Adoctor recently called to discuss my in-office consultation services for the development of the hygiene team. “We do not schedule any periodontal services in hygiene,” the doctor stated. When I asked why, he reported that the practice was so busy, they barely had room to see regular patients in the hygiene schedule. The scheduling coordinator added that there was no room in the schedule for additional perio patients. The doctor reported hygiene overhead was approaching 60 percent and recall/hygiene had become a “losing proposition.”
I must admit this is not the first time I have heard this Catch-22 explanation. However, I am always surprised by the response. Since we are near the end of 2005, this is an ideal time to review basic statistics for the health of the hygiene/patient retention/recall system and to set goals for 2006. Recall and patient retention are the heart of a healthy practice. The hygiene department is the driver for this success. Do you know how much hygiene you need to maintain a healthy patient base and growth pattern?
Here is a basic formula to enable you to analyze, project, and create a business strategy for current and future growth, not only in hygiene, but for the entire practice:
Step 1: Determine core patient base - Begin by calculating the number of active patients in the practice. An active patient is typically defined as one who has been seen within the last 18 to 24 months, with at least two hygiene appointments during this period. Take that number and multiply by two (i.e., twice yearly prophylaxis and examination) and divide by 12 (months). Multiply this number by 85 percent to allow for a real world 15 percent attrition rate (people moving, leaving the practice, passing away, etc.). Example: 1,500 patients x 20 = 3,000, divided by 12 = 250 x 85 percent = 212 patients per month in hygiene.
Step 2: Total monthly hygiene patients - Add the number of monthly new patients to the core patient base. Multiply that total by 25 percent to meet the perio requirement (i.e., patients undergoing active periodontal therapy and three-month periodontal maintenance - Code 4910). Add that number to the previous total. Example: 212 + 20 = 232 x 25 percent = 58; 232 + 58 = 290 patients per month.
Step 3: Annual hygiene patient requirement -Multiply monthly hygiene patient requirement by 12 (months). Determine your current status by calculating the number of patients seen the previous year in hygiene. Example: 290 x 12 = 3,480 required annual hygiene (recall) patients.
Step 4: Recall/hygiene requirement - Divide the annual requirements by daily patients who can be seen in hygiene. For example, let’s say the practice needs to accommodate 3,480 patients in the year. If hygiene sees eight patients per day, then 435 hygiene days are required. If hygiene sees nine patients per day, then 386 hygiene days are necessary. Calculations may also be done with hours or units.
Once you determine the practice/hygiene requirements, explore ways to meet those requirements. Do the analysis every quarter to determine if you are on target to meet practice requirements. Waiting until the end of the year to determine that you are “off goal” in hygiene means that you have lost 12 months of good production capabilities. In addition, the lost hygiene patients very quickly impact the doctor’s schedule slowing down. The result is fewer patients seen and the total practice production declines.
Annette Ashley Linder, BS, RDH, is a recognized leader in the field and an award-winning speaker and consultant. She is a featured speaker at dental meetings and provides in-office consulting services with her team of business and clinical consultants. She may be reached at her Web site at AnnetteLinder.com, via e-mail at [email protected], or by phone at (804) 745-6015.