Canceling hygiene

This dentist has historically cancelled hygiene appointments when the dental hygienist is absent. He believes patients prefer their usual hygienist. But Dianne Watterson encourages him to take a different approach, and reminds the dentist of the income he’s losing when he reschedules patients.

Dear Dianne,

I have a most excellent hygienist, probably the best I have ever employed. My patients all enjoy coming to see her for their preventive care. However, occasionally she must be absent. She has a toddler, plus, she’s had to be absent due to illness. My dilemma is that I’m faced with the decision of what to do with hygiene patients when she is absent. The easiest thing to do has been to just cancel and reschedule these patients. Is this the best thing to do? I don’t think my patients would like to see anyone else.

Dr. Tony

Dear Dr. Tony,

In my opinion, canceling a day of hygiene is the closest thing to blasphemy! The only solid reason to cancel a day of hygiene is if you live and work in one of the states that still require direct supervision in the dental office (Alabama, Georgia, Hawaii, Indiana, Louisiana, Mississippi, New Jersey, and North Carolina), and youmust be absent. Even then, you can often hire a temp dentist to come in so that the hygienist can still carry on with work.

When you cancel a day of hygiene patients, think about the consequences. First, you are sending a message to those patients that it’s OK to cancel an appointment, and you are inconveniencing your patients who often must go to great lengths to plan for their dental visits. They have to hire babysitters, take time off from work, or interrupt their schedules in any number of ways to make time for their preventive care. Don’t forget all the extra work you have just put on your business assistant to contact and reschedule people.

Next, think about the loss of production. An average day of hygiene will produce from $1,000 to $1,600. But you don’t lose just the production. You also lose any restorative dentistry that would have been discovered during the visit. Your fixed expenses stay the same in that you have to pay to keep the office open and pay all your auxiliary staff members. You may even have to pay the hygienist for the time off, depending on your benefits package. Canceling a day of hygiene could wind up costing you many thousands of dollars.

Here’s the answer to your dilemma. Have your business assistant identify a number of hygienists who are available for short-term temporary work. If you don’t have a local temp agency, ask some of your competitors if they can recommend any temp hygienists. It’s often not difficult to find hygienists who do temp work.

Don’t shy away from paying a temp hygienist a little more than the going rate. Remember that temp employees often give up whatever they had planned for the day to come in and help you. Plus, they do not get any benefits and they have to deal with unfamiliar offices. Just finding everything necessary to do their work can be discombobulating and stressful.

You mention that your patients would not be happy seeing someone else. Please repeat this truth—my patients will accept anything I accept.You need to accept that using temp hygienists is the best decision for your practice for many reasons. If there’s something about the temp’s work that you do not like, you don’t have to invite the person back.

If you treat a temp hygienist with appreciation, chances are he or she will return and help you again. Either your business assistant or your temp hygienist can greet patients by saying, “Good morning, Mrs. Smith. Lisa is ill today and unable to come in. To prevent inconveniencing you or interrupting your care, we have a wonderful hygienist who will be seeing you today.”

Everyone must be absent from work occasionally, but a little planning will prevent loss of production and will keep your patients smiling.

All the best,


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