Maximizing Profitability in Dental Practices Through Effective Hygiene Schedule Management

Dental hygiene is a vital component of dentistry and serves as a resource for all dental practices. It’s widely known that a successful practice involves “putting the bodies in the chair and collecting the money.” However, when the hygiene schedule falls apart due to no-shows and cancellations, it can have negative consequences for the rest of the practice. Hygienists are left idle, resulting in fewer exams and opportunities for the doctor, as well as fewer specialist referrals.

Many organizations implement hygiene schedule management systems with digital notifications and text messaging, as well as policies and guidelines for practice administrators. However, the success of these systems is largely dependent on how they are managed. Let’s first look at the reality within the hygiene department itself and the economic impact it can have.

Low Patient Volume

On average, small to mid-sized growing dental service organizations (DSOs) see around 5-6 patients per day, per single column hygienist. This is not an uncommon situation as these organizations often have rapid growth and the infrastructure frequently lags behind that expansion. Most likely the focus of the management team is dedicated to the integration of new acquisitions and less on the day-to-day operations in the existing practices.

Typically, most hygienists work on an hourly appointment basis, potentially seeing 8 patients per day. With an industry wide 30% failure rate of patient appointments, that brings the number of patients down from 8 to 5 or 6. Treating only 5 or 6 patients, most hygienists will fall short in their net daily production to cover their daily compensation, especially in the post-pandemic era where hourly rates have increased.

Economic Impact

Taking a closer look at average hygiene patients seen per day reveals the dollars and cents consequences of low patient volume. Understandably, hygiene productivity will vary, effecting the potential shortfall of low patient volume.

Low patient volume has a significant economic impact.  Working with a 3X business rule, or the hygienist at least tripling their daily rate in production, we can demonstrate how this scenario plays out. For these examples, I used an hourly rate of $45 even though there are fluctuations within different geographical areas. For an 8-hour day, that hygienist would earn $360 and would need to produce approximately $1,100 to cover his or herself.  A highly-trained hygienist providing comprehensive care can be productive, but they would need to produce around $200 per patient to cover their salary when seeing only 5-6 patients. A hygienist primarily providing basic procedures might only produce $100 per patient or $500-600 for the day, resulting in a significant shortfall.

Potential Impact of Improved Hygiene Schedule Management

While the level of care provided by a hygienist is paramount to performance level and will vary, think about the impact of adding an average of 1-2 patients per day, per hygienist across a platform.  Using the above figures of $100 and $200 per patient visit, we see the potential increase if we add an additional 1.5 patients per day on an annualized basis.  That would be between $36,000 and $72,000 per full time hygienist. An organization with 20 hygienists would realize an annual gain of $720,000 to $1,440,000! This is aside from the benefit of additional patient exams and subsequent treatment for the doctor.  Needless to say, that would have a large impact on the profitability of the hygiene department and ultimately the entire organization.

Urgency & Accountability

Having policies and procedures are great, but conveying the importance of those policies and holding staff accountable has the most impact.  Administrative staff members are swimming in a sea of tasks to accomplish on a daily basis, so highlighting the most important tasks to accomplish is imperative. That urgency must initially come from the top! Operational and clinical field leaders must put forth that priority to the office management staff.  After which, that urgency then channels from the office manager to any administrative staff.  This will be as critical as you make it.  If it is important to the leaders, it will be important to the staff on the office level!

One thing that will foster that urgency is accountability.  If the staff understand that they are accountable for generating healthy hygiene patient volume, the urgency naturally follows.  Providing a benchmark for expectations is also crucial to this equation.  Sharing metric analysis and/or providing hygiene patient trackers are both great tools to communicate the standing of each hygienist in the practice and ultimately the “report card” for the administrative staff.

Written by Marisa Dolce RDH, BS.
Marisa is a hygiene consultant providing strategies for effective clinical program design, hygiene operational systems, training and leadership development as founder at Oral Health Solutions.  Beginning with a formidable career in clinical hygiene, she then advanced to roles as clinical educator, dental sales, and speaker for OraPharma Inc. Marisa then transitioned into the DSO industry in hygiene leadership roles, working in a national capacity at Great Expressions Dental Centers and Mid-Atlantic Dental Partners for a period of 16 years. Read Marisa’s other article here: How Elevated Hygiene Productivity will Contribute to your DSO’s EBITDA – Group Dentistry Now.