Smart Systems Get The Patient To Yes

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Dental Consultant Advice: Hygiene Production Keys

Your hygiene department can make or break your practice, yet most hygiene departments underproduce.

Here is a list of the top five concerns I've heard and questions I've been asked over the years.

1. What percentage of production should come from hygiene?

The "industry standard" is 30% to 35%; however, the percentage of a practice's production that comes from hygiene will vary, as dentists have different treatment protocols, and their definition of "ideal dentistry" and "ideal hygiene care" will vary. As an example, I have one client who produces $5,000 a day and whose hygienist produces $1,200 a day. Another client produces $2,200 a day and has a hygienist who produces around $1,000 a day.

So what is a good amount of production for a hygienist? The answer should be based on what a practice generally delivers and its fee schedule. For example, offices that do scaling and root planing (SRP) on a more frequent basis will have higher hygiene production averages. This, of course, depends on the doctor's viewpoint on what the hygiene department should deliver. So depending on the type of hygiene a practice delivers, I look for what a practice can optimally do based on the type of services it offers.


2. What counts toward hygiene production?


Everything billed in hygiene except, for the most part, the exam.


Sometimes there is an "exam debate" as to what counts toward hygiene production. This is because of codes that only allow the exam to be submitted if the dentist does the examination/diagnosis unless state law, such as in Colorado, says otherwise. This really only matters if you pay or pay a bonus based on production. As long as the benchmark for the compensation/bonus is consistent and fair, it doesn't much matter, except it would be nice if hygienists were acknowledged for what they actually produce.


3. What should open hours be?


“Are you adding new hygiene days to your schedule?”


Open hours in hygiene are a chief concern. Let's do some basic math: Say you're getting 30 new dental patients a month. That's 360 new dental patients in a year, which means a possible 720 hygiene appointments.

Are you adding new hygiene days to your schedule? If not then there are big, gaping holes in your recare system that a city bus could fall through.

4. Salary or commission?

Base pay plus commission seems to be the best and most popular system. This protects the hygienist if the front desk drops the ball on the schedule but also gives the hygienist a reason to go the extra mile. Commission kicks in when production exceeds three times base pay. Also if the day does fall apart, or there's an open hour, the hygienist on base pay can be put to work calling overdue patients or handling other necessary tasks. However, doing so won't fly when a hygienist is paid on commission only.

How a three-times bonus system is worked out:

Calculate the daily average production for the hygienist over the past three months (or longer).

The minimum calculation is three times the pay. Example: Daily pay is $250 x 3 = $750 = Minimum daily baseline.

At the end of the month, multiply days worked by the minimum daily baseline. Example: 16 days x $750 = $12,000 = Minimum monthly baseline.

Assuming production is higher than the minimum monthly baseline, there will be a bonus. Subtract baseline from total production for the month. A quick example would be if the production for a month was $14,000 and the baseline was $12,000, then there's a $2,000 difference.
Multiply the difference by 30% (adjust up or down as you see fit) to arrive at the actual bonus for the month. Using the example above, $2,000 difference x 30% = $600 bonus.

5. Which codes?

Periodontal maintenance (code D4910), of course, follows SRPs. It is not preventive care but aftercare. However, sometimes patients are billed for a prophy (code D1110) when in fact what they received was a D4910 or some other aftercare treatment. If this is happening in your practice, there is likely a significant loss of production.

Sometimes this occurs as that's the way it's always been done in a practice, or because the hygienist or front-desk person does not know how to comfortably explain the differences in the treatments to a patient. The team member opts for the path of the least resistance so as not to upset or lose the patient.

For this reason, it is vital that your hygienist and front desk team be able to comfortably educate patients on the necessity of regular periodontal maintenance visits and how that is different from a prophy. This is done using effective case presentation techniques. Start by role-playing with your hygienists to see how well they can educate patients on the differences. It can be a real eye-opener.

Keep track of your hygiene numbers, and using incentives and proper coding will help achieve the mission of efficiently delivering the best possible hygiene care to all your patients.


 

Kevin Tighe, Cambridge Dental Consultants, Senior Consultant, got bitten hard by the business and marketing bug during long summer days working at his dad's Madison Avenue ad agency. After joining Cambridge as a speaker in the mid-1990s, Kevin went on to become Cambridge’s senior consultant and eventually CEO. Cambridge Dental Consultants is a full-service dental practice management company offering customized dental office manuals. Frustrated? High overhead? Schedule a chat with Kevin at 

Dental Consultants Tip: D1110 vs. D4910
Dental Consultants Tip: Calling Patients

Intelligent Dental Consulting

 

Your Dental Consultant

Shane Blake DDS Coudersport, PAMy name is Kevin Tighe. I am Cambridge's owner and senior consultant. Before joining the Cambridge team I was in charge of setting up workshops for large nonprofits throughout the United States and Canada. During that time, I was fortunate to receive mentoring from several world-class business consultants, including a dental practice management guru, which led to a position at Cambridge as their seminar organizer. In time, I began crisscrossing the country delivering seminars myself for the better part of a decade. Subsequently, I moved up to senior consultant and eventually owner.  Contributing writer to Dental Economics/DIQ, JADA, AGD Impact and Dental Town Magazine.

  

Client Reviews

Dr. Jacob Masters, DDS, Indianapolis, IN

CEO 1 Cambridge Dental ConsultantsI started with Cambridge in 2018 after 11 years in practice. My results have been great! I have been able to decrease the number of days I work per month and have finally improved my practice much more than I could do on my own! I highly recommend Kevin's on-target coaching! 

-Dr. Jacob Masters, DDS, Indianapolis, IN

 

Dr. Shane Blake, DDS, Coudersport, PA

Shane Blake DDS Coudersport, PAI have owned my dental practice since January 2005.  The practice is a rural solo provider practice.   The practice has always been successful but something was always lacking.   I did not manage the practice by the numbers and its shortfalls were overcome by sheer determination and hard work for both myself and the staff. 

My motivating factors to sign up with Cambridge in January of 2017 were that I had reached a point in my career where time with my family was worth more to me than the professional fulfillment that dentistry can provide.  The practice was so micromanaged that it required most of my time and I didn’t understand how to motivate both myself and my staff beyond the sheer nose to the grindstone path to success that had guided us the prior 12 years. 

Our consultant was instrumental in educating each staff member in what expectations are and how performance for each position is measured.   Staff members became more aware of their part in the overall success of the practice and doing their part.  Ultimately this led to a less stressful and more productive average day which decreased management stress and headaches and allowed life to be enjoyed just a little bit more with a little more time. 

We have had many changes in the practice after our initial integration over the last 1 ½ years.  Cambridge has been helpful in navigating those planned and unplanned changes.  My only regret is I had not called Cambridge sooner.

 

Dr. Kristin Rushing, DDS, Nashville, TN

Dental Consulting Client TennesseeI used Cambridge as well, it gave me a good foundation for employees to know what was expected of them as well as very detailed job descriptions that could be used to train new employees if I needed to replace a staff member. Mike also is good about coaching you so that you are knowledgeable about what your numbers and percentages should be but also things to look for when they are off.

Everyone is accountable for their numbers and communicate better as a team. We all want to be more productive and time was spent looking into my specific concerns as well as reviewing all facets of the business. Everything was reviewed including input from staff on ways to improve the office. I feel the morale in my office has changed and we are overall headed in a much better direction. As a side note, I've used a different consultants previously and their moto was simply to increase production. Patients felt pressured and we still had communication issues among the staff.

 

Dr. Jeremy Johnson, DDS, Monroe, WA

Dental Consulting Client WashingtonI'm extremely happy with my decision to utilize Cambridge’s services. My consultant, Mike, has been awesome! I love that I can call or email him whenever and always get a quick response. He even calls and checks in if he hasn't heard from me for a bit. My production increased immediately after the first in-office visit and has continued to climb. The initial investment was recouped in increased production about seven weeks after our first meeting.

My average per day production for the first four months I worked with Mike has been 20-25% higher than the prior two years. In fact, all of the four months have had higher average per day production than ANY month in the two years prior to working with Mike.

Last month I produced more than I ever have in one month since starting my practice in 2003. On top of that is the fact that my staff is driving all of this growth! They tell me which op to go to and when, then they get all excited when we exceed our goals! These four months have been the best months of my career!

That's a lot of exclamation points! This is all to suggest that you give Cambridge a call.

 

Dr. Andrea Mulholland, DDS, Columbus, OH

Dental Consulting Client OhioI have been the owner of a general dental practice for ten years now. I work four days a week and have an associate who is with me for three days.

The practice has always done well but I knew there were many aspects of it that needed improvement but I didn't know how to proceed. I researched several practice management companies but decided to go with Cambridge because of their good reputation and because I didn't feel pressured.

Mike is the consultant that I have worked with for the past year and a half and he has helped my practice tremendously. He really knows the ins and outs of a practice but I appreciated that he didn't use a cookie-cutter approach. He really treated my practice like the individual practice that it is and I didn't feel pressured to follow any suggestions that I wasn't comfortable with.

I know there are a lot of management companies out there. I just really feel like Cambridge is one of the best and was the best for me and my practice.

 

Dr. Jeffrey D. Weaver, DDS, Port Royal, SC

Dental Consulting Client South CarolinaWe have been using Cambridge since Dec 2013. We are really just getting started, but so far everything has been great. They really have given us the tools to quickly get our team focussed, and have created systems and measurable statistics for each area. YTD for 2014 compared to 2013, our production is up 12% (over $20,000).

Our office felt "stuck", like we simply did not know what we should be doing to get better. We knew the potential was there, but did not know the next steps to take. What we liked from the start is that Cambridge has been in every type of office and seen every type of problem/issue there is. Their ideas are proven and, so far, we have been very happy with the results. Our team is really pleased with the direction we are going.

We built our office in 2007 and, had we known, would have started with Cambridge much sooner. Good luck with your decision. I think you will be very pleased with Cambridge.

 

Dr. Ron McHargue, DDS, Moses Lake, WA

Dental Consulting Client WashingtonI was fresh out of school when I bought my practice in 2012. It came riddled with staff issues and I had no knowledge of business. I thought I could handle it and went for a year and a half before really coming to the realization that I was in over my head. I was stressed completely and needed help with staff issues and business advice.

I contacted Cambridge because of what I read on Dentaltown and because of their fair price and money back guarantee. Mike was very helpful in getting me over a couple of big hurdles dealing with staff. I now have a direction and a good plan for tracking numbers and keeping a pulse on my practice. I was hesitant to even hire a consultant, but I am very glad I did and wouldn't hesitate to get Mike back and work with him again.

 

Dr. Ed Warr, DMD, Ashland, OR

Dental Consulting Client OregonMy experience with Cambridge has been great. In June of 2014 I was very concerned as my year was down by about 6% from the previous year. I had used consultants before and hadn't liked any of them. But, I knew I needed help with what I did not know - I went to school to earn a DMD, not an MBA.

After researching several and having several phone conversations regarding their methods, I committed with Cambridge.

Their money back guarantee was a nice touch to lower the risk factor for me. So, I finished 2014 up 8% over 2013. In six months, Mike had helped me introduce practices that helped me have a 14% turn around in six months. I whole heartedly recommend Cambridge and their services.

 

Dr. Chris Burke, Pedodontist, Lexington, TN

Dental Consulting Client TennesseeI have used Mike Kittelson with Cambridge since I opened from scratch in 2009. Having no background in business, management or marketing he has helped us tremendously. Not only has he taught us which stats to track, he has coached us through employee issues, marketing programs, strategic planning for the future, and served as therapist and friend. He has also proved to be a wealth of information on helpful computing programs that have made certain tasks easier and improved employee productivity. I would recommend talking with Cambridge before making your final decision on which group to go with.

 

Dr. Dustin Snyder, DDS, Lewisburg PA

Dental Consulting Client PennsylvaniaWhen I initially contacted Cambridge, I was open for about a year and the production graphs were trending down, quickly. My Cambridge coach met with me, offered several ideas specific to my situation, and two years later, I'm having annual growth over 20% and we're already at record annual production with one and a half months left in the year.

I am now busier than ever, even under the previous owner! The best dental office manual I've ever used. I can't say enough positive things about what Cambridge has done for my practice!

 

Your Dental Practice Mangement Consultant and Coach

Shane Blake DDS Coudersport, PAMy name is Kevin Tighe. I am Cambridge's owner and senior consultant. Before joining the Cambridge team I was in charge of setting up workshops for large nonprofits throughout the United States and Canada. During that time, I was fortunate to receive mentoring from several world-class business consultants, including a dental practice management guru, which led to a position at Cambridge as their seminar organizer. In time, I began crisscrossing the country delivering seminars myself for the better part of a decade. Subsequently, I moved up to senior consultant and eventually owner.  Contributing writer to Dental Economics/DIQ, JADA, AGD Impact and Dental Town Magazine.

 

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