Content Dam Diq Online Articles 2015 07 What To Do 1

Thursday Troubleshooter: Why is this RDHs extra work discouraged?

July 30, 2015
This dental hygienist is doing extra work and can't figure out why she's met with resistance from her coworkers. She also wonders why the office is closed for half days around holidays, and sets aside half days for team meetings.

QUESTION: On a daily basis I work toward increasing my production by giving fluoride treatments, taking FMX even when it’s not scheduled, taking alginate impressions for occlusion guards, or whitening and placing sealants that was treatment planned on previous visits. I find resistance from the assistants who are not willing to help if I’m running a few minutes behind schedule. They complain that I’m doing treatment that was not on the schedule. The office manager has told me not to do so much but to have patients return another day. A few months ago the doctor asked me not to take FMX during recall visits because it takes too long to do an exam and the front desk has complained about this. While the dentist thinks this is great on my part he feels it's best to have patients return for FMX on his schedule. I’ve been a hygienist for over 20 years and this is the first practice that discourages production. Assistants and the front desk personnel seem content with the present situation. Also, the office manager recently blocked half a day of work time once a month for office meetings. During different holidays throughout the year our schedule is blocked to work only half days the day before the holiday. Is this normal in other practices? I spoke with my employers about this, and while they agree with me, nothing is done to change the situation because the rest of the staff is happy. Any suggestions are greatly appreciated.

The first answer is to look for another office that appreciates what you do – period.

The second answer is, if you like the office, look for ways to compromise, like any good relationship. I find that the push back that you are experiencing is really coming from fear – fear of running behind and not being able to catch up, fear of making patients mad because they have to wait for a few minutes if you run late, fear of letting someone else down, fear of not getting to the end of the day on time. The instinct of getting in extra production is the right one, so keep doing it, even if you get negative feedback. Talk to the office manager and dentist. As long as you don't run late, then it's definitely the right thing to do!

ANSWER FROM LINDA MILES,Founder of Speaking Consulting Network:
Based on your opening statement, I assume you’re being paid on a percentage of production. Otherwise your first statement would have been, “In order to give my patients the absolute finest care, I give fluoride treatments, take FMXs, and take alginate impressions for occlusion guards or whitening (when it is indicated), and place sealants also when necessary.” Instead you state, “On a daily basis I work toward increasing my production by…”

Your doctor should have a radiograph protocol indicating when FMX and BWX are to be taken. Then it shows up on the schedule only when the patient needs it, and not to increase daily hygiene production. Secondly, you mention the assistants are reluctant to help you when you do these added treatments. Again, being on a commission-based salary means it is benefitting you and not the rest of the team for these added procedures, and in some cases not benefitting patients if they don’t need or are not due for those production boosters. If the office radiograph and treatment protocols are established by the dentist before patients are seen, each procedure would then be on the schedule with the proper time allotted in the schedule. That would alleviate the inner-office frustrations of falling behind, and it would also eliminate the need for patients to return for an added procedure, which is an inconvenience to patients.

As for the staff meeting block a half a day per month, these meetings are tremendously important to the entire practice and should be looked upon with enthusiasm by all. Again, if you are on commission, perhaps there is a reduced hourly pay for seminars and staff meetings? This would affect your income, but look at all the benefits to patients, the practice as a healthy business, and to each staff member to have improved communication, more organized systems, and a better work environment (team attitudes) by having team meetings.

Finally, it is up to the dentist-owner to decide his or her office hours. Working only half days before holidays gives team members (and busy patients) time to prepare for the upcoming holiday or get out of town earlier if they’re traveling. So yes, many businesses and practices do this.

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