#884: Use Hygiene to Increase Profitability

Dental A Team Podcast

Tiff and Britt talk about how practices can give a boost to the hygiene department’s profitability, especially as 2024 gets closer to its end. Specifically, the two give insight on increased re-care, appointment efficiency, and consistent SRP. They also discuss ensuring your practice has enough hygienists in the first place for your client load.

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Transcript:

The Dental A Team (00:01.525)

Amazing to have you back, Brittany. Thank you so much for podcasting with me again today. I stole you again on another podcast day and I truly appreciate it. I'm excited today because I've got some hygiene stuff I want to chat with you and for the dental world out there listening. Britt and Dana are both trained hygienists, trained and licensed. And so I always like to steal you guys when I have some hygiene stuff. So Britt, how are you doing today?

Britt (00:29.875)

I'm excited to be here. mean, I do love a good hygiene topic, but I love all of them. You know, it's always fun to podcast and chat dental. That's us dental nerds over here.

The Dental A Team (00:35.084)

I know.

The Dental A Team (00:38.734)

It's true. It's true. You do. And I appreciate that and I value it. So thank you so much for being here today. Brent, it is hot. And I know it's funny because we had a call this morning with a company that we're just partnering with and doing all kinds of fun stuff with this company. And he's in Utah. And this morning, he's like, gosh, it's hot. And I think, I don't know if you agree, but like, I know it's hot.

But it seems to me when someone like acknowledges it, that they're like, how are you living there? That's when I'm like, yeah, it's like really hot. So then I'm like all day, I'm like, now I'm hot. Like I was fine. But how are you? You're 20, 30 minutes away from me in the same city. But the weekend was beautiful. Like, how are you feeling about summer so far? I feel like it's been a little wild with weather, but how are you feeling?

Britt (01:23.758)

you

I same. love it's been a little while since we've had a monsoon. So maybe that's why right now I'm like, it's, it's hot. Yesterday I was outside and like, no way is it only a hundred degrees outside. Like it feels way hotter than that. So it was a little more humid cause we got a little rain, but we haven't had a good storm. feel like really come through and cool it off very well. And at least like a week or so. So I feel like that's what gets me through the end of summer. I love it. It's gorgeous. Most of the time I enjoy the heat, but July, August is like the

The Dental A Team (01:28.203)

I know.

The Dental A Team (01:38.241)

Yeah.

The Dental A Team (01:46.966)

Yeah.

Britt (01:54.413)

I'm ready for it to be a little bit cooler.

The Dental A Team (01:56.653)

I totally agree. I totally agree. I was chatting with someone yesterday, she's getting ready to do a half marathon in DC in September. And I was like, how are you training for this? She's here in the valley, like, how are you training? And she's like, well, I was running this morning at 430 in the morning, and it was only 104. And I was like, okay, well, at least the sun's not beating down on you, I guess. But like, training for that sounds like right now. So I agree for all of us. I know.

I know for all of us Arizona natives and Arizona livers and goers like you got to enjoy the heat, which I do. I do. I enjoy it more than the humidity. So we'll stick with it. anyways, topics today, I really wanted to focus in on some profitability. We're nearing the end of the year coming up on quarter four. It's right around the corner and really just looking at what do we have left?

Britt (02:38.114)

You

The Dental A Team (02:51.017)

this year to accomplish for these doctors to hit their goals and these practices to really see that profitability increase this year. And I wanted to really speak to the fact that there are multiple people that are involved in the profitability of the practice. It's not just our dentists and our doctors who are filling their schedules. And it's like, do more, do another crown, do another bridge, do this, do another ortho case, like always getting these things in for sure. But when their schedules are full, their schedules are full. Coming up towards the end of the year,

their schedules are going to be really full. And one piece that I like to slide in here is really how hygiene can help increase that profitability. And Britt, think it's, it's even more important towards the end of the year to look at it because just like doctor schedules fill up really fast for any of your benefits, things like that. Hygiene, recare fills up really fast because people are trying to use that last cleaning of the year, which makes this portion a little bit wonky. So really just kind of working through some of those trouble spots and

and difficulties, but seeing how can hygiene increase the profitability. And Britt, I want to pick your brain specifically because you've done hygiene, you've been in that chair, I've done hygiene assisting, I've done hygiene scheduling, I've done all the other pieces, but I've never been a hygienist. And I think one of the pieces that I see most frequently come up when I am consulting practices is the hygiene department really feeling like one, we don't put enough emphasis on our re -care.

Britt (04:02.603)

Thank

The Dental A Team (04:17.161)

And so we're always clamoring for more, clamoring for new patients without regard to the re -care. So making sure they're in there. But then two, also a lot of my hygienists are like, gosh, what more can I do? Like, what are you asking me for? So really I'd love to hear from your standpoint, some areas that you feel like within re -care, not necessarily new patients yet, but just within re -care.

How can hygiene really make sure we're handling our re -care patients with care and attention, seeing them, and also leaving room for that growth in their schedule? What did you used to do, or what did you like maybe with your scheduling or what have you when you were chair -side hygiene?

Britt (05:00.01)

Yeah, think number one when it comes to profitability and hygiene is just kind of knowing where we're at, right? So where's our hygiene department at when it comes to productivity?

Are we being efficient with our time and our schedule, things like that. And some tips when it comes to efficiency, right? With our appointments, yes, it's appointment length. And I think sometimes it's hygienist, we can forget how much re -care frequency can impact our efficiency. So like one little tip is sometimes those patients who aren't doing all their work at home, I have a lot of work to do when they come in. I am stressed over the amount of time in the appointment to get everything taken care of because there's so much work to do.

you

looking at those patients and sometimes they might just need to come in more often. So I can get done efficiently. It's not so stressful on me. We're getting them healthier so they're not having so much to do every single time, reinforcing home care more often for them. So there's one idea of something to look at. Look at our efficiency. Look at our timing. Another one when it comes to hygiene that's around like efficiency and timing is I'm a big fan of starting same day SRP where we can. If I can knock out a quad that first visit while still giving them that great experience or if it's a re -care visit and they're like,

needs to be gut dead, get something started for them in that realm, get a quad done and have them come back for the other three. There's a lot of like little kind of efficiency things like that are just little hacks to get the production in and it's not just for the production, it's patient care first and making sure we respect our time and the work that you're doing that you're getting paid for the work that you're doing and if a patient's not doing the work at home and they need to come more often then have them come in more often because it's

The Dental A Team (06:22.598)

Mm

Britt (06:37.964)

the right thing to do by them and it's going to help your schedule.

The Dental A Team (06:41.146)

Yeah, I think that's really important. What you just said is that it's also the right thing to do by the patient because I fear often what's put ahead of that is insurance frequencies, out of pocket costs, like maybe feeling selfish because it's more work on you. So you're just like, gosh, I'll just, I'll take the hit. I'll take the brunt of it. But at the end of the day, the bottom line is that their mounts are unhealthy and we know that that's a systemic issue.

no matter where the unhealthy meter is at, where it's lying, it's still a systemic issue and it still leads to more more problems down the road. I think the more like all this gut health and all of these things surface and are coming out, I think there's going to be even more tied back to even simple routine home care. So I think that's really huge. And for that to be the forefront of our thought process when we are diagnosing, when we are treating patients, so even a patient that you've seen forever,

might come in today and they might have one quadrant that just needs SRP like that quadrant or two quadrants or four quadrants like things change and people change. I didn't have gut issues that I was aware of prior to five years ago, but then something changed. My body reacted to the world around me, the stressors around me. And all of a sudden now I have to be more consciously aware of the things that I eat, the,

you know, stress that I put my body under and things like this, but we forget that that happens, like that affects everything. And so our patients who have been seeing us routinely, oftentimes have changes in their lives that have affected their home care, their routines, or just the makeup of their body and their mouths are included in that. So I love that you said that because I think that's something that more people in the dental industry can really take to heart to kind of dispel some of the guilt.

that's wrapped around trying to do better for our patients and feeling maybe selfish or something in the middle of it. So I think that's huge. Now, a statistic, a stuff that we use here at the Dental A Team is we truly want our hygiene departments to be about 30 % of overall production for a practice. So that's increasing profitability rate there. Most practices, I'm gonna tell you that are not tracking it, aren't looking at it.

Britt (08:33.282)

Mm -hmm.

The Dental A Team (09:02.69)

Most of the time from what I've seen, the clients that I've worked with, they're typically around 17 to like 22 % production overall, which isn't horrible by any means. I've seen 12 and 14%. So 17 to 22 being my average isn't the worst. love pushing 25 to 30 % because that really, really helps to increase that profitability and make it so that the rest of the practice providers can really

use a schedule that flows well for them. So with that, your increased recare, your increased efficiency and making sure we're doing that same day treatment, we're doing SRP on people who need it, no matter how long they've been with our practice or not, things like that are going to hugely benefit that 30 % marker. with that said, we're adding, like we're like, gosh, you really need three cleanings a year. So we're to add a cleaning. So then that adds an appointment, right? Or we're going to do SRP. So then that adds an appointment. And then this

realm since 2020, hygiene appointments have been few and far between. hard to come by. So I think if I've got hygiene listeners on here, which I know I do some hygienists out there, they're like, cool story, bro. How am I going to put these patients? So what did you do to help with that? I know we implement a lot of block scheduling within the Dental A Team. And how did you work that into your own schedule? Because I know you're a huge believer in a patient always leaving with an appointment and

Britt (10:15.622)

huh.

The Dental A Team (10:30.428)

always leaving with an appointment from the hygienist. So how did you do that projecting and creating your own schedule for your future patients?

Britt (10:39.532)

Yeah, for those of you that are having full schedules out there and sometimes, right, we've got to make our block schedules and depending on how many hygienists we have or if we're trying to hire someone right now, understandable that we've got to plan things out a little bit. Block scheduling for sure. So with those patients that I would like to see more often.

Sometimes with block scheduling, might push them out a little bit. And with those patients, I'll say, hey, here's what we have right now. You can always call us and see if something opens up sooner, right? There are shifts in the schedule every day. Doesn't mean there will be something, but there are shifts, so you may be able to get in sooner. So if there are one that I'm like, hey, here's what I can do for you.

We have a lot of patients to manage, right? Our front desk does the best they can, but they're not gonna be able to call every single patient that's out there that needs to come in sooner. We can have a short call list to work through, but if it's important to that patient for them to come in, then they can be the ones that are responsible for calling to see if something opens up sooner to get those appointments in. And schedule them out for the year. Usually I'll schedule out, if they're coming three times a year, don't just schedule the next two, schedule the next three so that they can get on the books.

The Dental A Team (11:45.097)

Yeah, I love that. I tell practices that a lot and it seems to be working really, really well. Okay, I'm going to pivot a little bit away from your hygiene brain. Britt, if you guys aren't unaware, it has an incredible business brain and business like projecting introductory and numbers and all of these pieces. She's fantastic at that the HR side, all of those pieces. So want to pivot over to that side of, of your world, Britt, and really start diving into more of these numbers because I think hygienists like

Great, we've got some tips there. We'll kind of come back to that so that doctors and hygiene and team members can kind of see different areas where we can be more profitable. But as you're talking, I'm thinking, gosh, I wonder how many practices or how many practice owners out there don't have enough hygienists and maybe even don't know it. There's plenty of us out there who are out here who are searching for hygienists and hygienists. If you're out there, like come out from under the rocks, we need you. Let us know where you're at.

Britt (12:37.592)

Thank

Britt (12:41.152)

huh.

The Dental A Team (12:43.335)

So there are plenty of practices that are in the hiring mode right now, but I think a lot of practices maybe don't even know when they need to hire to expand on hygiene time and hygiene hours. So we're stressing and we're like squeezing tight on the hygiene realm and we're like, get them all in there, you're fine, you're fine. But what are some areas and some stats that practice owners and docs can really start looking at to say, I think it's time to hire another hygienist to add this into my schedule. Is it?

and how far out were booked, how which a lot of practices struggle. I'm going to caveat here. lot of practices struggle with me on that one because they're like, cool, I'm booked out six months, but tomorrow fell apart. And so why am going to hire a hygienist? So those are systems, systems in the background that needs to be fixed on a foundational level. But as far as like booking out availability, hours, like number of patients, is there any staff that you like to refer to when you're looking at a practice building out their hygiene?

department that you suggest to your practice owners.

Britt (13:46.254)

Yeah, so let's talk about the number you said first, Tiff, right? So hygiene, want that to be like 25 to 30 percent of our total production. We want to account for hygiene. You guys, a lot of numbers are just general markers to see kind of industry -wide, based on the average, where are you sitting? So if you run that number from the get -go, like Tiff said, like we definitely had some practice sometimes that are lower percentage, right? That's just going to be your flag to be like, all right, like what is it that's going on? For some practices,

is it's like, well, we only have one hygienist and really we know we could do two and if we doubled it, like our percentage would definitely go up and that's the thing that's holding us back right now. So it's going to tell a story and you've got to kind of take into the factors and see if there's anything you can do about it to change it. Now when it comes to how much hygiene we need,

The Dental A Team (14:23.643)

correct.

Britt (14:36.878)

Yes, scheduled out, like that's gonna give you an idea. I like going by active patients. How many patients do we have that have been to the practice within the last 18 months? And planning by that. And what you can do is just do the math. If a patient, let's say just a healthy patient, re -care patient coming twice a year to our practice, it would only take about 200 patients coming twice a year to fill one day a week, every week for the year.

So if you're looking at like, well, should we add a day? Well, let's see, how many hygiene days do we have? How many active patients do we have? Do we have, you know, about 200 per day right now, or do we have way more than that? If we have way more than that, then let's look at adding some hygiene days. How much more do we have and how many days might we need to add? Because the thing is, that's gonna be a super conservative number of about 200 patients, because really, you add to that, we're gonna have new patients coming into the schedule.

The Dental A Team (15:34.242)

Okay.

Britt (15:35.052)

You're not period maintenance that are coming more often or there's re -cares that are coming more often. So really that's going very minimum for they just came twice a year. Like that's, what you would need to cover a full day. And really they're going to be more than that.

The Dental A Team (15:47.353)

So if I'm doing this math, I love that math, that makes it super simple. So if I'm doing this math and I'm saying, 200 patients per full day of hygiene for the year. So then if I'm like, great, I'm gonna say Monday through Thursday, I have hygiene, so I have four days of hygiene. And if I have one hygienist every single day, full time, right? So I've got four days of hygiene, that's 800 active patients. That's beautiful.

Britt (16:15.116)

Mm -hmm. Yep. And that's not even adding in your new patients or anything. So with that many active patients, it's going to be a full schedule even for that hygienist because really you're going to have more than that.

The Dental A Team (16:18.305)

Right.

The Dental A Team (16:24.856)

For sure, for sure, that makes sense. So then these practices that we're seeing that are 2100 and 25 and 2800 and they've got three hygiene half like part time, like this is why we're struggling to really be able to get those hygiene hours in. That makes sense.

Britt (16:42.392)

So look at your total number of hygiene days. And even there's some practices now, right, where they've been able to piece it together and they've got a good crew. They know how to communicate. So everybody's on the same page and it runs really well. So of course, we'd all love to have our full -time people forever, but like.

right now, sometimes it might be piecing together some part timers and they help each other out and cover even and it can work out really well. Just communication is really key. And then there's some practices that have gone to with their hygienist, maybe it's an accelerated hygiene, right? And it doesn't have to be all the time or every day, right? It can be something very specific to what works in your office, what works for your team to be able to see and take care of our patients while we maybe look for someone more, look to add more time. So those are some

things to consider now. Sometimes it's that we don't have enough hygiene. I strongly believe for hygienists, if you're doing the things that are needed for your patient, getting your x -rays done, right, periodontal charting on a regular basis was ultimately doctor sets the standard, but if you're doing those regularly according to your standards, periodontal charting, recognizing periodontal disease when it's there, treating it when it's there, you can hit

that 30%, that 25 to 30 % by doing right by your patient. And then if you've got Adject Services you can add to it, awesome. You'll have even more opportunity to be able to add to it and contribute to that production.

The Dental A Team (18:08.469)

Totally agree. Okay, so I love that. Thank you so much for letting me pick both both pieces of your brain there. You have so much so much to offer and so many reasons why you're an incredible consultant and business administrator here on our team. So thank you for that. Now what I'm piecing together here guys is really just looking at like how can our hygiene department help us increase that profitability when you pull those numbers. That's why we talked about that 30 % first at 25 to 30 % first because like she said,

Britt (18:13.324)

Thank

The Dental A Team (18:38.165)

that's going to tell you your story and really give you a baseline of where you're at and where we can increase. So if you see that your hygiene department is less than that 25 to 30 % where we really like to see our practices, now you can dive into trends and really look at why is it less? Is it less and we're full? Is it less and we have a lot of cancellations? Is it less and we're not doing adjunct services? Is it less and we're, so if it's less and we're full, now we're looking at, great.

Britt (18:59.661)

Yes, ma 'am.

The Dental A Team (19:07.912)

What's our active patient count and do we need more hygiene space? Because one thing that I've found, and it sounds like it would be the opposite, right? Because your hygiene schedule's full. So it should be more percentage, right? It should be providing more. But one thing that I've seen in practices that are really struggling to understand that they need more hygiene hours is their hygiene department percentage will be super low because there are so many patients and so much happening on the doctor's side.

that the doctor's easily far outweighing the hygiene department because there's not enough availability for the hygiene department to get that percentage up. So we're living on like new patients and limited and same day treatment and churning and churning and churning on the doctor's side. And hygiene is scrimping by with re -cares because they don't have space for anything else. And so their percentages that 14 to 17 % and they're just like pulling their hair out.

because their doctors yelling at them to get more production. But really we have to do our due diligence and evaluate, are we giving the hygiene department the availability? If yes, tons of tips and tricks and just this podcast and a ton of podcasts we've done on how to increase that profitability. But we've got to look at first, if it's no, then what do we do to help increase that profitability as well? think that's huge.

Britt (20:23.926)

Yeah, and Tiff, that comes back to, right, when you look at that, if we're not kind of hitting that mark, usually if our hygiene production isn't quite where we need it to be, it comes back to that volume and value, like conundrum, like is it, are we doing everything for those patients and we're doing our adjunct services, like truly we're providing the top notch level of care that we want to provide to all our patients, but we just don't have enough hygiene, so we're not hitting it, so we need to add more volume, we need to add more hygiene, or is it,

The Dental A Team (20:35.984)

Mm -hmm. Yeah.

Britt (20:53.378)

We've got the hygienist, which lucky you. maybe we're not like completely doing all of our standards to the highest level that we want to be providing that care, not that we're providing bad care, but like what's our top standard that we want to be talking to all our patients about the level of treatment we want to be providing. Let's make sure that we're hitting that mark. And I'll make the caveat, right? I've definitely had some hygiene practices where if we've got doctors who do a lot of like

The Dental A Team (20:55.922)

Yeah. Congrats.

The Dental A Team (21:05.745)

Mm -hmm.

Britt (21:22.318)

surgical or all on X like super high producing doctors, right? That might impact your percent. So like that's part of your story. And I've had some hygiene departments that they're actually like over that 30 % within the practice, right? They're cranking it. Hygiene team is doing a phenomenal job over there. And it's like, all right, look at the doctor side. Is there a volume or value issue over there on the doctor side that we can work on? So.

The Dental A Team (21:26.289)

question.

The Dental A Team (21:33.659)

have to. Yeah.

The Dental A Team (21:47.056)

for sure. No, I love that you said that I've definitely seen that or my hygiene department. I've come in and I'm like 40 % day and ladies are like, yeah, we're killing it. And I'm like, yeah, what's going on with diagnosis? Where can we where can we increase? Where's the balance? Exactly. I think that's the perfect word. So what we found is that balance is like right around that 30 % marker. So I love that. All right. So you guys, you've got a ton of information out of this podcast from us. What I want you to do

Britt (21:56.716)

It's not balance.

The Dental A Team (22:15.95)

as I want you to go pull the stats and pull the numbers on your specific practice, dig into the trends that you're seeing. Just get a baseline. Where are you at? And are you in a space that you are right on the marker there? You've got that balance, you've got the profitability coming from both sides, or are you not? Are you swaying on either side? And then do your due diligence there and dig into why. You guys, brilliant Britt over here. That's gonna be your name, brilliant Britt. I finally figured it out.

Britt (22:42.919)

Too nice, Seb.

The Dental A Team (22:44.687)

Brilliant Brit. Brilliant Brit over here has provided us some really great tips and tools. And I want you to like go backwards in this podcast and listen to those stats and those numbers that she pulled and that she chatted about. Those are the important factors that 200 per day during the week of hygiene patients, that's going to be huge. That's your active patient count pulling those. am a huge advocate for watching your active patient count just as much as you're watching your new patient count. So keep an eye on both of those.

If there's anything you guys got confused about anything you want clarification on anything that you need or if you need help figuring this out or projecting or getting these in line or talking about the systems that are behind the scenes on all of these, I want you guys to talk to us, email us, write in hop on this link on the podcast and schedule a call like whatever you have to do. [e-mail]. Leave us a review below and we always read those. always respond to them as best that we can and we will

like we will gladly help you in whatever ways we can, we have a million avenues for you to choose from. But I want you to go do your due diligence first, pull those numbers, know where your baseline is, and then reach out when you guys need help, the resources are here. Britt, thank you so much for today's podcast. And thank you so much for the work that you do with our clients and with our non clients, people, like I said, who are just reaching out and they are future clients are never going to be clients, we don't care.

Thank you for everything that you do for all of them and the incredible value that you provide all of us. And thank you for being here today, Britt.

Britt (24:16.438)

Yeah, thanks for having me. You know, we all love it. Tiff too. We like to help anybody we can in dentistry. So we're always here.

The Dental A Team (24:18.573)

course.

The Dental A Team (24:22.859)

Yep, absolutely. Great. Awesome. All right, guys, go do your homework, reach out in whatever capacity or way you need to. We are always here for you until next time. Bye guys.