What's happening in hygiene?

Nov. 1, 2008
Successful businesspeople have plans, dreams, and direction to create the reults they want.

by Bill Blatchford, DDS

For more on this topic, go to www.dentaleconomics.com and search using the following key words: hygiene, dental hygiene, profitability, dental health services, Dr. Bill Blatchford.

Successful businesspeople have plans, dreams, and direction to create the results they want. Great leaders create solid systems no matter the economic winds. With the media and election coverage shouting dismal U.S. economics, do you have a solid grasp of your numbers? Or are you just trying to outproduce your high overhead? What is your plan, and how knowledgeable and accountable are your team members?

Let's examine one area of a multifaceted general practice — dental hygiene. We want solid systems that team members understand and support. Hygiene is a good example of an area in constant flux. What do you see is your purpose of having hygiene services for patients? Knowing your purpose will help create a solid plan to keep delivering excellent dental health services with efficiency and accountability.

Hygiene is necessary for creating goodwill, serving continuing care, and encouraging full treatment. It is also acknowledged as a "break–even service." Without a solid plan and vision of the purpose of hygiene, it can be a real financial loss. We recently found a two–doctor office, each with four days of hygiene, to be losing $182K in hygiene annually. A solid plan, stable systems, and knowing the numbers are the leader's responsibility.

Determine your hygiene profitability by figuring your own practice overhead per hour. Math details are available at [email protected]. An average overhead per hour could be $250, and if you have four days a week of hygiene, the overhead per hour for hygiene would be $125, because you deduct your lab bill from your expenses prior to figuring the answer.

You are paying your hygienist to see eight patients for one–hour appointments, making the expenses for an eight–hour day $1,000. Look back 90 days to see if hygiene is covering the overhead. If it isn't, you may not have a demand for four hygiene days a week, or your communication system has a breakdown in creating value for continued care, or your hygiene fees are low for your area. You may not be offering enough services in hygiene. For some reason, hygiene is not producing enough to cover your overhead.

When hygiene is not full for the days you have scheduled, what is your plan? Your team will tell you they need more help to confirm, do a chart audit, or handle the phones for appointment changes. When the capacity exceeds your demand for hygiene time, don't add another staff member. Instead, create efficient systems and make some strong decisions for what is occurring right now.

We know that for each full day of hygiene, you are likely seeing 200 patients two times a year. Four days of hygiene a week means you have 800 active patients. You may have 1,600 charts, but you only have 800 active patients. Twenty percent of America moves every year. In some corporate areas, that percentage is even higher. This means 160 of the 800 hygiene patients will be moving sometime during the year. If new–patient flow is a solid 15 or higher, you are attracting 180 new patients a year for a net of 20 new faces. If you are attracting 10 new patients a month, you are going in the hole 20 patients a year and your demand for hygiene is shrinking. Now, what is your plan?

Expand your hygiene offerings! Do you and your hygienist have an agreed–upon protocol for diagnosing and treating periodontal disease or is localized periodontal treatment tolerated? What is the diagnosis when there is a 2 mm pocket with bleeding? Become passionate about diagnosing periodontal disease with ZT4B — Zero Tolerance For Bleeding. Dr. Chris Kammer ([email protected]), author of "The Halloween Candy Buyback" in October Dental Economics®, is passionate about proper diagnosis. Are you offering periodontal medicaments?

If not, why not? Do you have an annual oral cancer exam with a light? Make it important in your practice. If your state allows, is your hygienist certified to give anesthesia? There is no excuse not to take advantage of this opportunity. If your state allows, does your hygienist deliver laser periodontal treatment? See the latest LSU study which shows bone regeneration by using a laser to treat periodontal disease. As a general dentist, you can perform the service if hygienists are not allowed in your state. Do you?

For hygiene to serve well, you must offer different services and be enthusiastic about the possibilities for patients. Watch your numbers so capacity does not exceed your demand. Now, imagine what could happen if your hygienist masters real sales conversations based on what patients want, not what you think they need.

Dr. Bill Blatchford is a leading dental business coach who has worked with more than 2,000 offices to help dentists achieve more time off, more net, and more enjoyment. Become a member of Blatchford FILES, Dr. Blatchford's monthly CD on winning at dental business. The first two months are free. Call (541) 389–9088 or visit www.blatchford.com for more information.

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