Dentaltown August 2018 - 12

howard speaks
column

The Hygienist's Challenge:
Bring Value or Vanish
Is your hygiene department an outdated horse-andbuggy model, or is it a virtuous value creator?
The benefit of traveling around the globe lecturing
is I've seen the world's only three publicly traded dental
offices, and done Dentistry Uncensored with Howard
Farran podcasts with executives from each of them:
1300 Smiles, in Australia: I talked with founder
Dr. Darrell Holmes in Podcast No. 850,
"Optimize Your Dental Practices."
Pacific Smiles Group, also in
Australia: My conversation with
co-founder Dr. Alex Abrahams was Podcast No. 841,
"Structural Organization."
Q&M Dental, in Singapore: Podcast No. 373 was
my Q&A with co-founder
Dr. Raymond Ang.
W hat's interesting
about all three is they have
the same business model-
and none of them has a hygiene
department. Those guys ask me,
"How do you do that in America?
You pay a hygienist $40 an hour to do
a $55 cleaning in a building that has 65 percent
overhead. How does that even work? That's why you're
not profitable."
What killed hygiene? It wasn't the dentist, and it
wasn't the hygienist-we aren't doing anything "wrong."
Blame insurance reimbursements!
The typical fee for a cleaning is
so low that in markets around the
world-including Singapore and
Australia-dentists are getting rid of
their hygienists and doing the work
themselves. It makes me crazy when
an insurance company pays only $55
for a cleaning but their CEO claims,

by Howard Farran, DDS, MBA, publisher, Dentaltown magazine

AUGUST 2018 // dentaltown.com

"We pay 100 percent of preventive dentistry, because
we really want to prevent disease." Dude, if you really
want to prevent disease, you've got to give dentists more
than $55 for a cleaning. I mean, it costs $60 in major
cities to get your hair cut nowadays, and stylists aren't
required to have a four-year college degree!

The importance of virtuous
value creators
Nowadays, the only way a
hygiene department works is
if the hygienists are virtuous
value creators. Your hygienists brush and floss their
teeth every morning
and every night, and
probably use an electric
toothbrush instead of
a manual one. Are they
conveying those virtuous
values to your patients,
or do they spend that time
talking about how their deadbeat
spouse left a towel on the bathroom
floor, and how crazy their 2-year-old is
acting lately?
The word doctor comes from the Latin word docere,
meaning "to teach"-and even though hygienists don't
have DDS degrees, they can still teach patients about
what's going on in their mouths and instill values. "I'm
a hygienist. If this was my tooth, this is what I would
do. If my gums were bleeding like this, this is what I
would do. If I had your situation, I would not manually
brush my teeth. I would go to an electric toothbrush.
I would get a water flosser."
Your hygienist should be taking out the intraoral
camera, looking at each single tooth and telling patients
whether she sees any possible issues that the dentist will
want to discuss further.

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Table of Contents for the Digital Edition of Dentaltown August 2018