The May issue of RDH magazine contains an article by Dianne Glasscoe, RDH, about problems with dental hygiene scheduling, and the author offers suggestions on developing productive scheduling priorities.
The magazine's editor, Mark Hartley, asked dental hygienists with profiles on MySpace: "What's your biggest gripe about your hygiene schedule?"
Here are some of the replies.
• Andrea Dedeaux, RDH, said, "I am happy with my schedule and only one change needs to be made. I would like to see a little prescreening for new patients before they are placed on the schedule. For instance, someone who has not been to a dentist in years should be given a lengthy appointment vs. the patient who is just switching dentists."
• Andrea Grammatica, RDH, said, "I have two gripes in particular about the hygiene schedule, and they are really the only ones I have about my career, which I love. First, I hate the fact that I do not have a break until lunch. My next patient is waiting for me by the time the DDS has done the exam, and I have walked the previous patient to the front office. I have to clean my room and put my instruments in the ultrasonic (thankfully I work with some amazing RDAs, and they bag my instruments for me). I never have a minute to run to the restroom. Seriously. We only have one in the office and it seems like someone is always in there. I rarely have a chance to go and holding it until lunchtime is not really healthy, so I drink very little during my workday.
"My second complaint is that the front office does not always understand what hygiene really does back there when they schedule patients. Sometimes they will ask me if I can do two kids in a 60-minute time block. NO, I can't. What if my previous patient requires something extra? What if one of these kids is late? Even five minutes would kill my schedule! And after I have reviewed medical histories with parents, taken X-rays (if necessary), charted restorations (yes, I do that on every patient at EVERY visit!), that leaves me very little time to scale and polish their teeth, let alone offer any oral hygiene instruction! And that doesn't take into account the fact that the dentist probably wouldn't come into my room on time to do an exam (which eats into my time as well), and then I have to clean my room and set up again for the next one. We have this conversation about every couple of months, but I realize our front office must think I am lazy.
"So in a nutshell, I guess I could say that I am really happy in general with dental hygiene and, of course, with my employer. Sometimes I question his logic in staffing choices, but overall I love my boss of seven years and have worked for him since I graduated from hygiene school."
• Tiffany said, "One of my biggest gripes is when a perio patient who needs to be seen for two hours decides to cancel. If they don't reschedule immediately, they often get allotted an hour when they call back to reschedule their perio visit. It's very frustrating because many times you don't see it on the schedule until the day of and by then it's too late! The frustrating part is that on their appointment note I always put in capital letters PERIO NEEDS 2 HOURS! Yet it gets ignored sometimes by whoever takes the call. We use templates in the office for both doctors and all three hygienists, so it should make rescheduling something like perio a little easier.
"Another gripe I have is that if I ever have a change in my schedule, I wish that the front desk ladies would come and ask if they could put a certain person in the hour that came available. Hygienists get to know their patients and know that some patients need more time than others. (And sometimes you need a few hours to become mentally prepared for who's coming in next.) Also, they don't always know if you're running behind, if you're not feeling well, or need to order more supplies and could use a short break."
• Shari said, "I would have to say a couple of gripes that I have about my hygiene schedule (I have three offices, so it varies from office to office) is the sheer demand for production, and the lack of respect from both the patients and the doctor. As far as production, I have my three-day-a-week office that runs us from 12-7 straight through (I'd kill for a half-hour break), and it rarely matters how late the patient is, regardless of whether or not they took their premeds, or if their one-year-old is crawling all over them and trying to grab the scaler out of my hand. It's always the same — do it, do it right, and do it fast. Working five days a week, there are days I can barely stand up, my back hurts so badly, then go through the insufferable 45-minute ride home, only to do it again the next day.
"I have to say there are days I feel greatly unappreciated. The doctors get multiple breaks throughout the day, waiting for patients to get numb, when the assistant is delivering the patient's bleaching trays, etc., whereas the hygienist is pretty much working constantly, which takes a severe toll on the body.
"However, there are perks to the job. We get our continuing-education credits paid for by the boss, as well as trips to the conventions and a masseuse once a week for about 15 minutes. So it's not all bad.
"Secondly, I feel that the patients across the board (with the exception of a select few) think that we are just some random person off the street that the doctor asked to clean teeth for the day. I cannot tell you how many times a patient has asked me a question, then asked the same question to the doctor and received the exact same answer, but only believes it because it came from the doctor. Few respect us as professionals; we are merely regarded as "the help." It brings down the morale among the hygienists, and negatively affects our work ethic at times.
"So, to wrap things up, practice-management consultants serve their purpose — to increase production of the office. This is often to the detriment of the extremely hard-working hygienists, who feel overworked and underappreciated.
• Kris said, "Where do I start? There seem to be so many. The practice I work for has four — soon to be five — hygienists. There are two doctors in the practice. We keep three full columns of hygiene going every day, and the hygienists who are not with a patient help assist or, in my particular case, I work on lab splints and whitening trays or do in-office whitening. Oh, yeah, I also have just been given the new task of new-patient coordinator.
"Now to get back to the question ... My biggest gripe? We have had a consultant come in over about a 12-month period of time. I think she came and met with us every other month. The hygienists were asked to meet together and come up with our ideal schedule. So we did. But naturally it never flows the way we want it to.
"The worst thing is to have a patient scheduled for about one hour of time when there was not enough information taken over the phone. So when the patient gets there, they haven't been to see us in maybe two to three years. One hour is in no way enough time to do your X-rays, perio assessment, update medical history, doctor's examination, etc., and then if they are a straightforward prophy, there is no time left to do that.
"Then we asked for time blocks on the schedule for each hygienist for a NP prophy and when you go to find one, there isn't one for two to three months. We have had a hard time with our scheduling coordinator, plus there are too many hands on the schedule. And then there are the last-minute cancellations."
• Stacey said, "My biggest complaint in my schedule is by far not being given enough time in the appointment to complete all the services the patient needs. 'Squeezing people in' only leaves room for error."
To visit Mark Hartley on MySpace, go to www.myspace.com/MarkhRDH.
