Last updated on November 1st, 2017 at 03:48 pm


This should be the mantra of every general dentist’s office. Seventy percent (70%) of an office’s production should derive from the hygiene department as a combination of actual hygiene done and work found and sold to patients out of hygiene. The rest of your income would come from new patients and should be “icing on the cake.”

As an owner/OM of an oral surgery office, we survive off of new patients—the bulk of these coming from referral doctors. Therefore, the better you are doing, the better we are doing. To this end, I do anything I can to help our referral doctors be as busy as possible. After helping my sixth referral doctor I started to notice an interesting trend:

Although on average they were adding roughly 20 new patients per month, they had not added another hygiene day or hygienist in the past 3 years (some longer).

I started running the numbers (I love numbers) and figured out the following: If you are getting 20 new patients per month for two years, by the end of the second year you would have added roughly 80 more hygiene appointments each month or roughly 10 more days of hygiene (assuming 8 hygiene appointments per day). Interesting, right?!

Understandably, there is a large focus on new patients. We spend hundreds, thousands, or even hundreds of thousands on marketing and advertising to make the phone ring and open the front door as wide as possible…yet there is little emphasis on repeat business and bolting the back door. Therefore, if you are like my good referral doctors and have not increased your hygiene days, then you have spent thousands of dollars to open the front door wide while not focusing on bolting the back door. THIS IS THE UNTAPPED GOLDMINE OF THE OFFICE.

(Related: Consistent Practice Performance – Eliminating “Down” Months)

There is an equation I want you to do.

1.   A= the total number of charts at the practice multiplied by 2 (#charts x 2) _____

2.   B=Total number of weeks per year the office is open _____

3.   C=Multiply A by .8 (A x .8) (remove 20% for patients who aren’t coming back, moved, etc.) _____

4.   D=Divide C by B (C ÷ B). Where D will be the number of potential hygiene appointments per week _____

5.   E=The number of hygiene appointments you are doing each week _____

6.   F=Divide E by D (E ÷ D). Where F will be your hygiene rate. The closer we are to 1, the better _____

This equation gives you a linear progression of your hygiene department. That’s a fancy way of saying: If you know what your new patients and current base are, you should be able to extrapolate hygiene demand 6 months out and plan accordingly.

Now, if you got an answer that was close to 1, lets say .8 or higher and you have not added any hygiene days in the past 2 years (or ever), then you did not calculate A properly. Not every new patient that walked in could have taken the place of existing patients that might have moved, been dismissed, asked to have their file transferred or passed away.

(Related: How Your Hygienist Can Help Increase Case Acceptance Part 1)

With modern advances in dental management software you can easily create a “hygiene hotlist.” This hygiene hotlist would be any patient that had been in for a hygiene appointment in the last 6-12 months but has not been in since. Patterson and Shein (probably the other too), are just databases and every database can be “dumped” or downloaded to an excel file where it is easily managed. This is what I do for my referral doctors…and they were shocked to see the results.  Here’s an actual case:

Doctor X:

Number of charts: 1,500

Potential hygiene days – working 50 weeks per year: 48

Number of hygiene appts per week: 36

Recall Rate: 75%

This doctor didn’t feel that his hygiene department was the problem yet he had been averaging 22 new patients per month for the past 2 years and had not added a single hygiene day. Downloading the database and creating the hotlist I found 186 potential hygiene appointments that could be scheduled right now! When I took it back 12 months, the number jumped to 300+. On the day I ran the report, 5 of the 9 hygiene patients left without scheduling their 6 month visit.

In conclusion, the only difference between a new patient and an existing patient is FAMILIARITY.  Patients of record know you, your staff, and your office, etc. Focus more on this area and I guarantee you that you will see an increase in your overall production and collections.

For more information about this or if you need practice management help in other areas of your dental office, call MGE Management Experts, Inc. at (800) 640-1140.


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