Hygiene is the aortic valve of your practice, serving continuing patients and new patients. What ever happens in those precious hour appointments has a great impact on your success. What happens in hygiene does not stay in hygiene. It impacts your bottom line, practice success in sales and financial arrangements. Conversations, timeliness, overhead per hour, no shows and the “wow” for new patients all impact a practice’s success. Your clear vision of practice success demands action to have hygiene math work for you. Know your numbers, including hygiene.

Increase the value of your hygiene appointments in your community. Eliminate cancellations and no-shows. Create the reputation of value by not offering “Can you come in this afternoon at 3 PM or we have an opening tomorrow at 9 AM and 2 PM or the next day, we have three openings.” Make hygiene feel successfuland popular. Bite the bullet on hygiene cancellations and say, “Our hygiene department is so popular, the next time we can see you is October 3.” When hygiene is full, numbers work. If hygiene is struggling for whatever reason, your bottom line is affected.

Does your staff know your overhead per hour? Do the numbers for your office. Take expenditure totals for 2004, subtract the total laboratory bill, divide by the number of days worked (if you are working over 180 days, you are working too hard), divide by the number of hours per day. This then is the total overhead per hour, minus the lab. Expenses of lab are subtracted as this is the only cost difference between Doctor and hygiene. This overhead figure may be $256, for example. For hours with hygiene, you divide your overhead per hour in half which would be $128 for each provider. When the Doctor does a procedure requiring laboratory use, add in the lab unit cost for that hour.

Are you stuck on why hygiene and Doctor overhead are same except for lab? Examine: your patients use the parking lot, equipment, posting treatment in the computer, bathroom, collecting of money, dental supplies and office personnel. The knowledge of $128 per hour per provider is important for scheduling both hygiene and Doctor time. If you have one cancellation a day in hygiene, what did it cost you? If the Doctor has a one hour patient cancel, what does it cost you?

For every day of hygiene per week, you have 200 active patients. This is a visit twice a year seeing the hygienist for a one hour appointment in an eight hour day. Therefore, in four days of hygiene, a practice has 800 active patients. You may have a larger number of patient charts yet, this is the number of active patients in your recare program.

Hygiene should have a daily production goal. The hourly production in hygiene should exceed the overhead per hour per provider. Let’s examine $128 an hour with your fees. Add together the fees for an adult prophy, bitewing x-rays, periodic exam and fluoride. Does it exceed your overhead per hour?

Do you see the urgency of keeping hygiene full with patients who see value in you and your work? Do a survey of the last 90 days in hygiene. Eight patients a day should be appearing. How many actually showed? If you have one cancellation a day, in four days, you have a half-day hygienist on call with no production. That is $516 in overhead you are supporting.

Examine which patients in your practice do not consistently show for hygiene. Do not reappoint. Let them call you. Ask for their credit card to hold the appointment. In fact, some practices are now having patients pre-pay for their hygiene visit. We recently changed cleaners who asked for payment prior to cleaning. I was impressed. If cleaners are doing this, dentistry can help increase the value by having guests reserve their spot with money.

If you have many cancellations, you are attracting people who do not see value. You are too full in hygiene with patients whose vision does not match yours. Select a new group of patients either with better marketing, greater internal service, better conversations and listening or make a lesser number of hygiene days available. Staff for what you presently have, not what you hope to have.

Added Blatchford information on hygiene math: 20% of America moves every year. If you have 800 active patients, 160 will be leaving each year. Your job is to attract more than the 20% you are losing, which is more than 13 patients a month.

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