The $300,000 'hygenius'

March 22, 2016
Val and Lori are two hygienists who have practiced with Dr. Janaclaus for 10 years.

Gary Kadi

Val and Lori are two hygienists who have practiced with Dr. Janaclaus for 10 years. In 2015, they each broke $300,000 in their annual hygiene production. When you add in the case acceptance they facilitated, they were responsible for over $1 million in practice revenue. In my book, that makes them "hygeniuses."

With the average general practice billing about $670,000 per year, "hygeniuses" are your treatment plan for breaking the seven-figure barrier effortlessly and ethically.1 When Val and Lori started practicing, together they generated about $950 per day in a tiny Midwest farming town with a population of 20,000. They called my company for some coaching on how to handle patients who cancel because "the cows got out." These days, they hit their daily goals 87% of the time. (I'm sure it would be 99% if it weren't for those darn farm animals!)

Remember: "Good is the enemy of great." With that in mind, here are three steps to turn your hygiene department into a high-purpose, total-health advocacy team. Now, this is not something to just "get on board with"-it is something to take seriously. Dental service organizations (DSOs) and management service organizations (MSOs) have prioritized hygienist production as a strategic initiative. The time is now for private practices to get the competitive edge by giving patients what they want to invest in-the sustainability and longevity of their overall health.

Step 1: The dentist must champion hygiene. My definition for leadership is you go first. If you want your hygienists to shine, you must shine first.

In my 20 years of experience in this industry, I've found that doctor-hygienist relationships vary widely. On the bottom end is, "hygiene is an intrusion on the doctor's day." Similarly, some doctors call preventive care "just a hygiene visit." What you really should be doing is viewing your hygienists as partners. You share roles as advocates for complete health. Moreover, your hygiene team is your first-class ticket to getting your patients healthier, gaining your personal freedom, and realizing big production gains for your practice.

Step 2: Evolve your hygienists into "hygeniuses." Your hygiene department is the "catalyst" for all growth in your practice. As you know, catalysts make reactions occur faster and reduce their activation energy. Because catalysts are not consumed in reactions, they can work their magic again and again. See your hygienists as catalysts!

Remember that, generally speaking, your hygienists are the only health-care workers who spend two hours per year with a patient. They should present from a place of certainty and purpose. When they do, the reoccurring issues of low case acceptance, open scheduling blocks, low morale, and high stress melt away.

Here are three ways to speed up your hygiene team's transformation into "hygeniuses":

1. Encourage them to join the American Academy of Oral Systemic Health

2. Sign them up for a two-day course with medical practitioners and dental supporters Bradley F. Bale, MD, and Amy L. Doneen, DNP, ARNP

3. Have them visit

Your results will be immediate when your hygienists learn the science behind periodontal inflammatory burden and its connection to chronic disease.

Step 3: Have your hygienists own and understand the value of the services they offer. In our research, we have found that a high percentage of dental team members think their practices' fees are too high. Furthermore, they would not spend their money in their own practices. Ouch! Now, if your own team thinks your services are too expensive, how can they authentically present cases and convince patients to see treatments as investments?

In your next team meeting, write on a white board all the valuable things you provide patients. What is the value of being seen on time, receiving education, and having access to the latest technology? Add up all the years of schooling and continuing education of your team. List the number of patients' lives you have saved and for whom you've made a real difference. Then, write down your soft-tissue fees. How much should they be? When you and your team feel in your bones the value that you really are, watch those 1000 codes become 4000 codes.

Getting to $300,000 is a process. Val and Lori were open to new ideas and willing to change. Dr. Janaclaus invested in them to get their hearts and minds ready to be complete health hygienists. Today, they know their value and have certainty when presenting. Your team, too, can achieve hygiene heaven with the help of dental "hygeniuses."


1. Income, Gross Billings, and Expenses: Selected 2014 Results from the Survey of Dental Practice. American Dental Association website. Published December 2015. Accessed February 2, 2016.

Gary Kadi is CEO of NextLevel Practice. He created NextLevel Practice to implement the Complete Health Dentistry business model, in which teams willingly embrace and implement change, patients respect their treatment regimens and invest in their health, and doctors enjoy practicing the way they envisioned when they graduated from dental school.

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