Is it possible for your Dental Hygiene practice to survive a recession?
By Cindy Isaak-Ploegman RDH
When I first graduated in 1989 it was easy to find employment as a dental hygiene clinician. At all three dental offices I had an interview; the only question I was asked was, "When are you able to start?" Three years later I was laid off due to a reduction in the client base. Due to the economic recession at the time, dental insurance companies were reducing their coverage of regular dental hygiene appointments from every six months to every nine months. Now it seems we face similar fiscal concerns again.
Do you every wonder if you are going to survive this recession? There is a constant pull between loyalty to professional values and economic pressures. As repugnant as daily production goals are, if a certain amount of revenue is not generated, renumeration for dental hygiene staff and practice sustainability is not possible. But how much revenue is enough exactly? Do we need to have an upper cap at all? How are we able to serve someone who we are trying to squeeze more income from based on our interests and not their own?
The idea of treating clients as sources of consumer dollars, who we need to compete for with the dental office down the hall, definitely suggests a business model of client care and not a professional or client based model (Ozar, 1985). If we find that our focus on production places clients' values or our professional or personal values in jeopardy, our upcoming webinar May 16, 2012 with presenter Laura Kessler on "Finding your voice in Dental Hygiene practice" will cover tips on how to succeed in your professional practice and remain in alignment with your personal integrity.
Sometimes a recession is a good thing as it causes us to re-examine why we do what we do, for whom we do it, and how we approach our role as professionals.
Client education has been highlighted as the key ingredient to ensure our clients are aware of the importance of what dental hygienists role is in maintaining their oral health and the link to their overall health (Christensen, 2011). There are huge opportunities to promote wellness in our dental hygiene practice given the recent research on systemic conditions and oral health as well as the importance for preschool age children to maintain good oral hygiene.
However, this does not imply that we should threaten clients by telling them that they will have a heart attack if they refuse to attend their regular periodontal maintenance appointment, or we then risk being accused of breeching veracity (Wentworth, 2011). The truth is that not every client is diabetic or at risk of a stroke, endocarditis, or having a low weight pre-term baby.
If clients know the value of a health service, they will not hesitate to seek treatment regardless of financial limitations (Christensen, 2011). This is true of treatment deemed unavoidable, but possibly expensive, such as the removal of suspicious lesions.
The challenge is managing our client load with care. Some practical suggestions include replacing diminutive terms such as 'cleanings' with periodontal maintenance appointments, preventive care appointments, or oral cancer examinations when referring to dental hygiene appointments (Elster, 2009; Levin, 2009). Also included are suggestions for replacing the term 'confirming appointments' with reminding clients of upcoming appointments (Levin, 2009).
As a research assistant for a dental implant study, I was faced with a challenge of having research participants attend sample collection appointments over the span of a year at preset times, with only a ten-day window for change and my own limited availability. I realized I had to connect with each of these clients in a personal way or they would not be motivated to be compliant with the series of appointments, especially after their crowns were placed.
I also found that discovering their preferred mode of communication was necessary. Turns out that some don't use email, some don't have answering machines, and some never answer or return my phone calls, but they have all attended their appointments. Scheduling the follow up appointment at the last appointment is key and following up that arrangement soon after it is made is a good idea.
Educating clients, connecting with our clients personally, and not denigrating our value to the dental health care team are all consistent with client-centered professionalism.
I would love to hear your comments about this timely concern and of your strategies or challenges.
**Please note our webinars are also available in the archived version so if Wednesday evening does not suit your schedule you are able to access Laura's webinar presentation and question and answer period at your convenience by logging into our website.
Christensen, G. J. (2011). Helping patients understand and accept the best treatment plans. Journal of the American Dental Association, 142(8), 197-200.
Elster, M. (2009). Recession proof your practice through patient retention in hygiene. Hawaii Dental Journal, 40(6), 15.
Levin, R. P. (2009). Making the most of hygiene appointments. Journal of the American Dental Association, 140, 1305-1306.
Ozar, D. T. (1985). Three models of professionalism and professional obligation in dentistry. Journal of the American Dental Association, 110(2), 173-177.
Wentworth, R. B. (2011). What are the ethical issues I need to consider when developing marketing strategies for my practice? Journal of the American Dental Association, 142(8), 966-967.