Working an Assisted Hygiene Program

When my good friend first began working in an assisted hygiene office she told me she was prepared to be overwhelmed. The thought of having to see 15 patients a day? How is this even possible? We both understood that offices that saw Medicaid patients needed to increase their patient load in order to cover their costs, but never knew how they did it. Neither one of us ever considered it an option for traditional dental practices.

Assisted Hygiene (AH) programs are possible AND productive. My good friend has been doing it for nearly 5 years now.

For a smoothly run AH program, the hygienist and hygiene assistant must work as a team that each respects the other. Looking ahead at the schedule and making the procedures flow together are key. It is the assistants responsibility to look ahead at the schedule and make the procedures flow together. This is key to being successful. The assistant will prioritize seating the patient, taking blood pressure, reviewing health history and taking x-rays. While the hygienist is with the patient then the assistant cleans operatories, helps the hygienist record probing depths, assists with sealants, or sterilizes instruments. Both parties arrive early to set up trays and operatories. By knowing exactly what needs to be performed at each appointment the schedule will flow more smoothly. This limits the time that the hygienist is actually with the patients to clean or scale only. Many times a hygienist finds themselves following the hygiene assistant’s directions as to what patient they will be seeing next and allows them to pop into operatory to operatory at the assistant’s command. My friend and her assistant are a great team, they are able to stagger their duties so that two patients can be seen back to back at one time.

By having a hygiene assistant, an RDH is able to go from working out of one operatory, to two operatories. Patient time is cut down because the assistant is performing the non-hygiene duties. Because of this, patients are able to be seated in a quicker manner and spend less time waiting in the front or in the operatory. The only time my friend has ever heard a complaint is because a patient was waiting to be brought back to see the dentist, and didn’t understand why all of the other patients kept going back while they kept her waiting.

Cash flow then nearly doubles because of the extra hygiene patients being seen, but the doctor is no longer paying two hygienists…he’s still just paying one! The assistant’s salary is more than made up for as a day of hygiene brings in hundreds of dollars for the practice, not to mention the amount of treatment that is diagnosed on the same day. If a patient cancels or no-shows, it is not a huge dilemma cause there are already several other patients that day to see. This also helps increase the salaries for all staff members, so the entire practice benefits.

Now, I know what you’re asking, “how does the dentist do an exam on every single patient?” He doesn’t. Legally, patients are only required to see the dentist every 12 months for the hygienist to be able to perform hygiene procedures on them. When a hygienist enters the operatory her assistant already has the x-rays displayed on the screen, and the hygienist checks for any suspicious areas as she is performing the cleaning. If the patient is due for an exam, if the patient has any suspicious areas, or complains of any symptoms, then the hygienist has the assistant put the dentist on standby to do an exam when she finishes. The dentist is never seeing every single hygiene patient.

From what my friend has told me she has had some great assistants that knew what was missing from the tray before she even asked for it, and she has had other assistants that she had to hunt down every time she needed them. If the hygienist is not involved in the hiring process of the assistant, then the dentist or office manager that is, needs to work closely with the hygienist to make sure the two are effectively working together. Not to put hygienists on a pedestal either, the hygienist needs to make sure that they are working in a fair and respectable manner with the assistant. Don’t expect the impossible, and don’t be afraid to pick up the slack when you’re not with a patient and the assistant is overwhelmed with the dirty instruments!

Happy hunting!