A: Great question! And I’m going to answer it in three parts: what the national average is, what they should actually be producing, and if they are not meeting those numbers, why and how to fix it.
Daily hygienist production—National average
Quick caveat: hygiene production figures can vary heavily depending on the area in which you practice and whether or not you participate with PPOs. But having said that, there are some general industry standards:
In a practice that participates with PPOs: Industry standard is anywhere between $1,200-$1,600 per day for each hygienist.
In a completely fee-for-service practice: Industry standard is above $2,000 per day for each hygienist.
(I’m not going to get into numbers here for HMO or state insurance practices, because that’s heavily variable and would need to be a separate article.)
Keep in mind, the averages I gave above are national averages, not MGE averages. In my opinion, the national averages are too low. Our clients tend to see much higher numbers.
Again, there are a few things that will impact these numbers for you—your location, your fees, your degree of insurance participation, etc—so I can’t give you an exact number here, for an exact number, I’d suggest a free consultation with us which you can schedule here. During the consultation, we can discuss your particular situation and work out a more exact range of productivity.
Seeing a significant increase above the national average means that:
- You have a functioning recall system—patients are actually showing up for their hygiene appointments every 4-6 months
- You are treating those patients for the conditions they are presenting with
- You are charging them properly for the work you are doing and
- Your hygienist is using all of their skills to the maximum of what they are legally allowed to do in your state/province.
If you are doing all of those things, it’s almost impossible to fall below the national averages (even if you’re in an area with lower fees). Most likely you’ll be beating the national averages by a healthy margin.
After all, it is extremely unlikely that every patient you see in your practice only needs a simple cleaning—doesn’t need x-rays, has no pockets that need to be addressed, is not periodontically involved, etc. So if you’re falling short of those averages, it means there’s probably an issue with your perio protocol, you’re not charging your patients properly, or there’s a major problem with your recall program or scheduling.
Which leads me to the next topic:
Why are your hygiene production numbers falling short? And how can you fix it?
1. You don’t have a good recall system—meaning that patients aren’t showing up and you’re losing patients, whether you realize it or not.
There’s something wrong with either:
- Confirmation procedure
- Patient outreach efforts
- Reactivation efforts
We’ve written plenty about how to build up your recall program and reactivate patients. I won’t rehash it here, but I highly recommend reading this article on calculating your hygiene department’s potential and watching this video on patient reactivation from our COO, Jeff Blumberg.
And if you need better systems for the four things I mentioned above, we provide training for your team on our on-demand video training platform, DDS Success. You can schedule a free demo here to check it out.
One additional point is that when a dentist’s recall program is suffering, I always ask them who is responsible for it in their practice. Saying “the front desk” is not a good answer. That’s a piece of furniture, not a person. There needs to be an individual that is responsible and accountable for the recall program—and if it’s not one person ultimately responsible for it, nobody will be.
2. Your hygiene capacity is so limited that only your best patients are showing up. There is one scenario where a large majority of your hygiene patients would need nothing beyond a prophy (exam, x-rays, etc.) I’ve seen this in practices where only your very best patients are showing up for hygiene. Since they always do all the treatment they need, show up for every hygiene appointment, and floss every day—they don’t need scalings or gross debridements. All the patients that do need these things aren’t getting on the schedule.
This could be due to lack of follow-up or that there are simply not enough hygiene slots available on the schedule.
This is an easy fix. Expand your hygiene department’s capacity and launch a serious reactivation program to get your neglected patients back into recall.
In another way, though, it’s not quite an “easy” fix because the idea of hiring another hygienist and implementing new systems for reactivating patients can be intimidating. If you’re hesitant, again, I’d recommend a free consultation with us that you can schedule here and we’ll help point you in the right direction. You could also attend our free webinar, The Profitable Hygiene Seminar.
3. Your practice isn’t treating disease in the patient’s mouth. Simply put, patients aren’t presented with clear-cut perio symptoms and they are just getting a cleaning.
This is rare as most hygienists take a lot of pride in their work and would bring these symptoms to the doctor’s attention.
The more common scenario is…
4. The hygienist IS doing limited scalings, gross debridements, etc, but is simply not charging the patient for it. I see this more often than I’d like.
- There is no clear cut perio protocol in your office, and
- The hygienist (and doctor) do not know how to have this conversation with the patient.
Failing to charge the patient is obviously bad for the practice’s production, but more importantly, it’s also bad for the patient.
The patient ultimately suffers because they never get the opportunity to recognize there is a condition and correct their home care (and hygiene schedule) accordingly. Because there are no consequences for the patient and no proper explanation of what’s happening, there’s no motivation for the patient to change.
It would be much better if someone explained exactly what was happening to the patient. Something along the lines of: “This is what’s going wrong and how we’ll fix it, and then there are some things you’ll need to start doing at home. It’ll be more expensive for this visit, but if you do these things and take care of your teeth—and go on a bit of a more frequent cleaning schedule for a little while—you have a better chance of keeping your gums healthy and preventing us from having to do this again and again in the future.”
How to correct this:
1. The doctor needs to lay out a detailed perio protocol for your office. In writing. It should include how these conditions are addressed—and it should include the prices, too. These aren’t “guidelines” or “suggestions.” This is firm policy; how things are handled always, without variation. This policy must be within your philosophy, achieve optimum care for the patient and their condition. And it should include little details like how often you do perio probing, when to take x-rays, etc.
2. Set up a time to do some kind of training with your hygienist, so they can get comfortable helping to educate patients when you’ve diagnosed the need for this treatment.Don’t just tell your hygienist to start talking to patients about it and assume they’ll do fine. If the hygienist doesn’t know how to address it with the patient and address their concerns, they’ll have failures and eventually become apathetic about it.After all, you wouldn’t put an employee on the phone without first teaching them how to answer the phone and field questions. So don’t do that with the hygienist, either. 99% of hygienists want to do a great job and help the practice succeed, they just don’t have the tools. So help them out.This is why many MGE clients will have their hygienist(s) attend the MGE Communication & Sales Seminars with them, so they too can learn tools for communicating with patients and increasing case acceptance—as well as assisting the doctor with educating patients on other procedures the doctor will perform.
Will your patients balk at these new changes?
Sometimes when we take on a dentist as a new client, they’re concerned that if they suddenly start charging patients for regular x-rays, scalings, gross debridements, etc, the patients will be shocked and upset.
Honestly, I haven’t seen this be a problem as long as you broach the topic well with your patients.
Work out a way of bringing it up that you’re comfortable with. You may say something along the lines of, “You’ve been doing a good job, but unfortunately we’re starting to get to a point where it’s going to need a bit more care. We can’t really maintain it anymore with a normal cleaning. We’re going to have to do some additional things now to keep you on the rails, and we’ll teach you to do some things at home to maintain it from here on out and keep you healthy. As long as we do that, it shouldn’t continue to be an issue and then we can go back to simple cleanings.”
Most people can understand and accept that just fine.
If you have a few patients (and it’ll probably just be a few rare patients) that resist it, refuse to take x-rays, etc, then you’ll have to decide if they’re a good fit for your practice. You’ll never be able to make everybody happy, and that’s okay.
So implement as much of the above points as you can, and take it seriously. You’ll see your production skyrocket because you’ll be treating ALL of your patients and charging for it. You’ll leave those “national averages” in the dust, and most importantly, your patients will get healthier and motivated to maintain their oral health long-term.
Sabri Blumberg provides this general dental practice management advice to furnish you with suggestions of actions that have been shown to have potential to help you improve your practice. Neither MGE nor Ms. Blumberg may be held liable for adverse actions resulting from your implementation of these suggestions, which are provided only as examples of topics covered by the MGE program.