No time like the present to get armed for wage raises season!
Six months prior to raise season and it is time to pitch to your boss, or if you are the boss, get prepared for pitches from your team members. So, let’s get started with important information to prepare you for the conversations and decision-making regarding compensation increases.
In 2022, the average full dental hygiene appointment (that includes everything in a hygiene appointment from diagnostic to preventative) was $267 per hour. In 2023, the 8.8% Ontario Dental Association (ODA) Fee Guide increase brought us from $267 to $290 per hour and now, in 2024 a 4% increase brings our hygiene fees to $302 per hour. The likelihood of another 4% increase in 2025 is very good, raising our hourly production to $314.
The reality of most dental practices today looks something like this.
In the graph above, you see that the horizonal line targets calculated from the ODA fee guide increases have been missed for years. Most dental offices are seeing the same results – the red(2022), green (2023), and yellow (2024) bars are not reaching their targets.
Daily we see that the 13% increase given through the fee guide increases were never realized by most dental clinics.
How does not realizing the fee schedule increases affect a wage raise?
When you approach your boss for a raise, they may not be lying when they say they cannot afford to give you a wage increase. Not meeting fee schedule targets year over year means that wage increases would be coming out of the owner’s pockets. However, if you can show your boss that you are meeting targets, you can make more money. Without RNA 180, how can you easily get the data required to show the results of your hard work? We’ll get to that. Keep reading….
Prior to Covid, we saw children (under 12 years-old) for 30 minutes, teens for 40 minutes, periodontal patients for 40-50 minutes, and appointments requiring recall exams were 60 minutes. Not a perfect world, but we survived and could make it to the end of the day. A fun fact: Prior to Covid, we saw patients for 2-2.5 units of scaling. How that was calculated seemed like a magic show, but defendable to the clinician.
Along with Covid came additional PPE requirements, regulations, boxes to check, and fallow time. In July 2022, the world of dentistry returned to normal, but the people working in dentistry did not. The luxury of fallow time was missed by clinicians because they weren’t required to work at top speed, and they had a valid reason not to have to. The only people paying the price for that luxury were the owners. Fallow time averaged between 14-17% resulting in lower production per appointment revenue.
In a market where the cost of doing business kept rising with no end in sight, the revenue hit felt like a losing battle. Then, to add insult to injury, we lost a significant number of dental hygiene professionals adding more strain on dental business owners.
So, let’s back up and see what we have so far. We learned offices did not get the 13% fee guide increase. We added an additional 14-17% of time to each dental appointment for fallow time (though no longer valid) to take the pressure off. The reality is there is no need for the extra pressure. Full stop.
Now, let’s discuss scaling time. The definition of a scaling unit has become diluted throughout the years. Our experience indicates that if you ask five hygienists for the definition of a scaling unit, you will receive five different interpretations. The procedural time in a scaling unit is subject to interpretation by each individual hygienist.
Example 1:
If I have a patient has for 6 units of scale insurance coverage, and I want to see them 3x per year, I divide the appointments into three appointments for 2 units each. But I book each appointment for a full hour.
Mark requires 6 units of scale @ 3x per year.
I schedule him for 2 units of scaling at 60 minutes each.
Mark’s chart notes read, “hand scaled and cavitroned for 41 minutes.”
Is 41 minutes 2 units?
Mark’s 60 minutes of appointment time became 30 minutes of billable time in terms of revenue.
30 minutes of Mark’s appointment became “free” time.
The problem:
I’m paid on 60 minutes; however, my boss, Dr. Jones, only receives 30 minutes of revenue. Can we expect my boss to increase wages when only half of revenue is received? We wouldn’t expect a hygienist to give up 30 minutes of income for every patient.
Example 2:
My boss decides to reduce the appointment time for 2 units of scaling. But we still have a problem.
I cannot complete Mark’s hygiene appointment during his scheduled time.
The Problem:
I want more time to complete Mark’s appointment, but my boss does not want to give services away for free. Mark wants only the services his insurance covers (6 units of scaling). Both the dentist and I want to give the best patient care efficiently while being compensated well for our hard work!
The Solution:
We don’t want to give away services for free whether the patient has or does not have insurance coverage. Generally, patients with no insurance will pay for all the treatment recommended, while patients with insurance will choose to have treatment only covered by their insurance. If the patient has 6 units of scaling and wants the treatment only covered by insurance, like Mark, we do only the 6 units of scaling letting them know you recommend more time.
When we book our time according to treatment required, we have both the time needed to complete the services required AND we maximize revenue. How do we do this?
Billing scaling units properly is the first step. Print the chart below on how to calculate a scaling unit and keep it in your pocket. You can use it to treat either the patient, or the insurance company. Just be cognizant of the time required to do either. Assign time frames for each of the other tasks in each appointment to develop time frames. Be sure to add in sterilization and probing time, so that all required services are reflected in the time required (these are unbillable services, but time is required!).
Now you have all the information and the tools to have a great conversation with your boss to proceed with the second step. With one last calculation, you can have all the information about your performance as a dental hygienist for conversations regarding compensation!
To Calculate Performance as a Dental Hygienist
TOTAL DAY PRODUCTION ÷ TOTAL # OF PATIENT HOURS = PRODUCTION PER HOUR
Total production is all the procedures completed for each appointment including procedures that are allocated to the DDS (recall, exam, radiographs).
Total # of patient hours is the total of all the patient’s chair-time during their appointment. (Remember, use the chart to calculate your scaling units.)
Start recording your performance for the next month. If you see areas for improvement, you will have a couple more months before raise time to do so and to show how stellar you are! It may seem like a lot of work, but I can guarantee you a solid result when you demonstrate your worth.
With RNA 180, your manager can provide the reporting for your success rates. With a couple of clicks, you will have that information at your fingertips eliminating the manual work.
If you do not have RNA 180, let us show you how we can eliminate the manual work, save you time, and create the necessary reports for decision-making made easy.
Good luck everyone!
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