Thursday Troubleshooter: Dental hygienist asked to do way too much unrelated to hygiene
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QUESTION: I've been a dental hygienist for 17 years and I’ve been in the same practice. I’m all for positive changes that will better the practice. We’ve had a consultant for several years. She's made a great impact in our practice, but there are times where protocols are set and the hygiene department has experienced some that do not work for our patients. The doctor is on board somewhat and assures us that he is the boss, but when the consultant returns he lets her protocols take over. This is frustrating. Some of these protocols are numbing the doctor’s patients. We leave hygiene openings so we can numb patients because he is double booking. The front office has multiple people on staff to work on the schedule. I feel that as a producer, our schedule is priority. Instead we’re pulling charts and confirming patients. The front staff always needs help, even though there are three full-time people for the area. I’m willing to help them, but as a hygienist in the clinical area we need to be cleaning rooms and sterilizing instruments and charting. They never come to the clinical area to help us, but now we have to do front desk duties and numb the doctor’s patients, and still see our own patients? I don't want to leave the practice but how do I approach this? When I approach the doctor he always has to talk to the consultant.
ANSWER FROM JUDY KAY MAUSOLF, Founder of Practice Solutions, Inc:
I would like to address several points. Per your statement the consultant has made a great impact in your practice, I assume it has been positive. It’s realistic to consider you may not agree with everything the consultant recommends. Ask questions if you have concerns so you can understand the why behind her suggestions. Are her recommendations in the best interests of patients, practice, and team, not any individual? If so, it is the expectation that you support the new protocol. Have an open discussion with the consultant and doctor if you don’t feel the consultant's ideas are in the best interests of the practice, and share evidence that supports your concerns.
I understand and agree that it is important for you as a producer to have a full schedule. However, if there is open time, it is important for you to assist wherever needed. The job description I use with my clients is—your job is whatever it takes that is legal, ethical, and within your licensure from the moment you arrive to the moment you leave. If someone needs help and you’re available, it is your job, even if it is not your normal task. Helping out in the front helps you keep your schedule filled. It sounds like your doctor wants you to numb patients to free him up to do additional treatment. You are still being a producer by helping him produce more, and by helping the practice as a whole to succeed.
It is time for you leave when you choose not to support the new protocols or standards that the doctor wants implemented. It is his practice and his place to make the decisions.
ANSWER FROM SHELLEY RENEE, founder of Shelley Renee Consulting:
Thank you for sharing your concerns. Your question is composed of several “symptoms." You will find solutions and relief by doing two things: investigating the cause for open time in hygiene, and clarifying the expectations of each team member. Trust me, you’re not alone in wanting to do only hygiene all the time. Doctors wish they could do only clinical all day as well. Since we’re also running a business, we need to understand the bigger picture. Once we see outside our own department the protocols might make more sense.
First, do you know if your hygiene open time is within a healthy range, which is less than 8%–10%? Do you know your periodontal treatment percentage? Do you know if you have enough patient base, adequate retention, or new patient flow to support your hygiene hours? Is the doctor wanting to grow or add services? Have you considered that perhaps the reason you’re being asked to help in other departments might be a strategy to use the entire team while the practice is growing, without cutting your hours?
It’s helpful to look at the big picture and the vision of the doctor. Perhaps only a few of the protocols have been implemented at this time and soon there will be more clarity surrounding the front desk roles. Please know that whether you’re anesthetizing a patient or confirming appointments, this all contributes to the office production. As a team member, you have the power to keep your schedule full. As an employee we tend to see only one piece of the puzzle at a time. Ask the doctor and consultant to share the future vision for your practice. Are they trying to stay competitive as a fee-for-service office? Are they trying to cope with staggering overhead? Have hours been added to the schedule? Ask for clarification. When you understand fully it makes coping with change much easier.
Hang in there! It sounds like better days are coming as you grow together with your team.
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