In your experience, what are the traditional adjunct responsibilities of dental hygienists beyond providing clinical treatment? I am asked to prepare a huddle prep, provide treatment plans and financial arrangements to patients, schedule patients’ recare appointments, send the insurance claims, etc. Is it typical for dental hygienists to be required to also perform administrative functions?
Thank you for your question which is relevant to current dental hygiene practice due to the expanding roles within our profession. Long-established responsibilities for dental hygienists would include the six standards for the dental hygiene process of care set forth by the American Dental Hygienists’ Association (ADHA) in the Standards for Clinical Dental Hygiene Practice.1 Basically, these are the responsibilities dental hygienists are taught to perform while attending dental hygiene education programs. Programs teach us to review health and dental histories, perform exams and risk assessments, formulate the dental hygiene diagnosis, develop a treatment plan, present the plan including costs, provide necessary interventions, schedule dental hygiene appointments, re-assess during post-treatment evaluations, and thoroughly document information. Accomplishing all these functions in an hour appointment is a challenging task. If an employer required presenting and scheduling dental treatment (in addition to dental hygiene treatment), including making financial arrangement with a patient and billing insurance for treatment, my concern would be time management. Completing all aspects of the dental hygiene process of care with excellence and in an effective way that most employers would want for their patients requires a substantial amount of time. If other services are required of the dental hygienist, then I feel the dental hygienist needs to negotiate for an increased allotment of time per patient or for those particular patients. Having an open discussion regarding aspects of dental hygiene care with your employer can be helpful. For example, explaining the benefits of exams and risk assessments and how motivational interviewing and education are important in the long-term success of not only dental hygiene treatment, but also dental treatment, might persuade an employer to allocate more time or eliminate some administrative responsibilities. The professional services we provide for patients must meet our personal ethical standards while also meeting the expectations of patients and our employers. In regards to huddle preps, this time is an excellent opportunity to provide education to our dental team, such as introducing new self-care products, explaining dental caries reduction interventions, and reviewing infection control protocols. The roles of dental hygienists are expanding and progressing in many exciting ways. I would encourage all dental hygienists to strive to find a balance in their work environment that would utilize their talents and expertise, while at the same time provide joy and peace in their professional life.
Reference 1. American Dental Hygienists’ Association. Standards for Clinical Dental Hygiene Practice. Available at: http://www.adha.org/resources-docs/7261_Standards_Clinical_Practice.pdf. Accessed March 21, 2016.
I see administrative requests as opportunities for dental hygienists to enhance their contributions as team members, practice builders, and valuable assets to the entire practice. Too often, dental hygienists mistakenly become isolated by narrowly focusing on the scope of dental hygiene as their only pathway to employment. Managing a variety of administrative functions could likely render the dental hygienist’s position even more valuable to running the business and less likely to be replaced. With increased value comes long-term job security. As long as time is made available to accommodate these administrative responsibilities in addition to delivering dental hygiene care, I would encourage dental hygienists to see what personal and professional enrichment may be gained from these opportunities. So very often we hear of the business owner having to look for ways to reduce costs and increase productivity and profit. Thus, if you enjoy the setting and the people you serve, this may be your opportunity to further solidify your long-term security as an employee in the business. The pressures of multitasking, working faster and smarter, and ensuring profitability have been constant factors in my son’s career as an engineer. He assures me it is simply part of the working world and his profession, and thankfully, he continues to enjoy his career.
I am reasonably sure that dental hygiene programs don’t teach insurance codes or claims, office financial responsibilities, or other administrative duties. It makes no sense to require these skills as part of a course of study because the national or regional dental hygiene board exams are not geared toward these abilities. That said, each office and the dentist who is supervising can run their practice differently than traditional dental offices. You have every right to say that you don’t do administrative duties, which might send you packing your bags in search of a more traditional position somewhere else. On the other hand, if they want to pay you dental hygiene wages to perform nontraditional functions and they give you enough time to do it and don’t base your raises on productivity exclusively, go for it. Enjoy the break from the assembly line of patients and foster trusting relationships with patients as their dental hygienist and office manager. Give your hands a break and reap the benefits, ask for a raise because you are now taking on two responsibilities.
As a dental hygienist who has been practicing for 45 years and has had the pleasure of working with outstanding dentists, periodontists, and my husband, my adjunctive role in our dental office, aside from my clinical skills, has been a leadership role in continuing education and product review for our hygiene team. Currently, our practice employs four dental hygienists. I coordinate our hygiene meetings and review systematic reviews and new products so that we can be continually on top of our game. I have taken on that role because of my involvement over the years in continuing education and because my husband is one of the practicing dentists. In addition, I, on occasion, organize supplies (I do not do the ordering) to keep our office as buttoned up and uncluttered as possible. While some offices allow for dental hygienists to schedule the patient’s next recare appointment in the treatment room, our office has decided to leave all the scheduling to the front desk. We schedule 60 minutes for most patients and at least 70 minutes for periodontal maintenance and new patients. We have an assistant (usually a dental hygienist whose is paid the hygienist salary) to assist in disinfecting our room, setting up for our next patient, sharpening instruments, and making sure the sterilization center is on task. If time permits, the hygiene team tries to pay attention to the aforementioned as well. The dental hygienists are also paid for their lunch hour. In no way are they expected or required to perform administrative functions unless one of our front desk staff is absent and then they might offer to help in some way. I remember years ago, working for a dentist (for a brief period) who hired a front desk person who was not qualified for the position. The dentist told me repeatedly that I had to help out was much as I could because he felt sorry for her and wanted to give her a job. After awhile, I caught on when I found out how little he was paying her. Clearly he was trying to save on staff and dollars, and pushing me to pick up all the rest. As a member of the team, it is nice to help out in every way possible in the office when you have a cancellation, but to be expected to take on administrative functions as part of your job description is, in my humble opinion, inappropriate. Everyone has her expertise in the office! If one of our dental hygienists has a cancellation, she might look around to see what needs to be done to help out or spend that time reading articles that I have earmarked for them in order to keep pace with current evidence-based dentistry. We feel this will contribute to the overall expertise of the practice and will ultimately circle around to continue practicing state of the art dentistry. I hope this helps. It is sometimes difficult to say no, and therefore essential that each dental office has a definitive job description that can be reviewed prior to accepting employment.