Analyzing the minutes spent on perio
Victoria DaCosta, RDH
I could barely wait to graduate from dental hygiene school, take the exam, and start taking care of patients. Six months later, I quit practicing as a hygienist. What happened?
Back in 1987, I was frustrated by the limited amount of time scheduled for treating patients. When I was a student, I had been taught to treat to the ideal standard of care.
That all changed when I entered "the real world" of dentistry. I had only 30 to 40 minutes to spend with my patients. In that amount of time, I had to set up, greet, seat, treat, coordinate the doctor`s exam, handle the patient`s exit, and clean up. No wonder I was not able to give the total care my patients deserved.
In school, I had time to do this ... and so I did spend hours while learning! I also had learned from my dental hygiene program the "whys" of practicing dental hygiene. So why the unhappiness?
In a perio minute, it came to me! I was not given the "time to heal" my patients to total health. Instead, there was only time to "treat" disease or perform an "insurance cleaning."
As the dental hygiene profession evolved - with expanded functions - hour-long appointments became the norm. But still almost 20 minutes out of every hour is devoted to nonpatient related tasks. And I still was not able to devote the time necessary to do what I believe was my job. I believe that the dental hygienist`s primary function is to heal, nurture, and serve her patients to total health.
And what does this function require? It requires a deep understanding of each patient`s needs. That level of understanding can only come with spending time listening to and teaching patients about their periodontal health.
Where is that time going to come from? Those 20 minutes spent in nonpatient related activities must be delegated to a hygiene assistant so I can spend adequate time with my patient.
What happens during those 20 minutes? The ideal appointment would include:
- Greeting
- Seating
- Health history update
- Oral hygiene review (assess tools currently being used)
- Perio charting (assessing bleeding score)
- Intra- and extra-oral exam screenings
- Patient education (behavior modification with intraoral camera)
- Review of current perio/restorative treatment plan
- Performance of scaling and tissue treatment
- Polishing/stain removal
- Product recommendation
- Exiting (discussion of what is expected next of patient)
The bulk of the "extra" 20 minutes would be increased time allowed in these areas:
- Health history update
- Oral hygiene review (assess tools currently being used)
- Perio charting (assessing bleeding score)
- Intra/extra oral exam screenings
- Patient education (behavior modification intraoral video camera)
- Review of current periodontal/restorative treatment plan
So what can you do to make your perio minutes count? Hire a dental hygiene assistant. Well, let?s do the math. Industry average shows hygienists earn between $28 to 40 an hour. Assistants earn $12 to 18 an hour. For the sake of this example, let?s pay the hygienist $30 an hour and the assistant $15 an hour. Twenty minutes (one-third of an hour) costs $5 for the hygiene assistant to perform the nonpatient related activities, thereby freeing up your hygienist to spend that 20 minutes doing the services previously mentioned.
If your hygienist had the extra 20 minutes to spend with your patients ? coupled with a reasonable incentive program ? just think of the additional revenue that could be generated for your practice. In addition, your patients will feel more comfortable, not rushed. Patients that are better educated about their oral health will develop a relationship of trust with your practice, accept treatment plans, and refer new patients.
By having a dental hygiene assistant, your hygienist is free to work more closely with your patients. The assistant is a utility person who helps make sure the work flow stays on schedule, decreasing inner office stress. Having a hygiene assistant has allowed me to have the extra energy and time to accomplish all of the tasks necessary to heal, nurture, and serve my patients to total health. That is why I went into dental hygiene.
