Content Dam Diq Online Articles 2017 02 February De Thumb

Staying on time

Feb. 8, 2017
This dentist writes in that the practice's hygienist runs behind every day. Patients are starting to complain, the practice consistently runs behind schedule, and the RDH's bad habits are going to be hard to break. Dianne Glasscoe Watterson addresses the issue.  

This dentist writes in that the practice's hygienist runs behind every day. Patients are starting to complain, the practice consistently runs behind schedule, and the RDH's bad habits are going to be hard to break. Dianne Glasscoe Watterson addresses the issue.

Dear Dianne,

I'm a dentist whose hygienist runs behind every day. I've had a few patients complain to me about having to wait on her when they have hygiene appointments. The hygienist has an hour to spend with every patient. One of her problems is that she walks in the door five minutes before her first patient, so she is often late seating her first patient by as much as 10 minutes. This problem gets bigger as the morning progresses, and it causes her to work into the lunch hour.

I'm very prompt and rarely keep my patients waiting, so this problem is annoying for me. My hygienist has been with me for several years, and her work has been satisfactory. But I need some help solving this problem with her.

- Dr. Mike

Dear Dr. Mike,

From the information you've shared, I'd bet a pizza that you're one of those nonconfrontational types who would rather walk across hot coals barefooted than confront a staff member about a problem. You cannot solve this without a frank discussion with her that includes clear directives about what needs to be changed.

First, your hygienist must be told that it is imperative that she seat her first patient on time. That means she must arrive at work no later than 7:45 (or 8:45 if you open at 9:00) in order to get ready for the day. Tell her that this is not negotiable.

The next thing I recommend is that your hygienist keeps a hard copy of her daily schedule and records the time when she actually seats her patients. This will help to keep her focused on the problem and will provide you with hard data. (If you don't trust her to record the actual times, you need to stop and think about why you keep her as an employee.) She should present her schedules to you at the end of the week during a short conference with you to assess her progress toward staying on time. The goal is accountability.

One common reason hygienists run behind schedule is because they wait until they're completely finished with the treatment before summoning the doctor. I advise you to begin a protocol whereby the hygienist completes all the preliminary steps (radiographs, chartings, and tour of the mouth) and then summons you. This "interrupted check" system gives you a range of time, say 20 to 30 minutes, to get to her operatory, and it allows the hygienist to be more prompt.

Another common reason hygienists run behind is because they're disorganized, and this wastes time. Your hygienist can save time by using a tray system, whereby all the trays are loaded with disposables ahead of time to enable efficient room turnover and setup. Another time waster is too much idle chitchat. I'm not against being friendly with patients, but conversations should be 70% dental, 30% other. Of course, if the patient is late, that is out of the hygienist's control, so make exceptions when that occurs. That's only reasonable.

I advise you to begin your staff conversation like this: "I appreciate the work you do here, but there's a problem that I need your help in solving. The problem is running late in seating your patients. Some patients have complained to me, and since I feel it's important to respect their time, here's what I need for you to do in the future. First, I want you to arrive at work no later than 7:45 in order to get ready so you can seat your first patient on time. Second, I want you to record the actual time your patients are seated, and then you and I will meet next week to assess your progress. Will you be able to do this?"

Before change can occur, staff members must be made aware of any problems. They must also understand what you expect them to do to correct the problem. When you express your wishes clearly and respectfully, you are exercising good leadership.

All the best,


Dianne Glasscoe Watterson, MBA, RDH, is an award-winning author, speaker, and consultant. She has published hundreds of articles, numerous textbook chapters, and two books. Her DVD on instrument sharpening is now available on her website at Visit her website for information about upcoming speaking engagements. Watterson may be contacted at (336) 472-3515 or [email protected].

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