By Wendy Briggs, RDH (Co-Founder of The Team Training Institute)
I’ve been a hygienist for more than 20 years and a hygiene production consultant to more than 1,718 practices in 12 countries around the world. Hygiene is my passion, and exploding hygiene productivity and profits is my expertise.
When I first started out, and for many years, I was satisfied with the status quo. I saw patients, did my job, and never really questioned the system. I was making good money for the practice, but I was nowhere close to my full potential.
Over time, I began to realize that I had an arsenal of incredible treatments to help my patients have a healthy mouth, but I wasn’t using much of it. The dentist I worked for was busy drilling and filling, but every day it was the same basic routine. We were using only a fraction of the latest tools available. I knew there had to be a way to actually use all the things I’d learned.
So one day I made a list of everything I knew to be true about the practice:
- We weren’t using 75% of the tools at our disposal
- The dentist had excellent skills
- The dentist haphazardly tried to offer more procedures (he wasn’t comfortable “selling”) with little results
- Our hygiene department procedures and scripting weren’t consistent with every patient
Over the next weeks and months, it became very clear to me that there was plenty of room for improvement in the practice. Every day I would brainstorm ways to improve. In a commitment to thinking like an business owner, bottom-line profits was the only measurement tool I used to rate every idea.
Eventually I came to this conclusion:
Hygienists are the front line of the dental practice and hygienists spend the most time with patients. Hygienists also have the most tools available to help patients have healthier, more attractive smiles. There’s tremendous untapped potential in hygiene care. And small changes to the hygiene department can have a huge impact on the bottom line of the practice.
Too many dentists and practice owners don’t consider hygiene a true profit center. And frankly, ignoring the potential in hygiene results is a huge loss of opportunity.
So, I began by testing my ideas on my own at the practice where I worked. Then, through my inner circle (my network of friends who were working hygienists in practices across the U.S.) we started beta testing my exact same scripting at the practices where they worked.
The results were incredible. Within the first 30 days, hygiene production doubled in every instance (many even tripled or quadrupled).
Here were the results from one of these hygienists:
The results were stunning and figures like this didn’t require months of difficult changes. With the right training and some easy scripting tweaks, the hygiene department transformed into a real profit center for these practices.
Going beyond the business results, I knew that improving hygiene care this way was the right thing to do for the patient. By offering more comprehensive care, patients were being given more options and more control over their healthcare.
Here are key lessons I learned about how to optimize a hygiene department:
#1: Increase Hygiene Production by Enhancing Patient Care
Our most fundamental job as hygiene providers should be to advocate for the patient’s dental health by doing the right thing every time for every patient.
Brian Tracy, a prominent business coach, once said, “What gets measured, gets improved.” So, how do we measure patient care?
Here are 3 key metrics that I look at:
- Fluoride: Get a minimum of 80% acceptance of adult fluoride (an 80% acceptance in fluoride = $32,000+ per hygienist over the next year)
- Sealants: Four sealants per day (just four sealants a day at $45 = $34,000 over the next year)
- Desensitizing Agents: Four teeth treated with desensitizing agents (treating four teeth a day with desensitizing agents = $34,000 over the next year)
What I find fascinating is that we think we are treating our patients with the utmost care, but if that were really the case, we would see these treatments done much more frequently. For example, the majority of practices have a fluoride acceptance rate of just 10%.
Hygienists have so many great options available to help high-risk patients, so it’s important to suggest these options when it makes sense for the patient. Never in my career did I have a patient say, “Hey, do you have additional preventive therapy to offer?” However, they did say things like…
“Bad teeth run in my family.”
“It seems every time I come here, I have more and more cavities."
Comments like these represent frustration and that’s a sign to offer more preventative treatment options and communicate their value to patients.
#2: Use Clear Communication For Improved Treatment Acceptance
Maybe you’re offering preventative treatments to patients already, but they aren’t accepting them. There’s nothing more frustrating than knowing your patient needs treatment, but they don’t move forward.
It’s important in these moments not to blame the patient, it’s not their fault. More often than not, it has to do with the communication style we’re using with them.
Here are some crucial ways to improve your communication and raise treatment acceptance:
Don’t wait until the end: Too often we wait until the end of the exam to talk through treatment options. If we do that, we’re out of time and aren’t able to adequately address any questions or concerns with the patient.
Don’t let insurance dictate your level of hygiene care: I’ll often hear hygienists say, “I refuse to allow insurance to dictate the level of care I provide.” But truthfully, it’s an easy trap to fall into. If a patient doesn’t want to pay out of pocket for a treatment, the conversation often stops there. Many hygienists don’t take the extra time to explain to the patient the value of the treatment and the health risks associated with ignoring the problem. I’ve long lived by the approach that if it was my father, my sister, or my daughter, what would I want them to have? I want the same for my patient.
Educate patients: In offices, I’ll often hear things like, “We should probably do a fluoride for that.” But, if I’m the patient and the hygienist hasn’t fully explained fluoride and its benefits, I probably won’t accept the treatment (particularly if the expense is out of pocket). Take the time to help patients understand not just what you’re wanting them to do, but why they should do it.
NOTE: You don’t need to get into the weeds of science or research. Instead, I like to use the simple phrase, “New research shows…”. For example, “New research shows that for patients who consistently have a professionally applied fluoride treatment, we can see up to 75% fewer new cavities. This is huge for patients who are always struggling with decay.”
Often a simple sentence like that is enough to help patients move forward with needed care.
Conduct an emotionally connected exam: What is the patient feeling? It’s important to identify the dominant emotion of the patient. Are they worried? Anxious? Angry? Uncomfortable? Once you identify the dominant emotion, find a way to relate to that because patients are looking for somebody who cares and addresses their concerns.
Often, a new patient will tell a hygienist that they’re scared and the hygienist doesn’t really stop and address that fear. Or, a patient might say they were upset with their last dentist, and the hygienist doesn’t ask any follow-up questions. These are all opportunities to learn more about the patient and build trust.
Avoid connection stoppers: When building a connection with a patient, it’s important to avoid connection stoppers like judgment, shame, and indifference. Patients are inclined to feel nervous and judged when discussing their lifestyle and habits, so it’s important to pay close attention to your words. Always put yourself in their shoes and don’t forget to tell them the good things you see.
#3: Offer Same-Day Hygiene
Same-day service is essential for maximizing hygiene production. Patients are often strapped for time, so if providers suggest making an additional appointment for extra services, the patient will usually decline that treatment. When services are offered the same day, the convenience allows patients to move forward more readily.
Additionally, same-day hygiene will transform production. Let’s take sealants for example…
Tanya, a hygienist from of Dr. Ayer’s office, did 33 sealants using the same-day process that we teach at The Team Training Institute. None of those sealants had been scheduled ahead of time, all were done same day.
I love seeing hygienist confidence soar when they reach these levels because they are providing better care for their patients and their production doubles or triples as a natural result.
And, it doesn’t take 33 sealants in one day to have an impact. Let’s say on average four teeth a day are protected per hygienist throughout the course of a year, that’s a $48,000 impact.
That is a huge win for you and your patients.
Below are results from a hygienist in a single-doctor practice. She had a $1,245 day. For reference, the national average of hygiene production per day is around $800-$1000. The next week after going through hygiene training, she had a $3,009 day.
NOTE: Some hygiene consultants think that the way to increase production is to shorten appointment times and cram more people through. I don’t recommend that approach. Rushed appointment hurt the patient experience and don’t allow for thorough conversations about care. You’ll see in this next example that production per patient rises and there’s no need to add more to the day.
This hygienist saw seven adult patients, one child, and one perio maintenance on her $1,200 a day. On her $3,300 day, she saw eight adults and one perio maintenance.
She had the same number of encounters (eight patients served), but look at the difference. She treated her hygiene patients with fluoride, more sealants, more x-rays, more preventative services, but the big game-changer for her was she did 23 same-day sealants and her hygiene production exploded.
Click below to watch a quick video to learn 10 secrets behind doing same-day treatment at a high level:
When we do the right thing for every patient every time, greater production naturally follows.
If you’re not sure where to start in implementing these ideas, I encourage you to consider in-office hygiene training. The fastest way to transform your hygiene department is to gather your team and learn today with an in-depth training day. Click here to learn more about our in-office training options.