Kiera and Dana dive into the hygienist’s mindset (which tends toward patient care over business numbers) and how a doctor can get a full hygiene team on board with metrics and measurables. They touch on the hygienist drought, growing your practice without stepping on your hygienists’ toes, setting expectations everyone can agree on, and more. Dana also touches on a hygiene team she worked with for a couple years that went from struggling to hit its goals to hitting even their daily goals 95% of the time.
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Transcript:
The Dental A Team (00:00)
Hello, Dental A Team listeners. This is Kiera and today is a great freaking day over there. I get the one and only Dana, Dynamite Dana over there. I did not say the other nickname. If you've been on the podcast for a while, you might know, but Dana, welcome to the show today. How are you?
DAT-Dana (00:16)
doing pretty good. Thanks so much for having me. It's not always that I get dedicated, you know, Kiera time. So I'm excited to be here.
The Dental A Team (00:22)
I know when Dana and I get a podcast, like it's not always common, but I mean, you guys might start seeing Dana a bit more. I've got a few plans and tricks up my sleeves for Dana. We've been together for a long time. Dana, like donuts with Dana tip. don't remember what that was like dentistry tips or something. You were on a roll. You used to, I think you still do them actually every single week. Um, but Dana, you were just a diehard dedicated and always without, will not share it.
DAT-Dana (00:39)
Yeah.
The Dental A Team (00:49)
but Dana always has the best story. So if you don't know Dana and you want like a good giggle in your life, you name it. And also Dana is the best with trivia. We do a company end of year party every year and it's always like trivia based. Dana whoops everybody. Like this woman knows facts and stats like nobody's business. So Dana, today's gonna be a fun day because not only is Dana dynamite this way, but we're gonna do a little bit of an office autopsy about a hygiene department. So if you don't know in Dana's Other Life,
Dana used to work at a prison as a hygienist and Dana that still is a trip to me. Like, did you ever get nervous that they were going to take their shackled hands and like stab you with an instrument? I'm truly curious because that's my fear. Let's just talk about that for one second.
DAT-Dana (01:27)
Yeah, I mean, there were
a lot of like protocols in place for protection and for safety. But at the end of the day, you knew where you were. you know, yes, there was always I think just a niggling element of I just need to be careful, pay attention beyond my toes. Yeah.
The Dental A Team (01:44)
Like you're working with sharp instruments.
I mean, it's not like you doled them out to take them in there. Like we're not going to have a sharp scaler. You get a doled one. Like you got to be in there. But yeah, cause I remember I worked in an office and they would bring in inmates and they would be like handcuffed top to bottom. And the girl would always be like, so what were you in prison for? And I'm like, why are we, why are we poking the bear? Like, why don't we just keep them calm? And like, I don't even want to know. Like, but she did it every time. I was only up there a couple of times consulting them, but.
DAT-Dana (02:04)
Thanks.
The Dental A Team (02:13)
Anyway, beyond prison, also is an incredible hygienist. So today we wanted to kind of office autopsy because Dana had a practice that she worked with for several years on hygiene and their number one motive and their number one objective was hygiene. And I think that this is such a, it's very delicate because I think dentists want hygienists to produce and as a practice, we want hygienists to produce. And Dana, as a hygienist, you feel, I'm not gonna put words in your mouth, but the assumption I get from a lot of hygienists is
We want to just do great work and we don't want to always have to be looking at numbers. Maybe that's true or not, but like Dana, I want to hear what's kind of like the mindset of hygienist and then how do doctors approach this? And then we'll dig into the practice that you worked with that like really freaking crushed it. But I think like, this is such a, I don't know. I feel like it's a sliver in a practice. Like no one wants to talk about it. Like let's just not touch it so it doesn't hurt. But then it like blows up and people are like, my freaking hygienist aren't producing and they don't want to like tick them off because no one's there.
So let's talk about it, because is that how hygienists feel and how do you win over hygiene?
DAT-Dana (03:12)
Yeah,
I think it's a mindset. I think it's a difference in mindset, right? I think dentists are always looking at the business side of it because oftentimes the dentists are the business owners and hygiene, their mindset is patient care. And so the easiest way I think to get alignment on that is you actually are caring about the same thing. You just don't realize it. And so it is getting alignment in like numbers tell us
how we are doing in patient care truly. So getting a hygiene team to understand that, getting them aligned that.
No numbers aren't everything, but actually numbers tell you exactly the thing that you care about most. ? And so I feel like they look at it from different angles. And if you can get them aligned and actually it is the same thing and numbers tell you hygienist, the thing that you care about most, which is patient care and making sure that every patient leaves your chair happy, healthier than when they walked in. Understanding that the numbers will tell you how well you're doing at that. ?
It's definitely a mindset shift, but I think once you can get them aligned with that and then understand that you're truly talking the same thing, it's a game changer.
The Dental A Team (04:25)
I love that Dana and as you were saying that it made me think of like when we do a practice assessment with a practice when they're reaching out to work with us or just wanting clarity the first question one of our first questions is like do you have a 10-year vision that you and your team are rallied around and as you were saying that Dana I thought about okay well if our hygiene department has a vision that we're all rallied around so let's say it's patient care well then the next question always that follows is how do we know if we're having excellent patient care and it's something that can't be a feeling
because we've got to be able to track and measure just like I can't say that I'm the best basketball player, but I have no way to prove that and measure it. My husband's in pharmacy and he's always like, if you're the best, then just freaking prove it, like stats and number it. Like, why do you have to it on feelings? Like, ? it's such a hard thing because then we really never as a hygiene department know, like, are we really doing the best patient care? So then we make actual stats of, okay, great, we have this many perio patients. Like, this is our perio percentage. This is our fluoride percentage.
This is how many reviews that we get, this is how many patients are leaving on time. And then like, this is how we know that we're like hitting our daily goal to make sure we're not missing like our FMXs or different things that need to be done on a regular basis. So as you said that, I thought like even a way to get hygiene teams on board is like, what is our vision? Like you said, and then how do we truly measure that? We got to have actual stats with that. It can't just be the warm fuzzies of I think I'm doing well because what's crazy is I can think I'm doing well and then I have to go run a mile.
And I'm like, no, I've been doing my cardio. Like I'm really a great runner. And then it's like, I ran a mile in 15 minutes and people are like, are you even running? Like until I track and measure, there's no way to improve. And so I think it's when people realize like, that's the only reason we're doing it is to see like, hey, if we've got the best patient care, then like, let's prove it, let's document it. So that way we're confident in that as well. So Dana, I'm curious, I'm a dentist. How do I get my hygiene team on board that there's gonna be a consultant that's gonna like make them?
track number, like what do people even say to make a hygienist, which is you like get on board with this idea. And then Dana, we're going to dig into like how you help turn around a hygiene team. So A though, how does this dentist get his hygienist on board or hers?
DAT-Dana (06:29)
Yeah,
I think it's an open and honest conversation of just like you said, like, give me give me descriptors of what an amazing hygiene department looks like to you. If you worked in an office and you said you walked in and this was the best hygiene team you've ever worked with you've ever been a part of what does that look like? And oftentimes that will lead to conversations about patient care about those things. And then it is okay, guys, how do we know, right? I
I want you guys to be the best hygiene team. probably sit here and think you are the best hygiene team. How do I know that though? And then you start to attach those metrics and those measurables to say, hey, like, we want to be this. We, we feel like maybe we even are but how do we know for sure? And I think that it's an opening that conversation and as well as like the
Best part of, yes, I worked very solo for many years in the prison, but when I went into private practice or when I got to temp in offices, the best thing that I loved was getting to learn from my other hygienists. And so we're going to get alignment. We're going to learn a lot from each other. Everybody's got their strengths and weaknesses. And so over the next couple of months, I want you to share your tips and tricks. We're going to talk about verbiage. We're going to talk about how to have conversations. But at the end of the day, our goal should be that
when patients walk in no matter which hygienist they see the same thing is done each and every time.
The Dental A Team (07:54)
And I love that you say that because it's like, this is how we get them on in. And I think like, doctors, don't know, Dana, a doctor giving you their, I don't know, expectation or sharing with you as a hygienist, does that like turn you off to where you just want to go like look for another job? Because I think dentists are so scared of their hygiene team leaving that they don't even want to like tell them what they're expecting from them. Cause they're just like, it's okay. Like it's better to just.
hang on to them rather than wanting to elevate. Like how do you navigate this like hygiene drought plus the need to grow your practice? Like how do you navigate that? And what does that feel like as a hygienist?
DAT-Dana (08:31)
Mm-hmm. I do feel like it can be a scary conversation. It can be an uncomfortable conversation or a conversation where a dentist kind of dread, but ultimately I think hygienists are
usually typically goal oriented, growth oriented, like they want to know what the expectations are, because at the end of the day, they want to hit it. And so they can sit here and say, Hey, I think I'm doing a great job. I feel like I'm working hard, right. But what actually tells them that? And it does come down to the expectations, the goals, the numbers, those pieces, I think
The Dental A Team (08:53)
Mm-hmm.
DAT-Dana (09:06)
It can be a difficult conversation, but I honestly think that hygiene departments, hygienists themselves, like they want to know what the expectations are because I'll tell you they are typically ? goal driven achievement people. Like they want to hit the things that you want. And so I think again, it's like clarity is the best thing that you can do for them. And if you are frustrated that they're not meeting expectations, they're probably frustrated that they don't even know what the expectations are.
The Dental A Team (09:17)
Air quotes typically.
I mean, that's fair. And I love that you say that because you're right, most hygienists do want to know what the goals are. And even if you just casually like put it on the table, they're going to casually look at that and just start to casually think about it. And I think like, Dana, I really want to dig into because I know you had a practice and you had an entire hygiene department and you worked heavily with them and they like all loved you, which I think is not common. Like I think you usually have like
three of the four that are super excited about and you got one that's just kind of off on their own planet, ? which happens a lot. But I think it's like, it's okay to give expectations. I think the piece that I've gathered, and I'm not a hygienist, so please, please chime in. I think hygienists just want to make sure that like, of all the things you want them to do, that you're not hurting patient care. So it's like, I'm okay to scan, I'm okay to probe, I'm okay to take x-rays. Like I really get the vibe that hygienists truly are not upset by that. But it's like, if you want me to scan,
probe, x-ray, plus scale, polish, do a great exam. Can we just be realistic and fair of not making me be the Olympic level athlete hygienist and maybe it's we probe and then we scan on the next visit so we could break it up so it's not having to happen every time. And I think when hygienists and doctors or hygienists and consultants come together and where it's like, OK, what are we ultimately all going for? Let's be realistic with our timing. I don't want them to have to be
A star players because not every hygienist is that. So I'm like, how can we make this tour like my B players can still thrive where my A's can like crush more and my C's feel like they it's not so far away. I think like when if you can build it that way, I feel like hygienists are way more apt and I also feel like don't don't try to get them to do every single thing right at once. Like let's do baby steps to where they like if we're not even doing fluoride, if we're not even tracking our numbers, like we're not going to scan every time. And I know doctors, you want to do that. Gap leap.
but you got to baby scale them up. So Dana, I'm just going to like hand this over to you. Like, what did you do with an office? How did you win them over? How do you scale up hygiene departments? Because I think it's delicate, but I think you're the expert on our team that does this very successfully with a lot of hygiene teams.
DAT-Dana (11:43)
Yeah, and I think when it comes to, Dennis, we've got to remove a lot of barriers first, right? That's the first thing. is, barriers are always going to be time. It's always going to be, well, my schedule's not full. It's always going to be, so we really talked about those barriers and yes, we want to make sure that your schedule's full, but when it isn't full, how do you maximize, right, what is in your chair? So we started with fluoride, honestly, which was an easy way, and I think that...
When we talk about goals, it helps to know like, why is this goal the way that it is? Right? Why is a fluoride acceptance goal 90 %? So let's talk about that, right? Think about the patients that sit in your chair. It's very rare that a patient sits in your chair that does that there's not something going on that fluoride would benefit.
Right? So even if they have immaculate teeth and they have very little dentistry done, let's keep it that way. Right? If they've got a lot of dentistry done, let's make sure it lasts as long as it possibly can. If they've got sensitivity, right? So just talking about what are the benefits, who can benefit from it? And honestly and truly statistically, that many patients that sit in your chair can actually benefit from it. So we did start with full ride and we worked on that.
The Dental A Team (12:31)
Mm-hmm.
Right.
DAT-Dana (12:58)
And then after fluoride, our next layer then was perio. And again, it came down to, well, the goal is 30 % of your patients, right, should be perio patients. Well, why? Right? Why is that the goal? Well, the goal is, right, science and statistics tell us that unless you have a very unique population within your practice, so unless you are in a college town and you pretty much see only patients in their 20s, right, or you're a pediatric practice, 30 % of the population
has that, right? And so that's just like science-based, that's just database. But having those conversations, I think, opens up windows to say, okay, this isn't arbitrary goals. We're not just picking numbers out of the sky. There's reasons that these goals exist. And unless you are truly unique in that situation, that goal applies to you.
The Dental A Team (13:29)
Hmm.
? yeah, go ahead. think that that's like, was just going to chime in real quick on like, I love that you broke down the why. And as you were saying it, I was thinking some team members don't need the why. Most dental assistants don't actually need a why. Most treatment coordinators don't really need a why. They're more like, let's just drive and go. Hygienists on the other hand, like, let's just look at their natural behavior. Very detailed. I mean, they sit there and they scrape that calculus. mean, Dana, the fact that you sit there and like, you want to get every little last piece of it.
If I've got a personality that's that obsessive of that small of details, they're going to want to understand the why. So as you were saying that Dana, I was like, even explaining to dentists, like why do they need to know why the goal is and why it's based with science? And because that's who they are. They're bred with like, we want to know the science. We want to know the background behind it. And I think, I think you even just taking that step with hygienist Dana, like kudos to you for calling that out. They're going to be way more inclined to buy in because like you said, it's feeding their brain and how they're naturally wired.
to be able to like, that makes sense. I can get on board with this and I can make sure I'm following rather than you're just making me look at every patient for fluoride because you want numbers. It's like, no, 90%. I tell everybody with fluoride, like my go-to for hygienists is I'm like, look at my teeth. They're really clean. You can clean me in 30 minutes. And yet how many hygienists in my entire life has offered me fluoride? And the answer is none. And I'm like, the fact that not even one offered it to me, like how dare you hygienists assume that I don't want to be proactive and preventative with my teeth?
Gizzles offer it to me because if I would have known I can't ever go back in time retroactively and do that and I wish that hygienists when I was you know 15 16 17 would have offered this to me to proactively take care of my teeth I did not learn about fluoride until I worked in a dental practice and I'm like rude you just assumed I was like clean and healthy and wouldn't want it versus like why not offer it because even your clean immaculate patients if you tell them this is the most proactive preventative thing you can do for your teeth
for 30 bucks or 45, whatever it is, like, do know how much a filling is? I'm going to say yes to you. So I think Dana, like kudos to you on that. But what else were you gonna say? Cause I know I cut you off on your thought process too.
DAT-Dana (15:55)
no, and my next thought process was then we tackled just alignment on all of those things. And so we spent a lot of time building Perio protocol ? and talking about the conversations that go along with it. And even on people who don't qualify right for Perio but are heavy builders because we just kept hearing time, time, we're running behind, we're running behind. And it is just...
navigating conversations with patients because you can have heavy builders and yes is that hygienist we want to remove every last speck of calculus but if a patient presents with too much to get done in an hour we have to have those conversations. Hey since I saw you last there is quite a bit of build up here. I'm gonna do the best that I can to get to get all of it off today but moving forward I think it would be super beneficial if you came more often and I could see you more frequently to ensure that I can get
The Dental A Team (16:36)
Mm-hmm.
DAT-Dana (16:51)
I can remove all of this every single time. And so it is, then it came down to conversations. And so we built up period of protocol. We talked about what if a patient refuses? We talk about, we still do restorative treatment if a patient refuses period? What are we doing in those instances? Because I wanted them to feel super confident. No matter who sat in their chair, they could navigate whatever they presented.
? And that they had something to fall back on and I think it was They had a very seasoned hygienist in their practice and I can't tell you how proud of her I was she made massive moves and had Conversations that I think she kind of knew needed to happen But because she had the framework to make them happen because she had a protocol to lean back on That she had something to give her confidence to say like yeah. No, this does
The Dental A Team (17:27)
you
DAT-Dana (17:45)
need to move in that direction. I mean she just made leaps and bounds. I mean she went from I think about 10 % perio to about 28 % when I was done with the hygiene department.
The Dental A Team (17:56)
my gosh,
that's incredible. And Dana, just to give like our listeners a little like glimpse of you worked with this team for about two years, not hitting goal. mean, not hitting perio, not hitting fluoride, not being a producing hygiene team to two years later. Fast forward, just kind of give a glimpse of what this hygiene team looked like when you were wrapping up with that office.
DAT-Dana (18:14)
Yeah, we went from pretty much not hitting goal routinely ever to hitting their daily goal about 90, 95 % of the time. So they made leaps and bounds and they had a lot of hard conversations because part of it was, you know, there is doctors play a part in this. And I think doctors oftentimes like will kind of be hands off. These doctors really wanted to be hands on totally fine. And so it was even getting alignment between the hygiene team and the doctors on perio.
on those pieces and so they had a lot of hard conversations they did a lot of calibration they even were calibrating probing depths and probe readings and like they've just put in a ton of work but that work gave them so much movement. ?
And I think just so much confidence as a hygiene department that like, we really can learn from each other. We really can teach each other. We really can have these conversations. And I think it also empowered the doctors to understand that like, again, it was a miss of expectations. Their team wanted to do a good job. Their team wanted to meet the protocol. Their team wanted to do what they wanted them to do or the standards that they had for their practice. They just needed to have the conversations, have the alignment and create those
boundaries amongst each other and it was truly amazing to see what they could do once they once they dug in.
The Dental A Team (19:37)
? Dana, this, think is just a, there were so many pieces I heard that I hope office has got the number one I heard was the hygiene team wanted to make their doctors proud. And I think so many doctors think like they don't want to produce or they don't want to do this. And 95 % of all team players, I think you and I would agree to this, coaching as many as we have, there's like a very, very, very small percentage that actually is like not wanting to take care of their doctor. I'm like 98 % of them all want to take care of their doctors. So I think you guys just realizing and hearing that.
The second thing is like Dana, it was two years that she worked with this hygiene team. And what I gathered from all of it was alignment and why, and then giving them the confidence. Because what I found with hygienists is a lot of times the reason that they do bloody profis is not because they don't like they don't want to charge out a bloody profi. Like I feel like the hygienists are like my hands hurt and I just got paid for a profi when I did a full mouth of bribement or whatever it was that they did.
but they're uncomfortable with the conversation. And I don't blame hygienists. You sit there for an hour with this patient and you gotta chat along with them. And it's very uncomfortable to then have to say like, you've been seeing me for 10 years and now I've got to tell you you have perio. Like that's just such a, like I would rather not because I have to see this patient so closely. Or dentists, like not to say you don't have intimate relationships with your patients, but you usually come in for like five minutes for an exam. And then when you are doing treatment with a patient,
Usually their mouths open and they're numb and you can't like, they're not talking to you. And where this is a hygienist, is like therapy session in there, like a hairdresser almost where it's like such an intimate relationship that these hygienists build. And so Dana, think kudos to you to give this hygiene team confidence. And that's what I gathered was like alignment, confidence, and then also getting the doctors to align on expectations. So that way everybody is there. And like also to hear you say that a seasoned hygienist was able to make transformation, I think
I also think kudos to these doctors that saw the need of the hygiene department. They were like, let's laser focus in on this for two years, like two years they worked in. Yes, they expanded a little bit to other departments, but like Dana, mean, I just think about it. If you get your hygiene team from hitting goal, like none to hitting goal 90, 98 % of the time, the amount of revenue, the amount of patients, the amount of diagnosing and co-diagnosing with your doctors that these high Gens are able to do the amount of perio uptick.
Like we're going from $90 pro fees to 250 to $400 scalings. And not to say we're doing it to uptick for revenue. It's just, what the patients need. And we're starting to diagnose it correctly. well, Dana, you like paid for yourself a hundred times over. it's, that is the type of stuff. And now that hygiene team is confident, they're equipped, they're able to care for patients. And I guarantee you, Dana, I'm not a hygienist. So I'm just curious, like.
My hunch is a hygienist who's able to have the confidence, have these conversations actually leaves with more confidence as a hygienist rather than the hygienist who feels like they're taking care of a patient, but deep down knowing that they let the patient down, they just didn't know how to get out of that conversation.
DAT-Dana (22:38)
Yeah, I think that that's that's one of the things that was like the beauty of being the person looking at from the outside in and I think it honestly truly I think allow them to like love being hygienist. I don't want to say again, right but even more ? because I do think that as
hygienist and I think they even admitted like, hey, we've known some of these conversations needed to happen or are on the horizon of happening and we just didn't have the tools we didn't have that and we didn't want to say something and then have a doctor come in and disagree, right? Or we didn't want to do the wrong thing unintentionally. so having those guidelines, having the set protocols, the set
The Dental A Team (23:12)
Mm-hmm.
DAT-Dana (23:20)
pieces in place, I think really gave them confidence and also really truly then they could see what amazing patient care they were giving. And I honestly think it brought them just like closer as a department, a better culture for the practice and truly love being hygiene.
The Dental A Team (23:40)
And I think Dana like I just see it even in you I hope you guys were able to see that clip of Dana like the the glowing radiance of excitement of being able to help hygienists love their profession even more to be confident in this I think that that is just magic for all of us to be able to watch that and see and I think for you guys listening one if you need help with your hygiene department I think Dana just showed like We really do very much give confidence to your department and I think doctors it's hard for you because you want to tell the hygienist what you want
But hygienists sometimes need to feel like heard, seen, and understood by someone who's more of a colleague and comrade to them. Like Dana is, she's a hygienist. She understands what those feelings feel like. And so to have a coach and a guide guide your hygiene department, bring the doctors and the hygienists together. But I love that it was like, let's explain why, let's align, let's give verbiage, let's get doctors and hygienists alignment. And then like really have somebody who's holding them accountable, driving these results with them. And the end result is a hygiene department that's flourishing, hitting goals and loving their profession.
And to me, that's gonna retain your hygiene department way more than not having the conversations. That's going to attract hygienists to your practice way more because you've now got raving fan hygienists who are confident that when someone new comes in, they give them the tools and the resources to be these great clinicians. I think Dana just like insane kudos and I hope people also hear that. And if you're interested, reach Hello@TheDentalATeam.com. This is what we do and Dana, like I said, Dynamite Dana over there, she just like, I think it's a subtle love.
of growing them of where they need to go and the results are just incredible.
DAT-Dana (25:13)
Yeah, they were, they were a great group. They really dug in. And you're right, it does, it does help when they know, you've been there, you face the things you've had to have the conversations. ? It just starts out with trust. And I mean, at the end of the two years, I just remember sitting down and saying, like, thank you so much for trusting me. Thank you so much for putting in the work. Because it's, it, it allowed me right, I'm not clinical really anymore, but it allowed me just the experience of
knowing and being super confident that like amazing patient care was walking out of there ? truly was a highlight for me.
The Dental A Team (25:50)
That's amazing. And I think Dana hearing that and the doctors win is that they also can leave at the end of the day, knowing that their hygiene department is delivering the patient care that they wanted, that they were hoping that like the doctor just could not get, I mean, and these are seasoned doctors. It's not like we were starting with a brand new practice. Like they had been working with this hygiene department for years. The hygiene department had gone through other hygiene coaching. And I think Dana just like to be able to give that to the patients, to the hygiene team and the practice, like
Such a gift and I'm really proud of you and I hope people listening realize this is a reality that has happened. Yes, we gave a one off office autopsy, but it happens for multiple other practices the same way. So if you're interested or you're thinking about it or other departments reach out and Dana, thanks for being on the podcast with me. Thank all of you for listening and as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.