By Eileen Morrissey, RDH, MS
Will Durant, an American historian, once said, "We are what we repeatedly do. Excellence then, is not an act, but a habit." More than a few hygienists promulgate negative postings that pertain to their doctor/employers on Internet subscriber lists. Since I spend a portion of my work life teaching in a community college dental hygiene program, I thought it might be interesting to interview some of my dentist colleagues who are in private practice and have worked with dental hygienists through the years. It was an opportunity to hear a different perspective.
It was enlightening, to say the least. Some of the things I heard about the ways of certain dental hygienists absolutely floored me. I work part time in a private dental office. I left these conversations feeling good about how I conduct myself professionally, yet bewildered as to why doctors would allow such antics to perpetuate.
For purposes of confidentiality, the doctors and hygienists will remain unnamed.
Dr. X. actually emailed me an image she photographed of how one dental hygienist leaves her tray prior to the exam. I emphasize, "leave the tray," because the hygienist has vacated the premises. She can be found in the break room, and this occurs between every patient. It is her self-proclaimed time to snack, and to check cell phone texts and emails.
If you could view this picture, you would see the dirty gloves that have been left on top of the instruments, including the explorer and mirror that are about to be used by the doctor for the exam. You would also note the complete chaos of the contents of the tray, as well as the condition of the mouth mirror, which is unusable in its present state. There is no one available to chart, since the hygienist is "between patients."
The doctor made me aware that the hygienist's cell phone is always in clear view of every patient. Texts and emails are announced with an incoming sound. Regularly, the hygienist will stop to check the phone.
The doctor is an employee, as is the RDH. She is a very popular hygienist, as she tells each and every patient how much she loves them and how grateful she is that they are a part of the practice. Truly a warm, fuzzy woman! While the owner of the practice is aware of this hygienist's unprofessional behavior, he chooses to ignore what would no doubt be an unpleasant confrontation, and focuses on the positive aspect of her presence in the office. Her coworkers, though, may well despise her for obvious reasons.
Next, Dr. Y. spoke about a hygienist who contradicts him openly in front of the patient regarding treatment plans. Or she undermines him once he leaves the room. She presents incorrect information, and pushes alternative medicine agendas after this doctor has presented his evidence.
I was appalled by the stories that I had heard, and know these doctors well enough to take them at their word. I am disappointed by the behavior of my colleagues, and wonder what can possibly be their reasoning?
From my perspective, what I am obligated to do professionally is to champion the cause of the philosophy of professional care in my practice. If there comes a point where I feel I can no longer do that, it is time to escort myself gracefully to the door marked "Exit."
I know times are difficult, and some of us are in work environments that may not be ideal. But if you cannot go along with the treatment being proposed, for heaven's sake, keep your mouth closed! Communicate with the doctor privately! It is not the moment to disagree with a diagnosis and a treatment plan. (Last time I checked, hygienists are not permitted legally to diagnose.) If you don't like what is being presented, go to dental school so that you can write your own dental treatment plan. Until then, it's not your job to be a Monday morning quarterback.
As far as the mess left behind on the tray, and the chaos that included dirty gloves and the debris-covered mouth mirror, that image will stay with me forever. Have you no pride? Somehow I can hear this hygienist's rebuttal. I'm betting she is going to feel good about saving the practice a few cents as she reuses those gloves to break down her room. Never mind OSHA's best practices...
Believe it or not, the laments of these two doctors were the tip of the iceberg. To both their defenses, I reiterate that they are not practice owners, and it is therefore the ultimate responsibility and obligation of their employers to put a stop to what is happening. While each voiced ongoing frustration and have expressed grievances to their collective hierarchies, their hands are tied because the owners choose not to take action. Sigh, and there are many more anecdotes that I heard from other doctors. Readers, I hope you don't see yourself here.
Onward we go; it is in our hearts' core. RDH
EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Rowan College at Burlington County. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at www.eileenmorrissey.com.