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Understanding the Hygiene Gaps

There are two common deficiencies or “gaps” in a dental hygiene program:

1.  Utilization Gap – the number of hygiene appointments available for the year compared to the number of appointments actually completed.

2.  Capacity Gap – the number of hygiene appointments available for the year compared to the number of appointments that would be required if all patients followed your recommended hygiene recare schedule.

imageLet’s look at a hypothetical example with nice round numbers to see what these gaps look like.  Dr. Smith has 1500 “active patients” (patients he has seen in the past 18 months) and two hygienists that combine for a total of 6 days of hygiene.  Jane works Monday through Thursday from 8am to 5pm and Amy works the same hours on Thursday and Friday.  They both spend one hour with each patient, and take an hour lunch.  The team does a good job, but each hygienist averages one hole in her schedule per day.  The team is happy, the patients are happy, and Dr. Smith is happy – but they would like to reduce the number of times the hygiene department doesn’t have a patient in the chair.

Let’s assume that Dr. Smith recommends the average patient come in twice a year and patients in the perio program should come back three times per year.  If Jane and Amy have 15% of the patients in perio maintenance, they need a total number of 3,225 appointments to fully accommodate the existing patient base.

Let's check the math.

1500 patients * 15% = 225 Perio Patients
225 Perio Patients * 3 Appts/year = 675 Perio Appts Needed

1500 patients * 85% = 1,275 Standard Patients
1,275 Standard Patients * 2 Appts/year = 2,550 Standard Appts Needed

675 Perio Appts + 2,550 Standard Appts = 3,225 Total Appts Needed

If Jane and Amy each take 2 weeks off each year, the hygiene department can accommodate a total of 2,400 appointments per year.

Let me check that math again...

Jane works 4 days/week
Amy works 2 days/week
Combined 6 total days/week

6 days * 8 Appts/day = 48 Appts/week

48 Appts/week * 50 weeks worked = 2,400 total Appts/year

Issue #1 – Utilization Gap

The hygiene department COULD have completed 2,400 appointments last year, but because each hygienist had one hole in her schedule each day, they only completed 2,100.  That’s 87.5% of all available appointments.  That’s a bit lower than the benchmark of 92-95%, but not way off the mark.  Assuming an average value per hygiene appointment of $100, that is about $30,000 in missed production.

Issue #2 – Capacity Gap

The hygiene department SHOULD have completed 3,225 appointments last year based on the needs of their current patients, but only has the capacity for 2,400 appointments.  This is a deficit of 825 appointments, and the doctor should work with Amy to find another day or two of hygiene in order to accommodate the existing patients, not to mention the 20 or so new patients per month that the doctor would like to add to the practice.

Conclusions

In order to understand the true strength of your hygiene department, you need to crunch some numbers and determine where your deficiencies are.  Is there a problem filling the schedule?  Do you have enough, or too many days of hygiene available?  You’ll do just fine, as long as you remember to…

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