Hygiene compensation is sometimes a cause of worry and confusion for both dentists and hygienists. Many hygienists seek greater financial recognition (either through a salary increase, more benefits, or both), while dentists may feel they are at the mercy of hygienists' compensation.
So that we are all on the same page, I will define compensation and recognition as follows:
- Compensation is what you give people for doing the job they were hired to do.
- Recognition, on the other hand, celebrates an effort above and beyond the call of duty.
Consider that if dental hygiene careers are to remain sustainable (in the current private practice model), hygienists must do everything they can to keep their employers/dentists in a fee-for-service environment. Patients are willing to pay for excellent dental care with out-of-pocket dollars, provided strong patient relationships and effective patient education are generated. Your relationships with your patients are more valuable than ever.
When compensation for hygienists thrives, you notice professionals who are measurably successful in helping their patients say “yes” to their oral health through the recommendation of necessary restorative, preventive, and therapeutic oral health services. They motivate and educate patients, and, while marketing the dental practice, these hygienists are exceptional individuals who are:
- Highly motivated
- Quality oriented
- Professional
- Caring toward their patients and offering highly personalized treatment
Hygiene Compensation Scenarios
Because of the number of variables that can occur from practice to practice, there is no one ideal method for compensating hygienists. What works in one situation may not work in another. Still, many hygienists and dentists wonder if the method of compensation they use is the best for their needs.
Listed below are the most common methods of compensation, benefits, and drawbacks of each, as well as comments from the most recent article based on the 2013 RDH eVillage salary survey respondents.
Straight salary
Generally calculated as an hourly or daily rate, straight salary is the easiest of the compensation methods to calculate. This reinforces value as team members.
Advantages: A straight salary allows the hygienists to feel secure about his/her income and allows the dentist to feel confident about overall costs. This method supports the expectation that hygienists will support the business through participation at team meetings, co-diagnosis of clinical care, actively marketing the practice, and helping to fill open or broken appointments.
Drawbacks: The practice assumes all risks of employing a hygienist who may be underused and yet is guaranteed a salary regardless of productivity. Hygienists who do not recognize a connection between their performance and their salary may be less motivated to work as efficiently as possible.
Responses from the survey:
- 79.3% responded they received an hourly rate.
- My hourly pay is $28. When I do not have a patient either from a cancellation or a no-show patient, I earn half of my wage 14 per hour.
Base salary plus commission
Hygienists receive a percentage of whatever they produce that is above and beyond their daily goal. This percentage can range from 5% to 30%.
Advantages: This model encourages the entrepreneurial spirit of hygienists who want to feel greater control over their own salaries.
Drawbacks: This model encourages the entrepreneurial spirit of hygienists who want to feel greater control over their own salaries. So overzealous treatment that is not in the best interest of the patient may be recommended. It may also inadvertently discourage hygienists from using production time to educate patients about self-care or any other practice-building activity not directly connected to hygiene production.
Responses from the survey:
- $300 base pay, then 30% of any addition production beyond $1,000 daily.
- $30 hour plus 25% of any amount over $800 hygiene production.
- A minimum hourly is guaranteed, then a commission for daily production totals.
Base salary plus percentage of hygiene collections
Drawbacks: The logistics of tracking this compensation plan are complex. And, although “prophy” fees are some of the most easily collected in the dental practice, not all hygiene services are. This model depends on factors that may be out of the hygienist’s direct influence, including poor marketing of the practice, ineffective appointment scheduling, fee schedules, and insurance plans.
Responses from the survey:
- I get paid 5% of collections received quarterly
- I receive 33 % after insurance adjustments and bad debt deductions and other adjustments
Commission only
Calculated at 30% to 40%-plus of hygiene production, depending on geographic location.
Advantages: Implies hygienists are in control their salary.
Drawbacks: This model means that the salary depends on factors that may be out of the hygienist’s direct influence, including poor marketing of the practice, inefficient appointment scheduling, and practice decisions regarding vacations and time off. This model may discourage hygienists from perceiving themselves as team members.
Responses from the survey:
- 30 per cent of hygiene production
- 28% of my production for each day
- 33% of the production of the patient being in my schedule
- If I meet or exceed my production goal for the day which is $150 per hour or $1200 a day, I get 6% commission. If the goal is not met, I get nothing.
- 33% of hygiene production, minus adjustments made for insurance participation.
There are many different ways dental hygienists are compensated. Whether you use one of the compensation methods described above, or work within an entirely different version:
Responses from the survey:
- Paid per patient seen regardless of the procedure. Flat rate of $50 a patient
- Up to four patients per day receive $167 a day. Each additional patient per day adds $12. Ten patients per day at $239.
- Realize that money alone is not the total package.
Kristine A. Hodsdon RDH, MSEC
Director, RDH eVillage
Kristine’s Disclosures: Kristine is a consultant and trainer with Pride Institute, and owner of Dental Influencers.
