Should I stay or leave?

Dec. 1, 1999
I have been working in a general practice in the East for the past six years. I also hold licenses in two other states (my husband`s company has transferred him several times).

Dianne Glasscoe, RDH, BS

Dear Dianne,

I have been working in a general practice in the East for the past six years. I also hold licenses in two other states (my husband`s company has transferred him several times).

The office I currently work in is a modern, multi-doctor office. Five hygienists are employed. Even though things are not perfect, the large staff seems to get along well. We have good office camaraderie, and I have come to feel at home here.

However, lately I have begun to feel overworked and underpaid. I know for a fact that our wages are below what other hygienists are making in this area. On a typical day with no periodontal scalings, I will see 11 prophy patients. These are on a 40-minute schedule. Some days, I can hardly find time to go to the rest room!

We have a production goal that is nearly impossible to meet, unless we have some high-production treatment, such as periodontal scaling or sealants. If we exceed our goal, we get a bonus of 20 percent of the excess. I would estimate that I meet or exceed the goal about 50 percent of the time, but the amount of the bonus is quite variable - certainly not anything you can depend on.

Another problem that really gripes me is that I am only given 40 minutes with new patients. There is no way I can do a thorough exam, X-rays, prophylaxis, and establish a good rapport with a new patient in 40 minutes.

However, there are some good points about this practice. We have 20 minutes flex-time built into the schedule before lunch and at the end of the day. This allows me to get my full lunch hour and to leave at or slightly before 5 p.m. most every day. If I need a day off for some special reason, it is never a problem. Also, I have always been treated in a caring manner if I have to be absent because of illness. I find that I enjoy working in a large practice more than a small one because I don`t feel micro-managed. Additionally, the doctors in this practice usually are prompt in doing hygiene checks.

My dilemma is that I have been offered a hygiene position in another office for a $15/day increase in salary. During the initial interview for this position, some "red flags" went up in my mind, especially when the doctor said he has a little problem staying on time. Also, he said he "intends" to set up a profit-sharing plan for employees. I`ve been burned by good intentions in the past. In addition, I found out that they rarely ever get out by 5 p.m., but rather 5:15-5:30 p.m.

Should I take the money or stay put?

Wavering in Washington

Dear Wavering

It is easy to sense that you are having a real internal struggle with this decision. There are many factors to consider, so let`s take a look at the issues more closely.

The good points that I detected from your letter about your present position are: (1) good working relations with co-workers, (2) respect for you personally when you need to be out, (3) a modern facility, (4) you get to leave promptly at lunch and at the end of day, (5) you don`t feel micro-managed (good word!), and (6) bonus possibilities.

The negatives are: (1)you feel pay is lower than average, (2) you don`t have enough time for new patients, and (3) time pressure.

Just comparing the negatives against the positives, it looks like there are more positive aspects in your present position than negatives. You probably would not have stayed this long if it were not a good place to work.

One thing I have learned in my long dental hygiene career is that money alone will not make a person happy. I have worked in offices where I made well-above-average pay, but I was not happy. Office stress, personality clashes, forever waiting on the doctor, fighting the clock - these are all examples of things that cause employee discontent.

However, in retrospect, my happiest offices were those where I made average money, but felt comfortable with scheduling and was treated as a fellow professional. My first practice straight out of dental hygiene school was such a practice. The doctor was a fine gentleman who felt his staff was the best staff in the whole world. He treated us like family, and, for that, we gave him 110 percent.

In order to make a proper decision, you must consider your station in life. Are you in desperate need of more money or are you comfortable financially? Remember, you may make a move into an office that pays more, but is not necessarily a better place to work. How much do you value getting out on time at lunch and at the end of the day? In addition, this doctor already has told you that he will probably keep you waiting excessively at times. Can you handle the frustration? Also, you are wise not to count on "intentions" for a future profit-sharing program.

Often, the lure of more money can be tempting. However, be cautious in leaving a practice where you are, for the most part, happy. Remember, there are no perfect practices.

As far as time for new patients is concerned, ask the office manager if more time could be given for these patients. Surely the doctors in your practice understand the importance of establishing a good first impression. Nobody wants to feel he or she has been rushed through an appointment, especially a new patient.

This discussion gives me an opportunity to list some questions that any hygienist considering a position should ask the prospective employer:

(1) Would you mind sharing why your present hygienist is leaving?

(2) What time do you typically get to leave in the evening?

(3) What benefits do you offer? Uniforms, vacations, paid holidays, continuing education, insurance, profit-sharing, retirement plan, sick days, etc.

(4) Will I be responsible for scheduling recare appointments or confirming patients?

(5) Does your staff punch a time clock?

(6) How long has your other support staff been with you?

- Is your wife an employee in the practice?

- How much time is allotted for a periodontal scaling or regular prophylaxis?

" Will I be doing sealants?

" Will I be allowed to take my vacations at the time of my choosing?

Best wishes with your decision!


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.