Dear Dianne,
I have two very competent, caring hygienists who have been with me for 10 years. I want them to feel like they are being properly compensated, but frankly, I don’t know how their pay stacks up compared with other offices. I pay them a daily rate that seems high to me, especially when they don’t have patients in their chairs. Just like any office, we have ups and downs with our schedule. They normally see about eight to nine patients, but they are both averaging one to two open slots per day. My practice is located in South Carolina.
— Dr. MIKE
Dear Dr. MIKE,
One of the most important stats you need to know is salary to production ratio for each of your hygienists. Take the hygienist’s gross salary for the past three months and divide that by the hygienist’s production; then move the decimal two places. The industry standard is that it should be around 33%. However, in working with offices all over the country, I’ve seen the salary to production ratio be anywhere from 23% to 55%.
Let’s take an example. Katherine has worked in Dr. C’s office for 16 years. Her starting pay was $25 per hour, and now her pay is $38 per hour. Christy has worked in Dr. G’s office for five years. Her starting pay was $32 per hour, and she’s received no raises since she was hired. Both hygienists work four full days per week. The breakdown of production by code shows that Christy has a significantly higher percentage of periodontal procedures overall. Downtime is a problem in Katherine’s office.
This comparison shows that Katherine is well above the industry standard of 33% for salary and production, while Christy is below the standard. Barring any other work-related problems, it would be appropriate to give Christy a raise. Steps should be taken to improve Katherine’s low production and downtime.
From the information you provided, it would appear that downtime is a problem in your practice. Let’s assume that the average cost of a hygiene appointment is $150. Let’s also assume each hygienist has one open appointment per day in his or her schedule, so that adds up to $300 in lost production daily. Now multiply that times 160 days worked in a year. That total is a whopping $50,400 in lost production, and this is a conservative figure because you mentioned the hygienists average one to two openings per day. But the costs do not stop there. There’s also the negative impact to the restorative schedule due to restorative dentistry that will not be diagnosed, as well as fixed office costs, such as salaries, that continue when production stops. Scheduling is a front business desk function, and it is prudent to address and fix the scheduling problems that exist.
According to the 2016 salary survey published in RDH magazine, the average hourly pay for South Carolina hygienists was around $33 per hour. The wage was similar whether in a metropolitan or rural area, with a range from $26 to $41 per hour. (Visit dentistryiq.com and search “RDH salary survey part 3.”)
I think it is important to look beyond a hygienist’s raw production numbers. You used the words “competent and caring” to describe your hygienists, which indicates they are people-oriented. That’s valuable in today’s world and can be a practice builder for you. Additionally, when hygienists are good communicators, they are usually good at promoting the dentistry you provide, which is also a valuable performance trait.
A man named James Goldsmith is credited with saying, “If you pay peanuts, you get monkeys.” I like to think above-average doctors pay above-average wages to above-average people who do above-average work.
All the best,
