https://www.youtube.com/watch?v=5F8S_pGqR_s

Carrie Webber:

Welcome to the Jameson Files. I'm Carrie Webber, and I'm so glad that you're joining us today for another episode. If you're a part of our Jameson Files community, thank you so much for staying connected with us. I'm excited to be with my teammate and friend Dru Halverson, the chief of advisor development here at Jameson. I really appreciate you being with me again, Dru.

Dru Halverson:

You are welcome! Thank you so much for having me.

How can you improve the hygiene aspect of your dental practice?

Carrie Webber:

You know, what I wanted to talk about today is something that we haven't really started diving into in the podcast. And I know that it is a top area of concern or opportunity. A lot of doctors that I talk to, one of their big questions is how do they improve the hygiene aspect of their practices? And that’s not necessarily the actual care that's being provided. We know that they're going to give good care, right? It's more about how do we do this more effectively, more efficiently, and how do we become more productive in the hygiene departments of our practices? How do we engage our hygiene team at another level to help us with the overall patient experience and relationship with us? So I wanted you to come and join me today so that we could talk about high-performing hygiene, what that means in general terms, but also how we can take our practices from being good in the hygiene realm to being great.

So Dru, when practices share that they want to improve in hygiene, what are some questions that you ask them? When they share that as a goal, that they want to go from good to great in hygiene, what are some questions that you ask to really start getting a sense of where their opportunities are?

Determine what your practice’s hygiene strengths and weaknesses are.

Dru Halverson:

Well, I want to know what weaknesses and strengths they see in their hygiene department. And I can always get a lot of strengths and some really good weaknesses from that question alone. So if you can draw a line down the middle of the page and put strengths on one side and weaknesses on another or opportunities that you see, then you can have a really good list of what to work on and what to pat yourself on the back about. And that makes a big difference. I always want to know how patients feel at the end of their appointment. Are they checking in with their patients? Are they always asking the patients, how was the appointment? Also do they continue to stay with you and return on a regular basis? Do they love coming to the practice for their hygiene appointments? That is a good question to ask them: what is the retention rate and how many patients are past due? And then also, I like to know treatment acceptance from not only restorative care, but also hygiene care. Is it where you want it? Is it high enough? And if it isn't, what's causing that problem?

Carrie Webber:

I love the recommendation of starting from where you are right now, in terms of where do you find yourself to be strong? Where do you find yourself needing to work on things? I think really high-performing teams start to rise to the top, because they have this openness to not only give themselves pats on the back, but they're comfortable with being uncomfortable, meaning they're not afraid to talk about and be vulnerable about the areas that they need to grow. 

Dru Halverson:

We all tried really hard to be great hygienists and doctors, right? However, that doesn't mean that we're perfect. And yet, it's sometimes hard to accept that maybe I could improve. Maybe I could do better. Maybe I could do something else to elevate my care of the patient.

Carrie Webber:

One hard conversation that I've been having quite a bit recently is that team members who have been on a team or have been practicing dentistry for many years can develop a resistance to changing the way they do something. I think it's because of the discomfort of breaking out of a habit. And so do you see a way in that exercise to really open people up people’s mindsets?

Dru Halverson:

Just bring it to their attention. What they may be saying is, “I have done it this way for 20 years,” or “I have done it this way successfully in the past.” And that's great to hold onto, but today's a new day and things always change and can be improved. So I really like to start talking about those things that I see in the practice. Talk about the feedback you’re hearing. People are sharing how they feel, each from their own perspective. So that is a conversation that tells an owner that the team is not all on one page. They have to all be on one page. They must have the same philosophy and the same workflow with every patient they see. If it's different from one provider to another, it confuses the patient, and a confused patient can't make a decision.

What are key techniques that result in huge leaps of improvement in hygiene practice?

Carrie Webber:

Yeah, that's great. So when you think about hygiene in general, going from good to great, what are some areas that you regularly see, when we start doing some work on it, that there's always a huge leap of improvement in the overall performance of the practice, in relationship to the patients? What are a couple of those that you see?

Doctor Hygiene Evaluation

Dru Halverson:

The first one is always the doctor hygiene evaluation. And we're not talking about how you do the clinical techniques. It's communication. It's body language. It's the tone of voice that you have when you do that. Doctor hygiene evaluation in practices that don't see high treatment acceptance or high hygiene treatment acceptance, or don't have patients that stay forever or don't stay active and current in hygiene retention—it all goes back to that doctor hygiene evaluation time. Every patient has to see that you are a team that works with the patient. You have to be in sync together, and you have to have a system or a flow that feels really natural. It can't feel like a system. It can’t feel like you’re just rehearsing something. And that system has to be natural with every doctor in the practice and every hygienist.

Carrie Webber:

Yeah. And something that I hear you working on very fervently with a lot of people is the timing of that evaluation. You know, there's some sweet spots in terms of when that ideally takes place, and we need to be striving more intentionally on a regular basis to accomplish that. We really like it more in the middle of the appointment. Why is that?

Dru Halverson:

Well, at the beginning of the appointment, the hygienist is going to be gathering all the necessary information—reviewing the health history, getting the blood pressure, diagnostic radiographs, perio charting, charting of existing and potentially needed treatment—so we can get our documentation in order before the doctor comes into the room. We also don't want it in the last 20 minutes. So I'm going to assume that the appointment is an hour of time for an adult. The first 20 minutes are for social graces, getting to know the patient, getting their chief complaint from them, and getting all the diagnostic information. The second 20 minutes is the sweet spot, as you said, for the doctor to come in and do the evaluation. If you wait until the last 20 minutes of the appointment, the patient's done, they are ready to go. They are thinking about work, picking up the children going on with their day. They're not focused on what they need to hear. And so the sweet spot is that second 20 minutes of time.

Carrie Webber:

So not only how we execute that evaluation in terms of how we're communicating with each other and with the patient and what we're striving to accomplish in that relationship with them at that time, but also in the timing of when we execute that. So looking at your schedule and being a little more aware in the coming days of when those evaluations tend to be happening, is it really chaotic? Is it all over the place? Is it really more of an in and out and on with your life? The more consistent we are across all providers, the better it is ultimately for the patient. And when it's better for the patient, it easily turns into being better for the practice. So what are some other areas that may be keeping them from being great?

Dru Halverson:

I'd like to wrap up just one thing: make sure at your daily huddle to look at your schedule, doctors and hygienists, and see when the evaluations should happen. Really look at the flow of your whole day so that you can do an effective doctor hygiene evaluation. And your evaluation needs to be approximately five to 10 minutes. It depends on the type of patient that you have in your chair. It needs to be very intentional and the body language and tone of voice needs to be very serious but yet comfortable. So sitting down with the patient, eye to eye and knee to knee, being in a communication triangle with the patient so that they can see the two of you, the doctor and hygienist, conversing about them, the patient. And that makes a big difference in the value of that appointment, and in the next treatment as well. 

Hygienist and Dentist Scheduling

So I've alluded to the second one, which is scheduling correctly. The schedule for the hygienist has to be correct. And it has to meld with the doctor and assistant schedule as well. So you can’t have too many evaluations in a day nor too few in a day. The other thing in scheduling that we teach here at Jameson on our Grow Platform is scheduling essentials, and if you’re not following those essentials in the doctor and assistant chairs and in the hygiene chair, you're not going to be able to get through a day in an even good flow and feel good at the end of the day. So it will affect your productivity.

Carrie Webber:

You know,