Boss, please tear up my paycheck! Im feeling like a saint, and I dont want my salary

March 1, 1997
Money. This subject agitates the humanitarian in each of us. How can something so elementary as a medium of exchange or means of payment be the cause of such contention? How can we get down to business and deal with this evergreen topic?

Heidi Emmerling, RDH, BS

Money. This subject agitates the humanitarian in each of us. How can something so elementary as a medium of exchange or means of payment be the cause of such contention? How can we get down to business and deal with this evergreen topic?

Inevitably, this generates controversy. This is not surprising since our culture has traditionally designated financial issues, especially for women, as undignified. It is supposedly degrading to have such materialistic concerns. Predictably, some claim that the true rewards of being a hygienist include providing optimal patient care, volunteering our services, serving our profession, or enjoying the camaraderie of colleagues. Indeed, these rewards helped draw me to the profession, and these rewards help keep me here.

The rewards of charity work are very fulfilling

Regardless, interesting comments have been hurled my way by some readers in response to an article on job hunting. For example: "In her article, she mentions salary or pay at least three times ... I have volunteered privately and professionally ... without monetary reward. That is why I became a professional. I wonder if Heidi would have declined a gubernatorial appointment because it is below the current hourly rate."

Hmmm. Despite the greedy and selfish image the reader has of me, I would not decline a prestigious political appointment. Dental hygiene benefits from and needs more hygienists who contribute to their profession. My admiration for these volunteers has prompted me to volunteer at the various levels of the ADHA, serve on a college advisory council, and fulfill unpaid appointments with the offices of the Nevada Secretary of State and the Nevada Attorney General.

The pride and sense of reward one feels from volunteering and supporting the profession cannot be reimbursed with any amount of cash. There`s nothing quite like those intangible rewards. Indeed, if dental hygiene did not include those other rewards, the money we make could induce very few of us to stay in the profession.

However, as disappointing as it is to burst this bubble of idealism, we are professionals in the business of health care. And money is a concern. After all, how many banks or grocery stores accept professional pride in lieu of money? How many hygienists feel they make too much money? I haven`t met a single hygienist who would tell an employer, "Please rip up my check. I`ve had way too much fun this week and my inner happiness would be insulted and tarnished by accepting any money." The philosopher Albert Camus once wrote, "It is a kind of spiritual snobbery that makes people think they can be happy without money."

Another letter reads: "It`s obvious what motivates her is not patient needs or care." I`m puzzled. I do not recall advocating compromised patient care for a decent salary. What I do advocate is fair compensation for the service we provide. It is not obvious to me how this precludes good patient care.

A good salary does not mean poor patient care

This should not be cause for dismay. There is, after all, nothing unethical or immoral about earning an education and subsequently providing a service to employers and patients with the expectation of fair compensation. This does not make one greedy or preclude one from providing excellent service. Henry Ford writes, "It is not the employer who pays wages - he only handles the money. It is the product [or, in our case, service] that pays wages."

Furthermore, unless one is independently wealthy, it is difficult to volunteer time and/or money, or even maintain a professional license, without the security of a stable livelihood. It is expensive to go on sabbatical and clean teeth in the Dominican Republic. It is a financial consideration to cancel a day of work or pay a baby-sitter in order to attend some important legislative hearing. It is costly to register and travel to certain professional meetings.

With these financial considerations in mind, we might ponder the wisdom of J.D. Rockefeller who once said, "I believe the power to make money is a gift from God ... I believe it is my duty to make money, and still make more money, and to use the money I make for the good of my fellow man according to the dictates of my conscience."

I reiterate: Our profession embodies business matters. Employers expect us to be mindful of overhead. We are expected to know the fees and insurance codes for various services we provide. We are expected to be aware of production, efficient scheduling, and the effect of cancellations and no-shows.

We should be aware of the production we generate for the office. Hygienists are direct providers of office production. The services hygienists provide are valuable. Not only do we provide direct production as prophies and root planings, we free the dentist`s time allowing the dentist to provide more lucrative procedures. Also, we generate production indirectly when we remind patients of needed restorative work. Many hygienists refer patients to the practice.

Do not leave `money` to employer`s whim

In turn, hygienists should not sell themselves short. Although it may feel awkward, hygienists need to negotiate not only before committing to a job, but evaluate their situations and contributions to the practice regularly. Too many merely leave it up to the whim of an employer.

Hygienists need to be clear about the method of compensation: hourly, daily, or commission. Explore each method, determine which best meets your needs and expectations, and then ask for it.

Hygienists have a legal right to know when they will be paid. Certain labor laws stipulate pay periods be regular. In other words, if payday falls on the first day of your employer`s three-week vacation and the employer intends to pay you after returning, that is wrong and may be illegal.

Finally, hygienists should be aware of the prevailing salary range in their geographic area. Simply discussing salaries and conducting salary surveys are not considered price fixing; market research is not illegal.

Hopefully, hygienists can become progressively less queasy when it comes to getting down to business and dealing with money. We do not work for the dentist. Rather, we work with the dentist and for ourselves. Money is a reality and, although not always the principal aspect for many, it is an integral aspect for all. P. T. Barnum said it well: "Money is a terrible master but an excellent servant."

Heidi Emmerling, RDH, BS, is a consulting editor for RDH, a writer, speaker, and clinician from Sparks, Nevada. Her e-mail address is [email protected]