is no need to be downtrodden by the bandit named time. We are all on this trail together, and there is always another way to move the wagon faster. RDH
Andy Goldsmith, DDS, FIALD, DICOI, practices dentistry in Minneapolis, Minnesota, and is the past chief dental officer and vice president of vendor relations for Smile Source. He speaks internationally on the topic of practice management and treatment-plan acceptance. Visit www.andygoldsmith.com for more information.
