Hygiene Profitability Dental Hygiene and Your Practice's Bottom Line

HYGIENE PROFITABILITY

Dental Hygiene and Your Practice’s Bottom Line

Background:

Prophylactic care provided by dental hygienists is the most frequent reason for dental visits. Although dental hygiene care is essential to maintaining good oral health, it has not historically been regarded as contributing to the profitability of dental practice. This article discusses new approaches to organizing dental hygiene departments and workflows to provide excellent patient care while making a profit.

Economics of Dental Hygiene:

The traditional focus on dental cleaning does not take full advantage of the potential contributions of dental hygiene care. Regular maintenance visits provide a great opportunity to provide patient education and motivation, while making the patient a believer and advocate for the practice. Dental hygiene can be transformed into a profit center while still providing excellent oral health care, and without overtreatment. Its importance to practice economics was demonstrated after the economic crash of 2008, when patients who were not spending money on extra services were still making routine preventive visits covered by insurance. Expanding the role of dental hygiene does not mean selling extra services, but rather treating patients as family, focusing on the presence of or risks for dental disease.

Many characteristics of the practice contribute to the profit margin of dental hygiene, although an industry standard of 33% has been described: one third each to the hygienist, to overhead and back to the practice. Practice overhead has a significant impact on the profitability to dental hygiene. Profitability is more likely to be achieved in fee-for-service practice, although it can be done in preferred provider organization settings. In terms of hygienist compensation, the most productive approach may be a base salary plus commissions, providing incentives to be productive. Some practices offer bonuses related to daily productivity and recommended treatments based on “proper, thorough and ethical diagnosis.” This approach to profitability may be more difficult to achieve in pediatric dentistry practice.

Dental Hygiene Services and Policies:

Where dental hygiene is a profit center, hygienists are expected to provide more services, depending on their level of expertise and the needs of the practice and patients. One expert states that hygienist should perform the maximum services that they are legally licensed to provide. This may include taking radiographs, performing anesthesia, or doing quadrants of scaling and root planning. Hygiene visits should be viewed as wellness visits. Hygienists appreciate the opportunity to support patients’ health by assessing vital signs, screening for possible oral-systemic disease and medication conditions or educating patients about nutrition or tobacco cessation as well as oral hygiene. Hygienists should be viewed as frontline caregivers in promoting lifelong health, in partnership with the dentist and patient.

As a rule, hygienists should not be dealing with issues like scheduling, no-shows, or cancellations. Making appointment should be the responsibility of business employees, who have responsibility for keeping hygienists productive. A team approach to patient care can provide wellness services beyond teeth cleaning, providing extra motivation for patients to make return visits. Keeping the practice schedule full can also benefit others who have the potential to earn bonuses based on productivity. Is has been estimated that the national average rate for no-shows exceeds 20%. One consultant suggests that the schedule should have no more than one-half hour of an opening per day, although it is advantageous to keep a few hygiene spots available for new patients.

Time Management:

In modeling for dental hygiene profitability, the focus would be not on adding more people but on better allocating the available time. For example, seeing patients every 30 minutes allow for minimal patient education on interceptive periodontal treatment – which should account for about one-third of hygiene production. Much of the information hygienist need to perform risk assessments can be collected on a health history, without chair time. Burnout is more likely to occur in settings with haphazard scheduling; operating at peak efficiency is less stressful for everyone. The practice should have a plan for keeping hygienists busy when cancellations or no-shows occur, such as contacting potential patient who are waiting for appointments. Burnout and musculoskeletal disorders are real risks for busy dental hygienists.

Benefits of Modeling for Profitability:

Beyond the bottom line, the profitability approach has benefits for the entire practice. This includes the ability to upgrade equipment or make other investments that help to keep hygienists productive. Since patients spend so much time with hygienists, expanding the hygiene program can help to build relationships and improve patient retention. Taking on an expanded role where they spend more time with patients also provides hygienist with the opportunity to do a better job as clinicians, promoting job satisfaction. If done “wisely and equitably,” the profitability model has economic and other longterm benefits for dentists, hygienists, and the practice – while also achieving the overall goal of improving patient health.

Dental Abstracts Volume 66, Issue 1