Hygiene schedule blockage

April 19, 2016
Is your hygiene schedule too full?

Michael Kesner, DDS

Is your hygiene schedule too full? Believe it or not, your hygiene schedule can be overbooked. This will inhibit your growth, cause your practice to plateau, and increase your cancellation and no-show rate.

Here's what I mean. Take a look at your hygiene schedule. Now look two weeks into the future. Is it booked solid, or are there some holes in the schedule?

If you have been in practice for several years, there is a good chance your hygiene schedule is completely full at least two weeks out. Believe it or not, this is not good. This is an indication of a capacity blockage in your practice.

If you don't have holes in the hygiene schedule in the next two weeks, then where are you going to appoint new patients who want to get their teeth cleaned? Where are you going to appoint patients who need scaling and root planing?

In my experience, when new patients or scaling and root planing patients are appointed out more than two weeks, the cancellation and no-show probability doubles. Do you see a lot of cancellations in your hygiene schedule the day before or the day of appointments? This is typically an indication of making patients wait too long to get a hygiene appointment.

Patients often lose either the interest on the urgency when appointed out more than two weeks. If this is a new-patient appointment (especially a marketed new patient), the patient will often just call another dental office that can get him or her in sooner.

In my practices, I am always looking at the hygiene schedule two weeks out. If the schedule is full, this is an indication that I need to either add another hygienist or hire an assistant for the hygienist.

A hygiene assistant will allow my hygienist to see almost twice as many patients in a day, which has the same effect on the schedule as hiring another hygienist.

My hygienists love having an assistant because they don't have to set the room up, take x-rays, or clean the room. The assistant also helps them with charting. These things make the hygienist more productive and efficient.

If you hire a hygiene assistant, I recommend putting your hygienist on commission. This will allow your hygienist to increase his or her income, which is only fair since the number of patients he or she sees each day will increase.

Also, by adding more hygiene appointments, the production increases on the restorative side of the practice. If I am doing twice as many hygiene exams in a day, then I am going to diagnose about twice as much restorative dentistry.

Alleviating the capacity blockage in hygiene increases the production of the entire practice. If the revenue in your practice has plateaued, take a look at your hygiene schedule. That is probably one of the places the blockage is located.

For some of you, the problem is that you don't have the physical space for another hygiene treatment room. You may need to turn an unused or underused doctor room into a hygiene room. Or, you may need to remodel to get the space for an additional room. Some of you have the treatment room that just needs equipment.

The money it costs you to add a new room and a new employee will pay for itself many, many times over. We typically see an increase in overall production of $25,000 to $30,000 per month from adding a new hygiene room. This is due to the increase in restorative dentistry generated, more new- patient appointments available, more scaling and root planing, and more recall patient appointments.

Let's look at the costs. If you get a loan to add a new treatment room, the note payment will be around $50 a day. Adding an assistant for your hygienist will cost you around $200 a day. So, for $250 a day, you can have a new treatment room and another assistant.

If you see patients four days a week, the additional production generated should be around $1,500 a day. That is a 6:1 return on your investment. Where else are you going to get that kind of return on your money? This is a $300,000 increase in your annual production!

Michael Kesner, DDS, has a practice that ranks on the Inc. 5000 list as one of the fastest growing companies in America. He is the author of the book Multi-Million Dollar Dental Practice and the CEO of Quantum Leap Success in Dentistry. They teach more production, higher profits, and less stress. Contact him at [email protected].

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