How Hygienists Significantly Boost Dental Practice Success

[00:00:00] Wow, here we are again. It's been moving fast and very exciting. Last session was phenomenal. We discussed treatment planning, we discussed how to sit, how to talk. Got a lot of feedback about that. Really helpful.

[00:00:13] Doctors wanted more. They want to know about how to integrate. What would I have been noticing in the practices and through my daily occurrence and dealing with doctors is I really think there's a there's a

[00:00:24] definite disconnect between the use of that respected hygienist and the non use of the hygienist. And that's what I wanted to discuss today because I think that that is the last piece

[00:00:37] but the most important piece of treatment planning, especially in great offices. I want to say this before I start. I've seen some unbelievable offices that has hygiene as 15-12, 15% of top line revenue

[00:00:52] and then I've seen offices that are amazing with 32% of top line revenue. If you think about it, if they're doing the same, the doctor is working harder. So my opinion is that hygiene,

[00:01:04] borazard, and gives us so much. You know, I'm just thinking of all the years and I'm going to touch on this some of the great hygienic I work with. We'll go name was sorry ladies and gentlemen but

[00:01:15] they were amazing and hygiene well accepted well integrated can be one of the most important aspects of the practice. Let's face it's the second person that's touched maybe third, maybe the assistant sat the patient, the front desk saw them, they came in, filled out their paperwork,

[00:01:34] assistant sat them, third person, first person who stands in the mail is the hygienist. First person that walks into my practice, I make a living. I support my family, I feed my family, I support everybody else's family within the practice. The first person that touches that patient

[00:01:49] is our hygienist. That's why the hygienist is really important and it's something to talk about and I think at this point, I want to lend my experience of what I believe should be the way to go

[00:02:00] with the hygienist. I think that the difference between me and some of my colleagues and I talk about it with other doctors is I look at a hygienist as a simple provider. They're not going to extract teeth,

[00:02:11] they're not going to drill crowns, but they are treating our patients. And I think that is the distinct difference between somebody that utilizes the hygien and the hygienist into moving treatment along from a preparatory to a preparatory and we'll discuss that in a minute. But what I'm looking

[00:02:28] for is a hygienist that gives me the ability to do quality dentistry, comprehensive dentistry, and yes, same-day dentistry. And I think same-day dentistry is the key with hygiene. And I have that off the top of my head. You could see some hygienists that pride themselves

[00:02:48] on committing the patient to same-day dentistry. And it's better for the patient. They don't have to make another trip. It's obviously better for the practice, especially if there's an opening

[00:02:58] and it's just better for the patient because they have done the work they wanted to do when they put off the so long. But every office is different. There's not an office out there that's the same.

[00:03:07] This is my bucket water, but I need a sip. And I just want to say every office is different. Some doctors do not utilize the hygienist to steer their patients to a treatment. They don't. They want

[00:03:19] their hygienist to clean the teeth, 30-35 minutes, go over any health emergencies, any health care concerns, and dismiss the patient or wait for an exam. They don't ask the hygienist to probe,

[00:03:31] which I think is the standard of care. Next question would be a simple question. Do you do a rested? How could you do a rested if you don't probe? You're just putting in an area that are bleeding.

[00:03:41] Some of the offices do not want the hygienist to spark, bring in initiate treatment discussions, whether the teeth are broken or not. To me, that's leaving a tremendous amount of dentistry undiagnosed because I believe having two heads a better than one, but also some dentistry missed.

[00:04:03] If we're not probing, we're not looking. Doctors very busy if the he or she comes in and doesn't do a thorough exam. We're missing out on some very important dentistry. I also believe that

[00:04:14] the ability of some of the hygienists that I have worked with and it's been a number, but thank God we've had maintained some hygienists for a very long time. Can handle all the tasks in

[00:04:25] an hour that we discuss. It's ex-raise, it's probing, it's cleaning, it's educating, and then it's transferring the patient to the doctor. I also think that through the years and we touched on this last week. You know, through the years, somebody like myself, I'm a very experienced. I've had

[00:04:41] a lot of years. I know what I'm looking for and I will have that discussion whether it be a new hygienist or somebody who needs us to discuss some things, maybe we're integrated a new

[00:04:51] a new procedure, a new program. We would discuss that because I think that a hygienist really is the bridge, a very important bridge between the doctor and the team. And I say that because it's a

[00:05:08] tremendous amount of power. Let's think about that. I'm going to talk about that a lot right now and that is that we have a hygienist that's been there for 10, 15 years say. She's making more than anybody

[00:05:19] else. Sometimes she's tripling some of the assistance or at least doubling and she's considered a provider but she does hang out with the team. She's very close with the staff. You know, for me,

[00:05:32] it's always been hygiene and team and doctors. But yeah, if you have a hygienist that could bridge the gap, I think it's wonderful. We like to integrate our hygienist into formulating treating clients. I think it's sort of like a very strategic handle. These are professionals trained

[00:05:53] providers that are looking at pathology and I always tell them through your experience. It looks like the tooth may be needed to be treated. You jot it down and you have the ability to

[00:06:08] to really affect the day of the practice. You could bring in the doctor, you could discuss treatment, you could say the patient really wants to get some things done because they travel. Now the doctor knows they're interested. There's a list of things that the hygienist thought about or

[00:06:25] talked about and showed the patient what she was thinking without making a diagnosis. The doctor comes in, checks the patient, looks at the patient and then goes through the list. Here she may find other things because my hygienist puts up the probing deaths. We already know

[00:06:45] we're going to get seven arrestants. We already know one area may need a period on it but we're going to do some scaling and root planning. We already know that. What we're discussing is the

[00:06:55] broken tooth and the upper right does it need root canal as the hygienist mentioned that if you're in pain let's get the doctor to look at it or does it not? And if it doesn't then let's get it

[00:07:05] fixed right away. And if it does, let's get it fixed right away so it doesn't become an abscess. Infection of more of a broken tooth. This is where I think the seamless transition between hygiene

[00:07:17] and doctor is actually to me invaluable. It's invaluable because I walk in and I've got a list looking at the mouth. I now have 11-12 areas of concern that I want to be treated.

[00:07:31] And it was expeditiously done. I could discuss with the patient what I believe should be done first. The hygienist could then help us in fortifying that and said, you know, Mary that's what we

[00:07:44] discussed. It's the same tooth that Whiteon is just looking at it a little more closer and giving you a diagnosis. It needs a root canal unfortunately, you know, the hygienist was right.

[00:07:54] It is pretty damaged. You know, she was right from her experience but it is just fortifying us. There are many practices I see when we initially take it over. I asked hygienists where they're

[00:08:03] going. They said, Dr. Jones likes us to walk out of the room and be alone. And I say to myself, why? Why do I have to bring an assistant to help me when the assistant could be doing something

[00:08:13] else in another opportunity, getting me set up from an expressi-ter. Hi, Janists own that hour. They should be benefit from some of the things they do learn and I mean the arrestings.

[00:08:24] To me, arresting has been an amazing product and I've seen it work. Is it abused? That's our job, Doctors. Our job is to make sure that we are delivering treatment that's needed. So we have to police the hygienist as well. If they put down on charting,

[00:08:40] six-mielmede a pocket and we look on the X-ray and it looks like a 12-year-old boy that is very healthy and has gums up to the CEJ, we will question her outside of the room because I want

[00:08:55] the best for my patients. But in my years, I have worked with some great hygienist that have delivered great dentistry from me and delivered great second opinions from me. And I think that is the issue,

[00:09:08] the biggest issue that hygiene can bring us, assistant a front desk they can bring us that confirmation the affirmation of the treatment. A hygienist does draw patients in. Remember what I say to the hygienist out there? They have tremendous power and with power comes

[00:09:25] responsibility. It's their responsibility, they are educated, they do socialize like I said with the other side with the team, not the other side but the team that's not the providers. So they are the sort of like the galvanizing group that brings us together. I had a hygienist

[00:09:44] for many years, she was excellent, no names but she moved to Ohio, I believe, and she was tremendous about really educating the team. And I found that production in hygiene was up because

[00:09:58] we got smarter and we watched our programs, we watched what we delivered and for me it was an exceptional situation and that's what we aspire to. We still have great hygienists. I do want to say one

[00:10:10] thing about last week, we had a discussion last week and I like to bring it all in and just discuss that a little bit. The discussion last week was more about you know the new doctor and what does

[00:10:21] the new doctor do? I must tell you that I believe that a new clinician coming into an office should make it her or his responsibility to spend time to ask the owner or the managing person of the

[00:10:35] practice that you would like to talk to the hygienist. You would like to get on the same pages hygienist. Maybe you're a lefty and you like to put the post it or the list on the bracket table

[00:10:45] to my left. Maybe you're a righty and you don't get where it goes. Maybe you don't want it to go in the obituary. Maybe the system of the office could be something you mesh well with

[00:10:57] and don't have to change or you'll discuss with the hygienist how we can integrate the office policy with what you're comfortable with. There's no reason not to have that discussion and in the end

[00:11:10] of of that situation what you do have is you have an amazing situation where you're walking into an operator and it's literally taking you half the time to treat and plan more treatment and getting

[00:11:23] that patient done and getting that patient working that day into an operator to do the treatment. I think it's amazing when we have somebody like that I am not a fan of 10 pygynists. I do believe

[00:11:35] that we need them sometimes but what I mean by that is it's just so much to download to them that if they're seeing a full slate of patients, it does run into a risk of having somebody not

[00:11:47] treating plan not going according to the culture we'll stop bringing that in. The culture of the practice and that's something that I do like to talk about because we are seamless in when we see

[00:11:59] patients and when we go into different discussions so we would like that to be absolutely going from one person to the other and I find that when you bring in different hands and start it up

[00:12:12] it's a little confusing and that's why I urge the young doctors to have that conversation with my genus to have that conversation even your assistance. Where do you like the material? How do you

[00:12:23] like it? Don't just go into an operator and say I don't know she didn't give me anything. You know it was just it was nothing really excited. You know we talked about culture and hygiene is amazing

[00:12:35] because I think that what I've seen is if you have a well integrated, well healed, hygienist you're going to see the best practices. Just on the whole I know there's a couple out there

[00:12:47] like I said before that our allies but those hygienists really galvanize bringing the patients together and bring this staff together. The staff looks up to them they have to realize that and with

[00:12:57] that they have to really work hard at being more of a leader if they're not and understand they bring a tremendous advantage to the practices. I have a practice that I gotta tell you most

[00:13:09] almost no-in at a tempations come to see that hygienist they love her and that's a big draw and with that you know you gotta balance do I tell her because it'll mean more money. We have to

[00:13:20] really be you know we touched on it last time we have to be really accepting of our team. We have to complement them. We have to give them advantage of of growing and learning and we have to

[00:13:35] give them the ability for a personal advancement to financial advancement. With the hygienist I believe that having an arrest in program it's my experience and the arrest in program is quite amazing it gets the hygienist very involved very much probing and formulating their own

[00:13:55] their own schedule with period scaling and loop planning and I see that it tremendous advantage and when they get involved in that type of work they find more dentistry. You know they always say

[00:14:06] dentistry big gets dentistry so if you're deep cleaning you'll find root carries. If you're going in and you probe to a calculus spot now you find three more millimeters you may need to clean it out

[00:14:18] that's a good thing that we found it I'm not just talking about money I'm talking about down the road we could lose teeth if we don't find it so my opinion that hygiene program is they have so many

[00:14:29] things to grow in our offices we want to institute sleep and where do you think that is instituted through the hygiene program we need a patience to be asked the question of how you

[00:14:40] sleeping pattern do you wake during the night are you told you snore do you have a wake up unfulfilled with sleep I mean it's so much that we can discuss from that hygiene room if the

[00:14:52] hygienist stands on ceremony we have an issue if they understand they are gifted to help the practice that's an integral part of the practice and we will have a great well-running machine this is all about something that I really would like to dive into and that's called culture

[00:15:10] culture to me is essential and it's essential because it's the way practices are run and practices are accepted and and grow if we don't have a great culture we can have a problem with

[00:15:28] and I don't like to call people staff but I do you know it could be a staff it could be burdensome so the culture is really what develops the the whole ambiance of the practice do we like

[00:15:40] coming to work do we say good morning many many years ago I started a very good trend I say good morning good morning good morning hey hey good morning you know I lived in New York City

[00:15:52] I live in New York City and you know when you live in New York City you have a you have somebody you have to say good morning to I was lucky enough to have a door man every morning I walk out

[00:16:01] I don't want to be a grump I'm in a bad mood Monday's I'm not my best day but I say good morning and I feel that there is no reason not to take that to the team to the office

[00:16:13] and every morning I like to say walking and say good morning how is everybody and from there we grow from there it just lots of so often such a different light everybody is you know

[00:16:26] I'll tell you something I met a I met a staff member for the first time after weeks of not getting there to meet her and a lot of things were said I'm sure that like to him's gonna come in he's

[00:16:36] gonna talk to you she was nervous what is he gonna say what is he gonna do I walked in I spoke to and I said wow you're awesome you're really great I mean I love the way you communicate you need training

[00:16:47] but you speak very well she and I said what do before I said that I said where do you want to work in the office where is your ideal situation she said assistance to be an assistant

[00:16:59] I looked at her and I said with your communication skills and she told me that she said assisting because she was nervous that I wouldn't think she was very good at the front

[00:17:09] meanwhile I spoke to her and I said I think she could be awesome at the front I think she become really good she has something that's God giving you know some people communicate very well

[00:17:20] and as I've said before and before and before communication is the essence of what we do whether it's patient staff you know anything becoming a great leader you need to communicate and what I've seen is

[00:17:35] people in the front people in hygiene when they could communicate they can move practices forward and this young gal today I call that office and I heard this young lady answer the phone

[00:17:47] I could not believe it it was night and day so encouragement you know sometimes we get caught we as the leaders we as the doctors whether it being associate with a staff member whether

[00:17:59] it be a doctor with his right arm we get caught in the waves in the movement of what's going on in all lives and we forget we all the leaders we all the mentors we have to walk in and say hey

[00:18:13] you doing how is it we can stop take a minute I'm really trying that for myself you know lately I've been trying to understand some of the ten most valuable things that I'm learning and you know

[00:18:26] it's wake up every day and push forward and one of the things of pushing forward is becoming better you know culture in a practice is something like a practice it is always improving or not

[00:18:42] I think that it just shapes the complete atmosphere whether young lady is scared out of her mind to meet me or she feels more comfortable so she can bring out her talents that alone tells me

[00:18:55] we need to develop a culture we need to develop a practice that people want to come to work yes it's work yes it's hard but I wouldn't do it with anybody else but this team and I got to tell you

[00:19:10] we as dentists where the ones that need to bring this attitude I walk into Main Street USA it's a it's alright it's not the best place I look at it three four chairs I look at the team they could

[00:19:24] care if they're there or they're somewhere else that is not the team I want I want people to really grow and I want people to really feel that this practice really cares for them and if they have an issue

[00:19:41] with family and that's the culture you're brain I think some of the things that are very important and we're going to get into it down the road and I'm going to give you a little bit of an

[00:19:50] update of what's happening in the next few weeks which is so exciting I've this podcast first of all again welcome to dentistry beyond the numbers I've been so excited about talking hygiene because

[00:20:02] I gotta tell you I was on a panel couple of years ago with Rolandomiya and Amber Ogre and we spoke about hygiene and you know I didn't realize but I was such an advocate for hygienists I am a

[00:20:15] pro hygiene I believe if I have a great hygienist or two or three I could build phenomenal practices but I could not build them without culture because the culture of the practice and giving people

[00:20:27] the opportunity to grow is the most important thing I don't care if they're assistance if they're hygienists front desk even associates every single person should be recognized every single person should be appreciated if they take a great impression after we rip them for not a good impression

[00:20:44] or scan let's appreciate them let's not look at it yes to us it is just what we pay them for but for them they're getting better the most and last thing I'm going to leave you with is

[00:20:54] something that's very near and dear to me professional development I want to talk about when I talk about culture some of some of doctors that are going to come on invest time in learning

[00:21:03] about this and what their culture what their their slogan or their mission statement is you know you can have a mission statement that is the number one thing of cultures is have a mission statement bring your team along remind them our mission statement is patient centric and doctor

[00:21:21] meaning we want to give our doctors and our providers the best tools to present and deliver the best care all along increasing and improving our patient experience that's what we're looking for that's the culture how do we get it well one of them is professional development

[00:21:39] and I can honestly say you know one of the things that attracted me when I when I sold my business to guardian dentistry partners was something called the Gromal that we've instituted I think it's

[00:21:52] phenomenal for young docs I took it to another level but I think young doctors need to pick a things that could really develop their skills both in the office and for the personal growth

[00:22:07] so I'm talking about the Hamza and again we'll go back to those five procedures and I want like we discussed to develop those doctors to be so good but it is a constant, constant improvement

[00:22:22] you're never done they say learning is never done you're never done you're gonna grow whether it be better crown of bridge most surgical training better retreats going advanced on rucanal therapy cosmetics and bondings or veneres these are the things if you're an assistant

[00:22:41] think about it doctors if you're an assistant in the US gonna assist them to start scanning and doing things and they getting better and better and you complement them they're gonna want to learn how to make temps they're gonna want to learn how to take better impressions

[00:22:55] they're gonna want to learn how to be more of a help high genists open their eyes to professional development give them reasons to speak to the patient about sleep about more crown of bridge

[00:23:07] about a rest in in gum disease we have the opportunity for professional development front desk people office managers there so much out there to really learn how to manage and control our practices

[00:23:21] that if we have a culture of learning, of culture of advancement why would a somebody leave our practice so what I think culture does and I could tell you how many doctors how many assistants

[00:23:35] how many front desk people come to me even doctors say I really just don't like that practice and I say why they go I don't want to get into it the red flag is culture because then

[00:23:46] not comfortable maybe the assistants talk about them who knows what happens but somebody could come over and that could be the reason another thing can happen is that once you develop that culture

[00:23:58] somebody could come over and say I'm never leaving I love this place I feel respected I've been growing I like my team I love the manager the doctors treats me respect any compliments me

[00:24:09] so that's an aspect of retention you don't need to spend a lot of money on medical insurance if you treat them like you want to be treated I wanted to bring that in now because I feel that

[00:24:20] we're gonna be going off to some other areas of dentistry and we're gonna be speaking to some exciting doctors that have really been great in dentistry I want to be a guide I want to be that

[00:24:33] guide I don't know if you guys ever saw the show the millionaire the millionaire was a show back in the seventies where this gentleman would take money from an old very wealthy man and he would

[00:24:43] go around the country meeting people that were outstanding and he would knock on their door come in and he would write them a check out of the blue for a million dollars the people were shocked

[00:24:55] some of the stories were unbelievable but there he was he wrote a check for a million dollars I think some people in dentistry can help us learn everything we talk about and more they've been

[00:25:07] so influential in the growth of dentistry I really want to get into the digital workflow and showing how digital workflow really lowers the cost of lab work and betters the quality to the

[00:25:20] digital workflow is important I want to look into really how doctors well gave them the the de la Honest to go out and stop companies and grow these companies I want you the listener to

[00:25:34] learn about this to hear about some of the docs that I know that are out there that are willing and able to come on and discuss their story and over the next couple of months we're going to be

[00:25:45] announcing it we're gonna be marketing it but we're gonna be talking about it but I want you to meet some of these people because to me they're constant mentors they give me too much kudos

[00:25:53] I'm loving the fact that they want to come on and talk about this story and I think we're gonna have tremendous learning experience from it to wrap up today it's simple great hygienists are hard to come by well trained hygienists are great and culturally accepting hygienists are the

[00:26:11] key because they are the leaders they advance us number one with them you could treat and plan a lot more with them you could bring in new products and new procedures and take it from there but those

[00:26:24] hygienists that you integrate into your practice that have been there and now very important will stay and be integral to this growth of the practice and what's the most important today is culture

[00:26:36] we want to be treated with respect we want to be respected and complimented when we do a great job when a patient comes back and says I came back for Susie the assistant she was so gentle

[00:26:48] Susie the assistant should get something whether it be public praise to the practice on the next staff meeting or how to or whether it be buying a lunch but make it known because everyone should

[00:26:59] know you appreciate culture and of course just taking individual careers to the moon to the moon it's in your pocket it's in your ability what are we waiting for let's get out there and become

[00:27:16] freaking amazing I mean that's what it's about if I have a cultural office that wants my team to grow and you're an associate of mine let's pick something I like to keep it in the home side right

[00:27:29] Rook can it clear line is Rook can now crown of bridge cosmetic surgical extraction bone we're having an implants I want to move the practice forward and production forward but the quality that we're going to deliver a second to none that's it in nutshell

[00:27:44] that's dentistry beyond the numbers learning what is out there what could be done and how simple it is to treat our staff with respect come on everybody we're great let's be the best these sessions offline by I'm loving what I'm hearing from people I'm always asking please let

[00:28:03] me know tell me how I'm doing on any platform you listen to it I think we've touched on some great things I think we're going to go forward with this and really develop so much in dentistry

[00:28:14] you know dentistry is you can tell I'm passionate about it you could tell I love it and I'm really grateful that I know a lot of people that I could bring to you the listener today's episode

[00:28:25] is something to take home remember those people the hygienists and the team remember to build culture I'll leave you with this the most important people that we the doctors need to impress I say

[00:28:37] it all the time is our team we want them proud that they're working for somebody like us from that everything grows if they walk in happy and prideful that they're working

[00:28:51] for an honest quality driven team or clinician they come to work on time they do the extra mile they believe in where they are thank you so much this is dentistry beyond the numbers my name

[00:29:04] is Dr Mark Leicton like me dislike me quote me don't quote me but definitely give me comments let me know I'm doing for you and always let me know if I can help by providing a topic that's

[00:29:17] interesting to all of us remember everybody I'll see you next time on dentistry beyond the numbers thank you so