Reader's Forum

March 1, 2011
The article titled, "The Mood Out There" (January 2011 RDH) showed a good cross section of how the hygiene profession is viewed ...

Dear RDH:

The article titled, "The Mood Out There" (January 2011 RDH) showed a good cross section of how the hygiene profession is viewed and how narrow the profession has become. I am also a registered dental assistant (RDA) as well as an RDH. I saw the need to be re-credentialed in my first profession back in 2007. With the economy, you have to keep yourself marketable. I have been in the dental profession since 1979 and have always kept my focus on patient care, not how much money I could make. If you love what you do, the money comes later and more than you can imagine! Employment has never been an issue since I have started in either profession.

Being multi-credentialed is well worth the investment of time and money for the training. Sharing your knowledge and experience with patients and colleagues is part of our training and professionalism.

For example, learning centers are looking for dental hygienists with current RDA licensing to teach in their dental assisting programs. They have faculty positions of teacher and teacher assistant.

I would have to say the comments about not finding substitute or part-time positions are true in Michigan. The comments about the dentists treating their employees with less respect than they deserve is sad and unfortunate.

However, life lessons present themselves in many ways. We need to make some decisions and learn not to repeat this poor behavior toward others in the future. After experiencing similar situations, I moved on to better employment situations, but I am grateful to have learned these valuable lessons.

The experience of moving 13 times over the past 30 years of marriage gave me the opportunity to embrace change. During these moves, we had two daughters go to four new schools in four years at one point. We all survived and they are very successful young women. Both are engineers – one mechanical with an MBA, and the other one is a chemical engineer, which goes to show that how you look at a situation has a lot to do with the outcome. We focused on the family unit and being together. Keeping in touch was made much easier with the technology of the Internet coming into play. So even if change was not convenient, we made it work and embraced it. Sometimes life gives you lemons; you make lemonade or are very creative with the lemons!

So with all the complaints about how hard it is to find work in their chosen profession, you have to remember that there are opportunities and options available that you can take. Just some thoughts to share, and thanks for a great magazine!

Sharon Libich, RDA, RDH, BS
Brighton, Michigan

Dear RDH:

The article titled, "The Mood Out There," identifies a new reality of hard times for hygienists. There are few jobs and lower pay, and this reflects the dismal economy where dental treatment is becoming a luxury that fewer patients can afford. It is unfortunate, but some dentists and management experts will say to hygienists, "What do you expect?"

1. Patients have less disposable income, fewer insurance/government benefits, and are spending less. They are not coming into dental offices.

2. Hygiene educators and colleges are graduating more and more hygienists in a greedy attempt to get more tuition money and department power. The field is over supplied with graduates who are promised big salaries that do not materialize. Over supply and competition equates to lower salaries.

3. Dentist employers are hurting financially because patient numbers are down. They cannot afford hygienists slowly doing the old style cleanings on salary. Many offices have dentists and expanded duty dental assistants do the cleanings because they have the time to do them. Hourly wages are becoming standard. Full-time becomes part-time.

4. Many hygienists have not endeared themselves with their dentist employers. Many have challenged their dentist employers for control of the practice and behaved like little princesses (or princes), making unreasonable demands and slowing production regardless of the economic realities for the practice. Dentists will not put themselves out for their problematic hygienist employees anymore. They don't need them. Sour grapes get spit out.

There are some things you can do to help yourself and the profession in this economy:

1. Recognize that the dentist is the boss and team leader. Be a good employee, and do your job the best you can and in a way that your employer desires. If you do not, you're gone. The dentist calls the shots because he/she is the one who pays you. All personal demands must benefit the practice, not you.

2. Do your cleanings fast and efficiently. The greater the profit the practice gains from your efforts, the better for you and your dentist. The days of the 45 minute prophy are over. Work fast and efficiently to keep your job.

3. Behaving well will be the best way of keeping your job and maybe even making more money. If you are prone to whine, complain, gossip, talk negatively, etc., stop. Antagonizing your employer and the other staff members is a sure route to unemployment. Treating your patients the "right" (by their standards) way is critical. If you don't have a pleasant personality, get one. Should patients not come back, everyone loses.

4. Sell dentistry. Support your dentist's recommendations for the patient. You are a team member and you must enhance your dentist's lead. Take the initiative. Plan each patient visit with your dentist to maximize treatment options and acceptance. Boost your dentist to the patients. Work and re-work the recall system and make follow-up calls frequently. Take lists home and confirm at night. A no-show is a no-no. You want to be the No. 1 fan of your employer. Back him or her to the hilt. It makes sense when your salary is involved.

5. Find ways to be more helpful to the practice. You are not just there to scrape teeth. Help with appointments, billing, clean-up, walking elderly patients to the car, ordering supplies, etc. Use the least expensive supplies that you can ethically use. Those little expensive conveniences add up to big bucks at the end of the year and may not be essential for good patient care. The more valuable you are and the more money you save the practice, the greater the chance that you will be appreciated and employed. Avoid the "little spoiled princess" attitude of many hygienists. In this economy, troublemakers become unemployed.

6. Get rid of those hygiene leaders and educators who have led your profession to this sad state of affairs. The trend of antagonism against dentists aroused by hygiene leaders in the past is not productive. Your income depends on your dentist. Dump educators and reduce college hygiene programs that are creating oversupply. Talk to local college boards and legislators.

7. If work hours are curtailed due to fewer patients, arrange in advance with your dentist and staff members what would be beneficial for the practice (for example, fewer hours for all vs. full layoffs for some) should things get sour.

Good luck. With a little more effort you can weather this economic storm.

E. J. Neiburger, DDS
Waukegan, Illinois

Dear RDH:

I was disappointed and a little shocked after reading "The Mood Out There." The article painted a pretty grim picture. I am a full-time hygienist in Bloomington, Ind. While I know that some of my colleagues are struggling to find work, or unhappy in their current practices, there are a few of us out there who are happy in our present positions and optimistic about the future.

I am employed by two doctors who do excellent work and are respected by their staff. We receive regular raises and production bonuses, although we are never forced to "sell" dentistry. Our patients get the quality care that they need, and we get the equipment and support we need in order to practice to the best of our abilities. I guess I should count myself among the lucky few, but I just wanted to give a little more of an uplifting perspective.

Jessica Reed, LDH
Bloomington, Indiana

Editor's Note: We're very grateful to Ms. Reed for taking the time to write about her job experience. However, the article did state at the beginning: "Many of the comments below would probably be viewed as negative rather than positive. Although some positive comments, such as 'I work for a great doctor and with a great team,' are included, more would probably have been published if the hygienist had added, for example, 'The job market is great here too.' The purpose of this article is to publish comments about dental hygienists' perceptions regarding their careers in the current economic climate." Many of the positive comments submitted in the survey simply did not offer any insight regarding local job markets.

Dear RDH:

I found Jane Weiner's article on treating and understanding geriatric patients (December 2010 RDH) to be a good review. However, there was an error that I'm hoping was a typographical one not picked up in the proofing process. On page 35, she states: "But they must have eaten. This is imperative. We also need to keep a sugar substitute on hand in the office in case the patient does have a hypoglycemic episode."

A sugar substitute will do nothing to alleviate a hypoglycemic episode. Hypoglycemia can and does happen – even when the patient has eaten, and the treatment is approximately 15g of carbohydrates in the form of juice, sugared soda, glucose tablets, or tube icing.

I would add that it is important to ensure that patients have their glucose meter with them during the appointment. Since many non-insulin requiring patients do not carry their meters (also true of many on insulin), it isn't a bad idea for the office to have a meter and strips on hand, just in case.

Jane's suggestions for adaptation of hygiene tools, her review of common medications and conditions and suggestions we can and should be doing to make appointments for our geriatric patients easier are all things we as clinicians need to consider and remember.

Margit Bergquist-Tracey, RDH, BA
Washington, D.C.

Editor's Note: Good catch. The article should have said "sugar source." We regret the error.

To submit letters to the editor, send to: RDH, P.O. Box 3408, Tulsa, OK 74101; [email protected]; or (918) 831-9804 (fax).

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