Th 293072

Keep the office open!

Aug. 1, 2008
I'm preparing to take three weeks off from my practice to go on a short-term mission trip.

by Dianne Glasscoe-Watterson

For more on this topic, go to and search using the following key words: locum tenens dentist, hygiene production, patient appointments, undiagnosed dentistry, temporary office closing..

Dear Dianne,

I'm preparing to take three weeks off from my practice to go on a short-term mission trip. I'm trying to decide whether to hire a dentist to be in my office while I'm absent. My hygienist's schedule is booked out six months in advance, and she has patients already scheduled on all the days I will be gone. My state is a direct supervision state, which means my hygienist cannot work if there is not a dentist on the premises. Would it be cost-effective to bring in a temporary dentist?
Tarheel (NC) Dentist

Dear Tarheel,

Before anything else, I want you to consider the cost of cancelling three weeks of hygiene. Assuming your hygiene department is typical, your hygienist is producing anywhere from $800 to $1,200 per day. For the sake of simplicity, let's assume $1,000 in production a day. At four days per week times three weeks, that's $12,000 you immediately lose by closing down the office. So, let's establish from the outset that you need to keep your hygienist working.

The other reasons to keep the hygienist working are obvious. Just put yourself in your business assistant's shoes having to deal with the scheduling nightmare created by cancelling three weeks of patient appintments! Where could she possibly reschedule all those people? Further imagine the consternation many of these patients might feel by having their appointments changed.

Also consider the production that will be lost from dentistry not diagnosed out of the hygiene chair. The hygiene department typically drives the rest of the practice, and 50% or more of your production comes directly from hygiene. If you produce $15,000 a week, the "opportunity cost" of shutting down hygiene is $22,000, or $7,500 times three weeks.

Where do you find locum tenens doctors? You could ask your colleagues in the area if they could recommend someone, or you could contact Forest Irons and Associates. His company provides locum tenens coverage for most of the eastern seaboard, plus many other states. His Web site is:

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In a recent conversation with Mr. Irons, he related that compensation can vary depending on the area and the scope of duties. Some locum tenens doctors are present primarily so the hygienist can see his or her patients, and the locum tenens doctor may see an occasional emergency patient. The compensation in this situation would obviously be less than if the locum tenens doctor saw a full load of patients. The pay can be set as a hourly or daily amount, or as a percentage of production (typically 35% to 38%). If the locum tenens doctor drives a long distance and/or stays in a hotel, there may be travel costs as well.

Another consideration is your staff members. If you close the office, do they have to take time off with no pay, or are they forced to use their vacation time? Put yourself in their shoes. They (like you) have bills to pay, and would probably rather take their vacation when their children are out of school and their spouses can take vacation time as well.

While your patients would rather see you, they will appreciate the fact that you made arrangements to have someone available to take care of them in your absence.

The main point is this: Even if you do not actually make a profit from keeping your office open in your absence, the benefits of doing so far outweigh any perceived negatives.

I commend you for giving of yourself and your time on the mission field. Go and have a wonderful time ... but keep your office open and your hygienist working!

Dianne Glasscoe-Watterson assists dental practices in achieving their highest potential through practical, effective onsite consulting. Her continuing-education courses help dental professionals refresh their knowledge base and reignite professional passion. Visit Dianne's Web site at or e-mail her at [email protected].

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