Considering that the dental hygiene department is the most routine reason a patient comes to the dentist, it should be quite profitable. Though it typically tends to be the area seen as least profitable or is the least profitable. When you break it down, your hygiene department should have a 30-35% profit margin for your practice.
As your office has evolved, you may have focused your time and effort in new areas or services, but this could have left your hygiene department struggling or on autopilot with no attention on how to change or improve. You don’t have to rework the entire system to make something go from not profitable to more profitable. In fact, it is about making things simpler and standard.
Here are the major areas of the Hygiene department that need to be looked at to make hygiene profitable:
Length of hygiene appointments
The average is 45–60-minute appointments.
You want to be sure you take into account the necessary amount of time to get the treatment done – be realistic. But, you do not want to be accounting for any unnecessary additional time that someone has deemed “necessary.” This is where you want to consolidate or multitask. A good hygienist will be able to cover patient education and talk to the patient about new services while scaling, flossing, and polishing. Break each topic point up according to how much time you have. If there’re 3 talking points, spend 1/3 of the appointment on each.
The time the patient is in the chair for a cleaning is extremely valuable – no matter what, your hygienist and the patient are going to be together in that space for at least 45 minutes. Building a relationship with the patient during this time is crucial. Patient education results in a patient who is understanding of their current health which peaks interest in maintaining that health. This can be the bridge to discussing the next service that a patient needs to move onto or recommending products to help keep the patient in good health. At the very least when a patient feels comfortable and cared for by their hygienist, they will be inclined to come back or to share their good experience with others.
Hygienist’s abilities
Utilize all of your hygienists’ skills. Make sure you are familiar with all the services your state allows your hygienists to perform. Then be sure they are doing those services. If they are not, you are limiting your production. Here is where you can implement more training to get your hygienists operating at full capacity – therefore increasing the overall production of the practice. Especially in a practice that cannot afford to hire an additional hygienist, you need to be getting the maximum potential out of the staff you do have.
For example in some states hygienists can perform root planing. In the states that do not allow for this, this task gets booked under the dentist’s schedule. So where you can, keep the dentist schedule booked with services only they can provide – keep the root planing in the hygiene department.
Some practices have expanded their hygiene department to include hygiene assistants – someone who can perform all non-hygiene duties and any minor hygiene responsibilities. Medical history updates, preparing patient treatments, etc. can all be taken care of by the assistant leaving the hygienists focused on their main tasks.
Hygienist salary
What and how you pay your hygienists should make sense for the service your practice provides. A hygienist’s production should be about three times their wages. Some dentist’s offices also include commission-based pay for their hygienists as an incentive to keep overall production high. You may also consider a bonus structure as an incentive.
For example, just paying a flat base salary leaves you liable to paying a salary when there are no patients in the chair. While a straight commission based pay can create unhealthy production where the hygienist is only concerned with the number of patients they are servicing and not about the quality of work they are providing. In most cases, base pay plus commission or bonuses is favorable. The hygienist is happy with their pay while also being properly compensated for providing quality work while keeping their schedule full.
Front desk
Be sure your front desk is running a tight operation. After determining the appointment time needed for hygiene, the front desk should always be booking off the correct amount of time needed for scheduling. They should be making sure patients are aware of their exact appointment times and doing what they can to ensure patients arrive on time. A loose schedule is a recipe for disaster.
You also need to pay attention to the front desk. Do not let this become another department on autopilot. They are the first area a patient comes into contact with when handling scheduling. If the front desk makes it difficult for a patient to schedule, is rude, is unreachable or gives out misinformation this will deter your patients from getting on the books. Some dentists will call in posing as a potential patient to see how the front desk is handling people on the phone as a form of quality control.
No-shows and cancellations
Inevitably you will run into no-shows and cancellations. To mitigate this, implement a cancellation policy and remind your patients of it. Most offices have a 24-hour cancellation policy and charge a certain dollar amount for no-shows and last-minute cancellations. The front desk should be sending appointment reminders along with the cancellation policy to patients on the schedule.
When cancellations do occur, have your front desk look at the schedule and fill in the holes where they can – call and move patients up to fill the gaps. Also be sure to follow up with patients who did not show or canceled without rescheduling. You do not want these patients to drop off and never return for their next service.
Reactivation
Look at your hygiene department and evaluate what is happening with patient drop off – patients seen once and never again or patients who have not been in for a while. Every practice has inactive patients to some degree and this needs to be addressed. Assign a staff member to make enough phone calls per day to get through your inactive patient list in a timely manner. Depending on the size of your inactive patient list, this may mean that you need to place 100 or more calls to inactive patients a day. If you don’t have the time or manpower to do this, hire a reactivation service.
A reactivation service allows your staff to focus on the duties at hand there in the office while still having someone take care of getting inactive patients back for their next service. While automated services that send out texts or emails to patients about how long it’s been since they’ve been seen, sound nice they’re not always effective.
The most productive form of reactivation involves phone calls and real people. When surveyed, most dental practices came back stating that they hate making phone calls. That doesn’t change the fact that it is the most effective way to get patients back in. So if that’s the case, get a reactivation service to place the phone calls for you.
Given your patient’s customer lifetime value, reactivation can provide an immediate boost in your practice’s profitability. So instead of focusing all your efforts on getting new patients in the door, realize that reactivating existing patients is up to 5 times cheaper than acquiring new ones.
Analyze your hygiene program
Every week or every month, you need to take a look at the statistics of your hygiene area. The department’s finances, staffing, completed appointments, no-shows, etc. Look at these in relation to one another as well. Identify problem areas and fix them, identify profitable areas and strengthen them.
Do not make the mistake of assuming that because something is not doing well or is not profitable that the problem is too big to confront solving. On the reverse, do not also make the mistake of overlooking an area because it is profitable and therefore assume it cannot be made more profitable.
Once you have determined what makes sense for your practice, standardize it. This makes it easy to train, easy to track and easy to maintain going forward. Once you find what works, stay the course. You may need to hire more hygienists or add additional days/times to your hygiene department but before you do be sure to look at what you already have in the factors above and make those as efficient as you can!