# Hygiene math for success

July 1, 2005
Hygiene is the aortic valve of your practice, serving established and new patients.

Hygiene is the aortic valve of your practice, serving established and new patients. Whatever happens in those precious hour appointments has a great impact on your success. What happens in hygiene does not stay in hygiene. It impacts your bottom line or practice success in both sales and financial arrangements. Conversations, timeliness, overhead per hour, no-shows, and the “wow” for new patients all have a role in a practice’s success. Your clear vision of success demands action to have hygiene math work for you. Know your numbers, including hygiene.

Increase the value of your hygiene appointments in your community. Eliminate cancellations and no-shows. To accomplish this, create the reputation of value by not calling patients and saying, “Can you come in this afternoon at 3 p.m.?” or “We have an opening tomorrow at 9 a.m. or 2 p.m., and the next day, we have three openings.”

Make hygiene feel successful and sought after. Bite the bullet on openings and say, “Our hygiene department is so popular, the next time we can see you is October 3.” When hygiene is full, the numbers work. If the hygiene department is struggling for whatever reason, it does not work for the bottom line.

Do your numbers in figuring overhead per hour in your office. Take expenditure totals for 2004, subtract the total laboratory bill, divide by the number of days worked (if you are working over 180 days, you are working too hard), and then divide by the number of hours per day. This is your total overhead per hour, minus the lab. The reason we subtract the lab is the doctor and hygiene overhead is the same, except for the laboratory expense. This figure may be \$256. For hours with hygiene, you divide your overhead per hour in half, which would be \$128 for each provider in our example. When the doctor does a procedure requiring laboratory use, add in the lab unit cost.

It is true - hygiene overhead is the same as the doctor’s when lab costs are subtracted. All patients use the parking lot, equipment, and dental supplies; require the services of you and your staff for treatment, assistance with treatment, posting treatment to the computer, presenting treatment plans and answering patient questions, and collecting and posting payment for the services you offer.

Knowing the overhead in our example is \$128 per hour per provider is important for scheduling both hygiene and doctor time. If you have one cancellation a day in hygiene, what does it cost you? If the doctor has a patient scheduled for a one-hour appointment cancel, what does it cost you?

For every day of hygiene per week, you might have 200 active patients. This is based on a visit twice a year to see the hygienist for a one-hour appointment in an eight-hour day. Therefore, in four days of hygiene, a practice has 800 active patients. You may have a larger number of patient charts, but this is the number of active patients in your recare program.

The hygiene department should have a daily production goal. The hourly production in hygiene should exceed the overhead per hour per provider. Let’s examine \$128 an hour with your fees. Add together an adult prophy, bitewing X-rays, periodic exam, and fluoride. Does it exceed your overhead cost per hour?

You can start to see the urgency of keeping the hygiene department full with patients who see value in you and your work. Do a survey of the last 90 days in hygiene. Eight patients a day should be appearing. How many actually showed? If you have one cancellation a day, after four days, you have a half-day hygienist on call with no production. That adds up to \$516 in overhead you are supporting.

You should also examine who in your practice does not consistently show for hygiene appointments. Do not reappoint. Let them call you. Ask for their credit card to hold the appointment.

If you have many cancellations, you are attracting people who do not see value in hygiene. Your hygiene department is too full of patients whose vision does not match yours. Select a new group of patients by utilizing better marketing, performing greater internal service, improving your conversation and listening skills, and/or reducing the number of hygiene days available. Remember, staff for what you presently have, not what you hope to have!

Dr. Bill Blatchford’s Custom Coaching Program is now available anytime, anywhere. Utilizing 18 years of practice-management experience with more than 1,100 offices, Dr. Blatchford’s custom program involves minimal travel and maximum personal time with the coach, interaction with other doctors, and tons of support. Leadership, systems, case presentation skills, communication, and profitability are emphasized. He can be reached at (800) 578-9155, or visit his Web site at www.blatchford.com.

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