Salary and benefits were very hot topics in the Career Assessment Survey results that were published in the July 2004 issue of RDH. These are very important areas that dental hygienists wanted to talk about in order to enhance their professional status and careers in dental offices across the country. So, how do dental hygiene professionals strive to achieve the salary and benefits they deserve in a general or specialty practice? How do we discuss this with our employers in a positive manner in order to be respected, appreciated, and valued as important members of the dental team?
Another major concern of dental hygienists was how to get benefits when working full time or part time. They also felt that experienced hygienists and those with seniority should be paid at a higher level than new or graduate dental hygienists who may begin working in the dental office.
I felt it was important to consult with a few dentists and dental hygienists to add their insights concerning what has worked for them in starting a practice or building an existing practice that has been established for a number of years. While you may not agree with their insights, you will hopefully better understand their points in the salary and bonus area.
The partners in a dental practice in Sparta, N.J., stated, “When we started our practice six years ago, we waited for patients to call for an appointment. We advertised the practice in the Yellow Pages, participated in different insurance policies, and sent out letters to people in the community announcing the opening of our practice. Our employees came first, and many times we would go without a paycheck in order to pay our staff’s salaries and provide them with their benefits package. Our employees know what our goals are in the office. We provide our employees with an annual raise that is based upon how the office is achieving its goals. We also provide them with an annual bonus. As our practice prospers financially, so does our team.”
Another dentist in Flanders, N.J., told me, “The number-one thing that I look for when hiring someone is my ability to work with that individual on a daily basis. It is also important that they are professional, educated, caring with the patients, willing to learn new things, and come to work on time every day. I also value the people that I work with and sign an employment working agreement with them that covers salary per hour, benefits I can afford to provide, vacation, sick days per year, holidays, uniform allowance, bonus if the office meets or exceeds its goal, and the time of their next review.”
The dentist continued, “There are no surprises and everyone knows what their responsibilities are and what the office goals are for the year. This makes things simple and easy to understand.”
Several dental hygienists I spoke with provided some interesting insights in this area. Mary from Connecticut told me, “You must know your worth when negotiating salary and benefits. You must take the time to determine what you bring into the practice each day ... not only the revenue from fees for services, but also the extra things one might do - for example, maintenance, infection control coordination, inventory control, or simply listening to patients and being the dental hygienist they come back to see at their following appointments.
“Everything you do can be translated into revenue for the practice. If you see eight patients per day, and they are each billed $200, you are providing the practice with $1,600 for your services. Shouldn’t you make at least a third of what you bring in, which constitutes $500 per day?
“If your employer is not willing to provide you with that, then that’s when benefits can be discussed. Benefits can include paid sick days, holidays, vacation days, retirement benefits, uniform allowances, and continuing education reimbursement. Also, consider asking your employer if he/she will pay for your membership in your professional organization, the ADHA.
“Once you document your monetary value of benefits you provide to the practice, then you know you can bring this information to the table when negotiating an increase in your salary.”
Mary continued, “Dental hygienists should think about asking for a bonus or commission on services they suggest to a patient in a treatment plan. Also, sometimes offices dispense products to the patients after home-care instruction and a fee may be collected. Why not get a percentage of the profit? It’s something they should consider asking their employers.”
Winnie from New York records her daily production. Winnie told me, “This has been beneficial to see my monetary worth to the practice, for both myself and my employers. They always agreed that the dental hygiene salary should reflect 30 to 33 percent of production. From keeping track of it, I have a bargaining tool.”
Winnie has been fortunate to receive regular raises even without asking because her employers go by that guideline. Winnie works part-time in that office. Her employers provide health benefits, but she must pay the entire premium. For paid holidays and vacation time, she asks them and they usually provide her with these additional benefits. Winnie’s motto at work is “An honest day’s pay for an honest day’s work.”
Debbie from New Jersey told me that the dentist she was working for was very pleased with her work and provided her with one hour per patient for maintenance visits and 90 minutes for new patients. She could schedule the patient for as many visits as needed.
The dentist asked Debbie if she wanted to work on three Saturdays per month, which she did not want to do. The dentist insisted that she work with him on Saturdays and offered her $2 more per hour. Debbie still hesitated and he countered with $4 more per hour. She negotiated to work two Saturdays a month and he agreed to pay her an increase of $3 per hour. Now that Debbie currently works full time for a pharmaceutical company, she only works one Saturday per month and has negotiated a yearly review with this dentist. She reports that she is doing well working part time.
Barbara from New Jersey has a different approach when asking for that yearly salary increase. Barbara told me she uses Post-It notes, and it works for her. She states, “Dentists dislike confrontation, especially about money matters. I have placed Post-It notes on my time sheet that read, ‘It’s been a year since my last salary increase. May I please have a salary review?’ The increase has been in my next check with a thank you for reminding them. Who knows how long it would have been if I didn’t ask?”
I agree with Mary and Winnie that you need to document your productivity each day (maintenance prophylaxis, scaling and root planing, probing, polishing, fluoride treatment, irrigation, radiographs, sealants, professional education, maintaining patient appointments in the computer, treatment planning with new and existing patients, maintenance and ordering of dental hygiene supplies, etc.), so you know exactly how much money you bring in as a dental hygienist for that office. You also need to keep track of procedures recommended (restorative procedures, composites, veneers, crowns, onlays/inlays, tooth whitening procedures, intraoral photographs, etc.).
You may want to negotiate a percentage bonus on procedures you recommended to the patients that will help to increase revenue in the dental office.
Employers value an employee who is punctual in arriving at work on time; maintains a professional image; has a registered dental hygiene license; is educated; is experienced with working with all individuals (children, adolescents, young adults, adults, geriatric patients); emanates professionalism, care, and patience with their patients; keeps up-to-date on new or existing products or developments; is pleasant to work with; and works as a team member.
Employees of a dental practice need to be informed about the philosophy of the office, the yearly goals and objectives, and what the employer is striving to achieve for the office. Everyone must know what needs to be accomplished, how it relates to their job, and what they hope to achieve.
Once everyone is clear on what the internal process is, then everyone is a winner and should be valued and appreciated for doing a great job with every patient during the year.
Through organizational skills, time management, accomplishment of job responsibilities, and teamwork, everyone should be able to sit down with their employers and discuss their professional achievements for the year, and then should be compensated accordingly. The dentist and the dental hygienist should have an open line of communication to discuss how salary and benefits can be enhanced in a positive and professional manner when all goals have been achieved.
Best of luck to you in achieving the salary and benefits you deserve in the dental office. I want to thank the dentists and the dental hygienists who provided valuable insights for this article.
Christine Hovliaras-Delozier, RDH, MBA is president of Professional Savvy, LLC, which is based in Flanders, N.J. Chris is an oral care consultant who works with various companies in clinical trials, product development, professional marketing/relations programs and materials, professional sales, and continuing education symposiums. She has written articles for several dental hygiene publications and works with professional organizations in presenting continuing education courses and other projects. She can be reached at [email protected].
Contents of employment contract
The dental professionals consulted for this column have provided us with some good insights of what has worked for them in achieving raises and benefits. I would like to provide you with some things to consider for future growth and expansion in your career.
Ideally, for any of us practicing dental hygiene, having a written employment agreement or work contract is highly recommended. This contract doesn’t have to be difficult to do and will help identify salary, benefits, and date of next review. This will be helpful for everyone and it is documented in writing.
The employment contract should include the following:Your nameYour employer’s name and addressEmployment start dateSalary (per hour, per diem, commission)Hours agreed to work each weekDesignate full-time or part-time status and number of hours for eachPercentage earned for recommending other dental services listed in patient’s treatment planBenefits, including medical, dental, vision care insurance, paid holidays (specify), paid vacation (number of weeks, specify months), 401K or retirement plan, uniform allowance, professional membership allowance, continuing education course allowance, and professional meeting attendance. These will need to be discussed and negotiated.Job description (roles and responsibilities)Review (bi-annually or yearly and specify month)Reasons for terminationSignature of employee and employerThis contract can be written on bonded paper and kept in the dentist’s files and your files. In this way, you both know what you are receiving as salary, benefits, and bonus. For the benefits you may not be receiving right now, you and the dentist can discuss how you can achieve more benefits in the future, based upon what the dental office goals are.