I went back three months and found that approximately 80 percent of the dentist's production was from recent recall patients. Add this to the productivity of the hygienist, and you will see we pay for ourselves many times over.
12 patients are too many!
Dear RDH:
I am writing in response to the article, "Peace & Prosperity," by Dr. John Wilde (April 2001 issue). I feel he is trying very hard and with good intent to bridge the differences that often arise between hygienists and dentists when it comes to salaries. It is true that a universal problem exists with hygienists feeling undervalued in a practice, and Dr. Wilde seems to have compassion for this dilemma. However, his solution of "expanded hygiene" upset me the minute when I read what it entailed. Obviously, every hygienist would love to have an assistant, but at what cost? At the cost of seeing 12 patients a day? I think not.
Having written the article, "You've Been Doing This How Long?" for the February 2000 issue of RDH, I could not more strongly recommend against this kind of daily production. Seeing 12 patients in a day is a fast track to mental and physical exhaustion, not to mention just plain old pain. Is it worth it? I say no. This is unrealistic, and I have to wonder what kind of quality cleanings a hygienist can deliver in these numbers per day, not because the hygienist isn't capable of quality prophys, but just because he or she is just plain pooped. It is too much.
I recommend that all hygienists not be tempted by a larger paycheck at the cost of their own mental and physical well-being.
I wonder if dentists look at the total production brought in by their hygiene program. It seems that when I read production numbers for hygienists the only things counted are prophys and maybe X-rays. What about the exams? Does your office charge for a periodic exam at the prophy or is it included? The patient should be charged separately for the dentist's exam. The production from dental work on recall patients should also be counted as the hygienist's contribution. If patients are not on regular recalls with the hygienist, it is plainly obvious that the dentist's production would be drastically cut. Dentists cannot rely only on large, new-patient production. The vast majority of any dentist's production comes from recall patients. Is this not part of the hygienist's contribution to production? I strongly believe it is.
Out of curiosity, I searched our office's records to see what ratio of the dentist's production was directly from recall patients. I went back three months and found that approximately 80 percent of the dentist's production was from recent recall patients. Add this to the productivity of the hygienist, and you will see we pay for ourselves many times over. Would the hygienist's salary fall within the recommended 33 percent range? Absolutely! Hey, you may find a raise is indicated!
Please do not think I want to ride on the hygienist vs. dentist bandwagon. I do not wish to. After 30 years of practicing hygiene, I have had enough of the never-ending division of hygienists and dentists. I have a better idea. How about dentists simply realizing that there is no practice without a hygienist — unless, of course, the dentist wants to clean teeth all day? Hey, that's not a bad idea. After doing nothing but prophys for a while, I'll bet any dentist would beg to bring a hygienist back into the practice!
I want to throw one more thing in here. In my article published last year, which consisted of 12 ways to survive hygiene for the long run, I forgot one more helpful hint — gloves. There must not be any pull across the palm of the hand, which creates tremendous fatigue. There are two solutions. Spend a little more money on sized gloves that are hand-specific rather than ambidextrous. If that doesn't work, wear gloves that are a little larger regardless of whether you have hand-specific gloves or not. It seems a bit awkward at first but you will adjust. The lack of pain will be well worth it. I also suggest you look into alternative latex gloves before an allergy can develop. There are very nice nitrile gloves available in regular white, not the smelly blue ones.
Stick in there, hygienists. Keep up your own standards and always know that you are a very much needed part of any dental practice.
Candace L. Beecher, RDHEF
Upland, California
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