Mirror, mirror, on the wall, who's the most valuable of all?

What's your worth? That's the question we ask ourselves and our employers from time to time. Those of us in the dental environment know this is a topic that can cause dissension in the workplace. Next to the doctor, the hygienist has always been ranked at the top of the salary chain. "Why?" we ask. The most common response is "They produce the most revenue." If you've been working in the dental profession for any length of time you probably have accepted this philosophy. The hygienists are well trained. They work hard. They bring in significant revenue and they are paid well for their skills.

Experience and education in dental assisting along with my own in-office statistical study has helped me recognize a new philosophy. A successful dental office is like a high performance car. Each part must function efficiently to make it run at top speed. As you look closely at all the positions within a successful dental practice you will find that all staff members are working hard, are well trained, and are financially supporting the practice.

The front desk is the hub of the dental wheel. The person responsible for managing the patient schedule sets the mood for the entire day. Daily emergencies and cancellations can cause havoc in the patient schedule. Maintaining a full schedule is a challenge and frustration for the front desk staff. How does this effect production? It's the number one factor for a productive day. No patients, no revenue.

Many offices assign the billing duties to the front desk assistant as well. Whether it is a dual duty or designated to one staff member, getting insurance companies and patients to pay for services is never easy. It takes intelligence, diligence, and emotional stamina. Again, no collection, no revenue.

Dental assistants come with a variety of educational backgrounds and training depending on their state's regulations. Regardless of the dental assistant's background, when they join the dental team they must adapt to the dentist's preferences. Supplies, equipment, and procedures vary from office to office. In my experience, the dentist who has become accustomed to working with an assistant will not see patients without one. This is not only because of safety issues, but for efficiency as well. Production is maximized when the dental assistant's skills are utilized to the fullest extent within the limits of their state's dental law. In my study, utilizing an expanded function dental assistant increased the number of patients seen in a day by 30-50%. The statistics I gathered resulted in an average daily production for the expanded function dental assistant equal to or exceeding that of the hygienist.

To become aware of the contribution each staff position provides, employers need to do their own in-office study. When production is broken down and assigned it is evident that all staff members are part of the revenue picture. The first step is to identify the percentage of the total office production the hygiene program contributes per month per hygienist. This percentage will vary from office to office.

My study resulted in 30-35%. Next calculate the drop in production when the dental assistant or front desk assistant is not available. These positions are often held by cross-trained assistants. The study showed a 25-30% drop in production when one assistant covered both positions for a day. This drop in production affected the next day as well since close monitoring of the patient schedule was inhibited. The final step in the study is for offices that utilized expanded function assistants. Monitoring days with and without expanded function procedures will identify their contribution. My study realized a 30-35% increase in production, equal to the hygiene program.

As one reviews the statistics, the "mirror-on-the-wall" reflects a dental team with members very close in value. So why such a difference in pay scales? Education, training, licensure, are all part of the equation. Staff members should be compensated for their initiative to expand their skills and educate themselves. But more significant than salary level is self-image. All members of the dental team need to recognize their value as well as that of their coworkers. Misconceptions of one's worth, whether too high or too low, will cause strife in the work environment. As attitudes change, respect and cooperation can lift the dental practice to new levels both financially and emotionally. Staff members will realize the success of the practice is supported by a team of individuals doing their jobs well. Pay scales determined by education and experience, not production issues, will balance the scales. This is the foundation for a pleasant and productive work environment. It's imperative that we all look closely in that "mirror." If we are honest with ourselves we will see that no one deserves to be "queen."

Diane Kelchner, CDA, EFDA, B.S., is employed by the Rural Health Corporation in Nuremberg, Pennsylvania. She is a member of the Luzerne County Community College Advisory Board in Nanticoke, Pennsylvania. She is a charter member of the Northeast Pennsylvania Dental Assistant Society.