The role of the hygienist

– is there more to it than meets the eye?

The top 6 ways in which you can become involved in practice development and customer service.

Let me begin by explaining what I am NOT going to be addressing in this article:

1. Â I will NOT be writing about the role of the hygienist in dental health education and
2. I will NOT be writing about new clinical roles and responsibilities for the hygienist/therapist.

That is better left to the more knowledgeable. I am not a dentist, have never done a days work in a dental practice (thankfully) but, after 8 years and 450 clients I claim to know a little about the business of dentistry – and that’s my focus because I believe (and have witnessed) that the hygienist can take a much bigger role in practice development, given the desire and the chance.

Why bother?

Well I am assuming that the mere fact of your reading this magazine (and this article) indicates an interest in doing more than just “get in, S&P, get out”. My observation of many professions over the years reveals what I call the “20/60/20 rule”:

• Â Â Â 20% are committed and want to get involved at every level in their practice(s), in their patients, in the team and in the profession;
• 60% want a well-paid and interesting profession, good relationships and to “finish at 5”;
•    20% dislike the job, the people and the hours – and wear it on their faces most of the time.

So having dispensed with the latter group (who will shred this article) let’s move on.

The first two groups want to enjoy the following in their professional lives:

1. good pay and progression;
2. appreciation for what they do from the rest of the team and the patients;
3. a nourishing physical environment and
4. a good laugh every day

My focus here will be to explore the possibility of you becoming involved to a much greater extent in the evolution of management and marketing systems within the practice.

Why? Because you have the desire to do so – and because you are working with a principal who wants to grow their practice, over time, to become more profitable, to provide better clinical care and a higher level of customer service – what you might call “a future that is worth showing up for”.

So let’s take a look at what I believe are the 6 key areas in which your contribution can be valuable.

1. Customer Service – Become The Patient Journey Champion

I have frequently quoted an American sales trainer of the 1960’s, Joe Gandolfo, who coined the phrase “selling is 98% understanding people, 2% product knowledge – you have to have 100% of the 2%, but it’s the 98% that makes the difference”.

We can “spin” that phrase into UK dentistry very easily and suggest that successful dental practice is now “98% understanding your patients as people, 2% clinical knowledge – you have to have 100% of the 2%, but it’s the 98% that will make the difference”.

We all know that the most popular and successful hygienists are those who develop the best relationships with their patients.

Over the last 8 years I have worked with many practices on developing the perfect patient journey – delivering a standard of customer service that enrols your patients as your unpaid sales force and encourages them to recommend family, friends and colleagues to visit you.

However, I have also observed that, no matter how much I say on a training day, the likelihood is that dental teams will get back in their professional hamster wheels the next morning – and just carry on doing the same old things.

So how do we make sure that the training becomes embedded?

An idea that has worked well in the past has been to nominate a “Patient Journey Champion” in the practice, who will take responsibility to ensure that a newly designed Patient Journey has been understood by all team members, is being implemented daily and can be measured by reference to some form of checklist on a regular basis. If you would like a copy of just such a checklist, email me at chris@thecoachinggym.com and I’ll happily send one.

    2. Become involved in internal marketing

I attended “Dental Boot Kamp” in Canada some years ago, an independent training company who teach dental teams throughout North America how to discuss treatment plans and gain closure from patients (yes – selling skills – that awful 4-letter word, sell).

There were over 600 dental team members in The Toronto Sheraton, learning how to open treatment planning conversations, how to overcome patient concerns and procrastination and how to “close the sale”.

My surprise what that the majority of dentists there freely admitted that most of this process was handled by the hygienist in the practice who was paid a percentage of the treatment fee as a result of her successful efforts, in addition to her normal professional fees.

In fact, many dental treatment plans were conceived and discussed in the hygienists’ surgery before the dentists became involved – as a result of conversations initiated by the hygienist on cosmetic treatment options.

I define “internal marketing” as:

1. Making sure that all existing patients have been offered the chance to buy additional services from the practice and
2. Making sure that existing patients are “enrolled” by asking them to recommend the practice to others.

We train our clients at The Dental Business School in this area, giving them the language and skills necessary.

I’m suggesting that you can become an Internal Marketing Champion and thus increase your income and your involvement with both patients and team.

3. Become involved in external marketing

“External marketing” is the process by which the dental practice becomes more visible in the community.

Traditional approaches include Yellow Pages, other forms of advertising and direct marketing. These are usually expensive and produce a very low “hit rate” per pound invested.

With over 85,000 people per month in the UK now searching the internet for information on cosmetic dentistry, your web presence is also an important factor.

The approach to external marketing that I prefer is more direct and focused, concentrating on the development of relationships with local SIG’s (special interest groups) in both the personal and professional arenas. Personal would include local leisure clubs, beauty spas, and sports clubs. Professional would include local small business groups (people in business have money and teeth!).

The cross fertilisation of clients through strategic alliances with these groups is an excellent way of growing a business – and I have argued that a hygienist may well be better placed and better skilled in this activity than the dentist themselves.

4. Financial management

My thoughts here are born out of a true story.

Many years ago I was called in to perform a rescue operation for a dentist who was on the point of bankruptcy.

He was a fantastic clinician, a specialist in his field and enjoyed a full appointment book of high value patients.

But he was a lousy money manager – regularly draining the business of cash to support a fancy lifestyle.

When I arrived, the dentist owed money to his bank, the tax man and his trade creditors – all of whom were rapidly running out of patience.

I could see from the cash flows that the business was capable of success – it just needed stringent financial controls – and the dentist was the least likely person to observe the disciplines necessary – so who could do the job?

You’ll guess the answer, of course. His hygienist had skill in book-keeping and we arranged for her to spend 3 days a week providing hygiene and 2 days per week as financial manager for the practice.

She and I worked as a support team for the 2 years that were necessary to get the business back on its feet – and I’m happy to say that the business is now profitable and thriving – owned by the same dentist who has learned to live within his means.

Do you have these skills? Or do you think you would like to develop them and make that a part of your professional life? There are still plenty of dentists out there in financial trouble and struggling to work with external book-keepers who do not understand the nuances of dental practice.

    5. Team-building

I surveyed 2000 dentists in October 2005 and asked them “what is the single biggest challenge facing you in dentistry right now?”

I expected them to bleat about nGDS – but the answer was a surprise.

“How do I recruit, retain and motivate my team?”

That’s what is worrying dentists more than any other subject (nGDS was third, after maintaining associate profitability).

To build and keep a team you have to invest time. Time to listen carefully to what team members are telling you works best, works badly and what has to be changed.

Dentists complain that they have no time – and so they ignore time for team-building. As a result, morale drops and staff turnover increases.

Who has some of the best people skills in a dental practice? The hygienist!

So have you considered looking for a role to play in team development throughout the practice? Are you capable of facilitating group and individual progress meetings, arranging training, providing a forum for the exchange of internal business intelligence?

6. Overall strategy

A dental practice with no 3-year vision, no 12-month plan and no 90-day goals is just adrift on the ocean. The sails are set, the crew are on deck – but there is no navigator and so the direction and ultimate destination are a matter of chance.

Dentists recognise the need to plan but they are frequently overwhelmed with pressure of work and choice.

 They need a strong management team around them to delegate the detail – but also to discuss the “big picture”.

 Are you a member of that team?

 You are a walking archive of valuable internal business intelligence – how the patients’ feel, how the team feel and what has to happen next.

 Put yourself forward as a member of the principal’s “personal board of directors”.

 In conclusion, I believe that a dental hygienist with the right attitude, skills and knowledge can play a much bigger role in today’s dental practice – and if that means you can share in the enhanced rewards available, we have a win/win.

 CPD Questions:

• What are the key responsibilities of a Patient Journey Champion?
• Define “internal marketing”
• Define “external marketing”
• Give examples of the types of SIG’s that would be of interest to a dental practice.