Staff Rx: Staff wars

Jan. 1, 2001
In an ideal team, everyone helps everyone else so the day runs smoothly. There are no inequality issues.

Dear Dianne,

I work in an office with two front-desk assistants, two chairside assistants, and two full-time hygienists. Once a month, the doctor pays for all the staff members to go out to lunch. The doctor does not go with us, but he encourages us to discuss things that need improvement in the office. These meetings are usually friendly and provide us with time to be together as a staff.

However, at our last meeting, things turned ugly! One of the chairside assistants began making accusations. She said that the hygienists did not pull their share of the load and never helped the assistants out, although the assistants are expected to help the hygienists. She said that she did not feel this was fair. Then, the other assistant chimed in and agreed with her.

Naturally, I became defensive. The conversation became quite heated, and I stated that I felt the assistants' accusations were totally unjustified. I challenged her to prove what she was saying.

I feel I work very hard to provide good care to my patients. I use what little down time I have to sharpen instruments and keep my operatory clean and organized. I often help with sterilization and other non-patient duties when I can.

This confrontation came quite unexpectedly. However, I feel the resentment that what was expressed must have been brewing for a long time. Our doctor is a quiet, nonconfrontational type, and he is having a hard time dealing with this volatile issue.

Can you offer any suggestions on how we can get along better in our office? Even though the storm has passed, I am afraid another ugly confrontation is lurking.

Blindsided in Berkley

Dear Blindsided,

The rivalry between chairside assistants and hygienists is as old as the profession of dental hygiene. Although unfortunate, it is a common occurrence.

As hygienists, we have several duties that are greatly simplified if we have an assistant. For example, periodontal probing performed with the hygienist calling out readings to an assistant is efficient and much quicker than probing "solo." A single periodontal charting can take three times longer to do without an assistant. Additionally, sealants are easier and more accurate if done with an assistant to help keep the field dry and isolated.

On those days when our patients are tightly booked, an assistant can be invaluable in helping the hygienist stay on schedule by assisting with operatory tear down/set-up and processing radiographs.

However, when the doctor only has one chairside assistant and two operatories, it often is difficult for the assistant to keep everything running smoothly for the doctor ... and that is her first priority. Only on those rare occasions when a patient cancels would an assistant have time to help the hygienist.

When there are two chairside assistants for one doctor (as in your office), there are many times when one assistant is not directly involved with a patient. Therefore, opportunities exist for the hygienist to utilize an assistant.

Problems arise when assistants are not informed that they are expected to help the hygienists when the need arises. Indeed, I have had assistants tell me that they do not feel they should be expected to do anything other than direct chairside duties.

Why do some assistants feel this way? Often, these feelings of resentment are rooted in jealousy over the difference in pay, since hygienists typically are paid double (or more) than what assistants are paid. Although I feel that staff members should never discuss their wages with other staff members, it is common knowledge that hygienists are compensated better by virtue of their education and being income-producers in the practice.

However, there are times when assistants are justified in feeling that hygienists do not share in the nonpatient duties. I have seen hygienists casually head for the staff lounge to read a magazine during down time, while dirty instruments are piled up in the sterilization area. I have observed assistants literally running from room to room, trying to attend to the doctor's needs, while the hygienist is engaged in personal telephone calls.

I tend to believe your particular clash arose out of simple jealousy.

Here are my suggestions:

  1. Make sure that you, as a hygienist, do whatever you can when you have down time to help the assistants with non-patient duties.
  2. The doctor needs to have a staff meeting and define more precisely what his expectations are regarding assistants and the hygiene department. I feel the doctor is making a mistake by sending his staff members out for a staff meeting without his presence.
  3. Understand that assistants do not understand what you do as a hygienist. Assistants do not understand how stressful it is to be "solo."
  4. When someone is angry or jealous, kill that person with kindness.

Sometimes I receive angry complaints from assistants like, "I do twice as much work as she does, yet she gets twice the pay I get!" My reply to that is, "You know, I feel chairside assistants make wonderful hygienists. Why don't you go to hygiene school?" I can make this statement because I used to be a chairside assistant before I went to hygiene school.

In an ideal team, everyone helps everyone else so the day runs smoothly. There are no inequality issues. People should not have to be told to help other members of the team by doing whatever they can to make caring for our patients efficient, relaxed, and productive. But, alas, ours is not a perfect world.

Wouldn't it be great if all hygienists had his or her own dedicated assistant and two operatories to rotate? But that is meat for another article. Best wishes!


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. Visit her Web site at http://www.professionalden