Can hygiene really be a profit center?

by Vicki McManus, RDH

Without question, hygiene departments can be one of the most profitable aspects of a dental practice. Strategy is the key. In the past, dental office growth stemmed more from personality than planning. Let's take a look at how you can develop a strategic plan for developing a highly profitable, patient-focused hygiene care center.

There are two issues that need to be addressed in developing an ongoing profit center from hygiene:

1. We must focus on current demand and capacity.
2. We must focus on how to stimulate income centers within the department.

Calculating demand is simple. Go to your current patient charts and count the number of charts. That is the demand. Put another way, this is the number of people who want you to care for them.

Next, calculate your capacity. This will tell you how many patients you can serve. Figure 1 shows the number of patients hygienists can serve in a 16-day month, assuming one-hour appointments.

Most hygiene departments are not profitable because they are underserving the demand of their patients. If you have an "overflow" room in your practice, I submit that you can increase productivity as well as profitability by dedicating it to hygiene services.

The second challenge is to increase the variety of services offered in the hygiene department. The most productive procedures include whitening, sealants, child prophies, and nonsurgical periodontal therapy.

The "typical hygiene department" produces $8,000 per month ($96,000 per year). I have coached dozens of offices that produce more than $300,000 and several that produce more than $1,000,000 per year — not total office production ... this is the hygiene department only!

Here is a strategy for creating a $300,000 hygiene department. Like any recipe, you need a few key ingredients:

• 1,000 active patients-of-record
• Two operatories for hygiene
• Average recare fee of $130 (including exam, prophy, X-rays, fluoride)
• Active new-patient flow
• Strong nonsurgical periodontal program
• Focus on additional services

A team focused on scheduling 1,000 patients every six months (40 patients per week) would yield $260,000 per year. Isn't this easy? Just complete 40 recare patients per week!

Let's add 20 new patients per month. Statistically, we know that 70 percent of the new patients have some form of periodontal disease. Just to be conservative, let's say 50 percent and that each patient needs only two quadrants of therapy (again, I know this is conservative). This would yield 20 quads of root planing and scaling. Add to this adult fluoride, bite guards, whitening, and other valuable services.

Complete the simple worksheet in Figure 2 to see the benefit to your bottom line.

Taking into account salaries for the hygiene and administrative team, supplies, and equipment depreciation, this type of department yields a 35 percent minimum profit to the doctor, or roughly $126,725 net per year. Compare this to the "typical hygiene department" that grosses $96,000 per year with a net of zero. I think you can see the benefit of expanding your department to meet the demand of your patient base.