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And get educated patients and happy hygienists in the process
By Cathy Jameson, M.A.
Let’s
look at seven specific ways to make the hygiene department within
your practice excellent—a department that helps patients get and
maintain a healthy mouth, educates people about the restorative
needs in their mouths, and generates a healthy profit margin for
the practice.
1.
Set production goals for the hygienist.
He/she should be producing at least three times his or her salary.
Pre-block the schedule for approximately 1/2 of the production goal
in primary appointments. (Pre-block for a minimum of six months
and preferably one year if you are advance appointing.)
Primary procedures for a hygienist are any periodontal appointments,
sealants, and appointments that include a full mouth series of radiographs
or a panoramic radiograph.
2.
Integrate a comprehensive, non-surgical periodontal therapy program
into your practice.
Many practices are providing non-surgical therapy for their patients
and are calling those procedures “adult prophies.” Do not shortchange
yourselves. You are providing care that will help a patient move
from a diseased state to a healthy state. The treatment for this
patient is entirely different than for the patient who is healthy
and is coming in for a preventive appointment (which is called an
adult prophylaxis).
Spend the time and money necessary to bring your practice current
with the latest and greatest in non-surgical periodontal therapy.
Learn all aspects of the therapy: how to diagnose, treatment plan,
present, file insurance, overcome objections, and treat the disease.
3.
Define and implement a job responsibility of “hygiene retention
coordinator.”
This wonderful person would have the following responsibilities:
• He/she COULD schedule hygiene appointments, unless you are scheduling
at the chair, manually or on the computer.
• Confirm all hygiene appointments.
• Send out notices that confirm all ‘advance-scheduled’ hygiene
appointments—after these notices have been cross-checked with the
appointment book to make sure that all changes have been noted before
the cards are sent out.
• Send out notices to patients who are past due but have, for whatever
reason, not scheduled an appointment in their designated month.
• Contact all patients who are past due for a hygiene appointment
and schedule these patients for their appointment.
• If unable to reach the patient by telephone, the hygiene coordinator
would send a very positive, educational letter to these patients,
along with a brochure of some nature, encouraging the patient to
contact the office to schedule an appointment.
• Fill any voids in the hygiene schedule.
4.
Hire a hygiene assistant.
In most areas of the country, there is a shortage of available hygienists.
So, as our profession moves to a mode of more comprehensive hygienic
care, we find that the personnel to support that effort are in short
supply.
Schedule hygienist time/assistant time into every appointment to
maximize the talent of the two fabulous dental professionals. This
will provide patients with quality, comprehensive care and effective
scheduling that is productive and profitable, with stress control
for all people (assistant, hygienist, doctor, and patient).
EXAMPLE—This might be the breakdown of the hygienist’s time and
the assistant’s time:
Assistant: Greet, seat, review health
history, take necessary radiographs and develop radiographs.
Hygienist: Provide probing, record
data, prophylaxis, and fluoride (if appropriate), intra-oral camera
if available, discussion/education of possible areas of concern,
and involvement with doctor evaluation.
Assistant: Coronal polish, home care
instruction, schedule next appointment, complete paperwork and dismiss
patient.
There may be several other alternatives. You can see how productive
and educational this type of scheduling can be. Obviously, a great
hygiene assistant is needed, one whom you believe will give the
patient an even better experience because he/she has been with two
wonderful professionals.
5.
Schedule each patient according to his or her individual needs.
Do not schedule generically—individualize. Let the hygienist determine
how much time is needed with each patient.
Use
a 10-minute appointment book. The right appointment book will make
all the difference in your days. If you are scheduling a hygienist
with an assistant, you need two columns, one column per active chair.
Your appointment book, whether manual or computerized, should let
you schedule hygienist time and assistant time.
6.
Study the 1995 CDT-2 codes from the ADA.
Change your previous codes to reflect the current codes as outlined
by our association. These codes will be updated again in 2000.
File insurance by code. The ADA does not designate a code unless
it is defined as a specific procedure unto itself. In addition,
be sure to read the codes specifically and schedule, make financial
arrangements, and collect according to the actual procedure being
administered.
7.
Make it possible for the hygienist to use an intra-oral camera on
every patient.
• Use the camera to record any new areas of concern that have arisen
since the patient’s last visit.
• Use the camera to redo any photographs of dentistry that has been
previously diagnosed but left untreated. Use the intra-oral camera
to re-educate a patient about previously diagnosed and recommended
treatment may help them make a decision to “go ahead.”
• Show a patient the evidence of periodontal disease: the pockets,
the bleeding points, or the inflamed tissue. This will help the
patient understand what is happening and encourage them to proceed
with a more accelerated mode of treatment.
• Validate the need for and the benefit of co-therapy/home-care.
Forty to 60% of the doctor’s restorative dentistry should be coming
directly out of hygiene. Most hygienists tell me that approximately
half of their patients need some sort of restorative dental care.
Give the hygienist the time to educate patients about the benefits
of restoration and to use the intra-oral camera.
Each of the above seven strategies will make a significant difference
in your hygiene department’s profitability. However, if you put
all seven into place, your hygiene department will thrive. Not only
will you have a happy, personally and professionally satisfied hygienist
who will be less likely to “burn out” or go somewhere else, but
you will also have a hygiene department that will further educate
your patients, help them get and maintain healthier mouths, and
increase your profitability in the process.
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