Category Archives: News

Keeping Patients Committed with a Membership Plan

According to a McKenzie Management Survey, of every ten new patients that visit a medical practice, seven will never go back. Thats a lot of not-returning patients!

In his recent Dental Economics Article “Membership plans keep patients committed to your practice,” Dave Mohan writes that a world of endless choices has created a new level of fickleness among consumers.

“Loyalty to one brand or one entity is becoming rare,” he writes. “It’s no different with your patients. If you aren’t doing it already, now is the time to implement a patient loyalty and retention program.”

So, where do you start? Monahan suggests with the uninsured.

“The most vulnerable patients in a practice are those who are uninsured and pay out of pocket,” he writes. “They truly have endless choices and often shop around for oral care. They are also typically the most profitable patients for a practice and the patients a practice can least afford to lose.”

Monahan goes on to write that research from the Fitch Brand shows the uninsured are patients who are uncomfortable not having dental coverage, avoid hygiene visits and are skeptical about accepting additional treatment recommended by the dentist.

“The great news is that 89% of uninsured patients are interested in purchasing a dental care plan if it’s simple, transparent, and affordable,” Monahan writes. “They have looked at dental insurance, but they do not buy it because of the long, complicated agreements that include limitations, exclusions, annual maximums, and other terms that make it difficult to understand.”

And this, he writes, is where a membership plan comes in. 

A membership plan is a dental care plan that you offer directly to your patients. Patients pay a monthly fee directly to your practice for preventive care and discounts off other treatment. Membership plans eliminate the cost and hassle of an insurance middleman, enabling patients to get the oral care they need at an affordable price while enabling dentists to run a successful, profitable practice.

Monahan writes that his research has found that the cost or fear of a high cost is the number one reason patients with no insurance avoid the dentist. However, membership plans allow patients to understand the costs up front, and that kind of transparency builds trust because they know they will not be surprised by bills during or after the appointment.

“When uninsured patients get access to the oral care they need at an affordable price they want, they feel a sense of relief and appreciation,” he writes. “They visit more often, become more committed to their hygiene visits, and accept more restorative treatment. As a result, membership plan patients are loyal to your practice and will become your best patients.”














Dental Horror Stories

Have you ever been totally grossed out by something that happened at work? 

Whether it be something in a patient’s mouth or the way instruments are cleaned, there’s kind of a lot that could make hygienists feel sick to their stomachs at dental practices. 

Dental Practice Management compiled their best (or worst, depending on how you see it) finds from hygienists all over the country in their blog “Your top scariest dental horror stories,” and we’re here to share them with you.


1. Pennsylvania 

“I worked in a small dental office back in 1992-93 where the dentist did not autoclave the instruments. Everything was cold sterilized. Once I came back from lunch and was advised to take the morning instruments out and prepare the trays with them for the afternoon! Once I tried to use the autoclave but was scolded by the office manager! I worked there three months before moving on.”

2. Texas

“A lady arrives at the dental office and walks directly at me at the “check in” area to ask a question. Willingly and with a smile, I was very eager to help her until she then puts a tooth (root and all) onto the counter and begins to spin it. It was like she was playing “spin the bottle” with her index finger. I awkwardly stared as she said, “My husband’s tooth fell off. Can this be placed back in his mouth?”

What!? How?! Really?! She was very serious! I stood explaining how that couldn’t possibly happen. She didn’t quite believe me, so she picked up her husband’s tooth and left. I sprayed CaviCide all over that countertop, door handle, window door, and everything she touched. I went back and wiped down all the areas until I started to laugh and explain to my staring coworkers what had just happened.”

3. New Jersey

“I worked for a guy who used to put HVE suction tips in the cold sterile! Ugh! I wanted to die! I always threw them out. He never knew.”

4. North Carolina

“Toothbrushes with coarse pumice were used on heavy plaque/food debris in mouths prior to dental treatment (fillings, crowns, whatever) then rinsed, put in the ultrasonic, then in cold disinfectant, and REUSED!!!! YUCK!!! I was reprimanded for throwing some away.

Needless to say, I wasn’t there long. There was no way I could be a part of that and sleep at night. The doctor felt he was OK in doing this and was not going to make any changes. I cringe at this memory.”

5. Michigan

“How about a dentist finding old extraction instruments at an antique sale bringing them into the office, then soaking them in ultrasonic sterilizing? Even still rusted, they were used on a patient.”

6. Texas

“I filled in for another assistant. She had prepped the room before leaving. Well, when the doctor used the mirror to retract the lip for the injection, we both noticed that the back of the mirror was covered with impression material. The doctor became angry and I had to dodge the instrument as it came flying across the patient’s head and hit the window behind me.”

7. Oregon

“I worked for a dentist who would give a drunk patient nitrous. He said it was OK. One time, she inhaled a crown and gagged on us. Another time, she puked all over me. I left the practice and I heard she died. Not sure of the real reason, but I have my ideas…”

8. Ohio

“My boss was being divorced and was an emotional mess. He hires a woman who said she was a certified assistant with 15 years experience. She was certified to take X-rays, but was insubordinant, incompetent, sexually provocative with our male patients, unwilling to learn, and rude to the hygienists. Ultimately she whispered to a patient that he should leave the office because the doctor was just trying to get money from him. The doctor finds out and fires her.”

9. Texas

“I once worked in a pediatric clinic that had a dentist who proudly sported a “No crying” button on his jacket and wore earplugs during procedures. One assistant had to leave the operatory in the middle of a procedure because she didn’t want to vomit in front of the crying child. Of course, we assured the parent (who was not allowed in the back) that her kid was well taken care of!”

10. Michigan

“An older guy came in and wanted his niece’s dentures to be relined to fit him. … what?!”

11. Florida

“The doctor’s mother had come in for dental treatment. The patient had generalized advanced periodontal bone loss. To relax while in the chair, she would place moist 2×2 gauze squares over her eyes and meditate. The doctor asked me to obtain a maxillary preliminary alginate impression.

As I removed the impression from the patient’s mouth, I realized both maxillary central incisors were now missing. I quickly checked the impression, and to my absolute horror, there were the doctor’s mother’s two maxillary central incisors, sitting in the alginate impression!”








Exit Interviews: Why Do Them and What To Ask

Editor’s note: This is the first of two blogs in our series about exit interviews.

No matter their reason for leaving, nor if they were fired or quit, each outgoing employee should be asked a series of questions as part of an official exit interview.

In her blog post about exit interviews for Glassdoor for Employees–one of the worlds largest recruiting websites–Jessica Miller-Merrell writes that one of the best ways to get honest feedback is to ask employees who no longer rely on you for their livelihood. 

“Employee exit interviews can reveal powerful insights that you wouldn’t have access to otherwise,” she writes.

Miller Merrell goes on to write that businesses can conduct exit interviews face-to-face, build an exit interview form or exit interview template using a service like Survey Monkey, or encourage company reviews on Glassdoor.

Below are questions Miller-Merrell suggests should be a part of the exit interview.

1. Why did you begin looking for a new job?

“Asking this sample exit interview question opens up the opportunity for a variety of answers,” Miller-Merrell writes. “You may see that an employee simply needed a job closer to home, or it may point to a specific instance or situation that sparked the search.”

2. What ultimately led you to accept the new position?

“This is a good exit interview question because it will allow you to contrast your company’s position with a different organization’s,” she writes. “The key to this answer is actually in what you don’t see. For instance, if an employee indicates that they are leaving for higher pay, this could mean that your compensation package isn’t competitive enough.”

3. Did you feel that you were equipped to do your job well?

“If you want a direct way to better retain the employee who fills this position next, ask this question,” Miller-Merrell writes. “It’s one of the best exit interview questions that will help you generate an immediate proactive response. Be prepared for tales of technology woes, inadequate training and more, but also be prepared to gain valuable knowledge of what you can do better next time.”

4. How would you describe the culture of our company?

“This question isn’t probing for specific examples but instead will help you identify trends,” she writes. “As you keep track of employee exit interviews, watch for trends throughout to help you identify real concerns. Identifying trends can also help you separate legitimate concerns from the personal opinion of employees who are emotional or feel negatively about the company.”

5. Can you provide more information, such as specific examples?

“Your natural reaction may be to shy away from asking for specific examples, but this follow-up question, which is beneficial throughout your survey, may reveal personnel problems or other things that are easily fixed, preventing the loss of another employee,” writes Miller-Merrell.

6. What could have been done for you to remain employed here?

“There is no question more direct than this one,” she suggests. “Often, a frank question will give employees an opportunity to open up where they were afraid to before. Obviously, this question isn’t aimed at fulfilling their request in order to keep them employed there, but it will help in the future.”

7. Did you share your concerns with anyone at the company prior to leaving?

“This common question points back to your employee culture and whether your employee felt comfortable to share concerns with superiors or coworkers,” Miller-Merrell writes. “The key here is to understand if you promote an environment where employees feel safe and comfortable to voice their opinions.”

8. If you could change anything about your job or the company, what would you change?

“Though you’ll likely gain a lot of insight throughout the exit interview, this question will help the employee to focus in on the biggest or most important reason they’re leaving your company,” she writes. “This is also a non-confrontational way to encourage them to reveal the real reason they’re leaving, as it isn’t asking what they didn’t like, but what they would change. It shifts their answer from a complaint to a suggestion, which many people feel more comfortable providing. Often, just the way we ask a question can make all the difference.”

9. Management is often a key factor in an employees decision to leave. Were you satisfied with the way you were managed?

“Asking your former employee about management is critical. Understanding if there’s any issues or direct problems will help you take preventative measures from losing future talent,” Miller-Merrell writes. 

10. Did you have clear goals and objectives?

“Employees don’t like feeling like they’re just a cog in the machine,” she writes. They want to know that their work matters and helps drive towards a greater goal.”

11. Did you receive constructive feedback to help you improve your performance?

“Again, your employees don’t want to feel like they’re stagnant,” she writes. “Understanding their personal objectives, and helping them improve their arsenal of skills should be a key area of focus.”

12. How can our company improve training and development programs?

“This ties into your ability to engage employees,” she writes. “Higher engagement leads to higher employee retention.”

13. Would you consider coming back to work here in the future? In what area or function? What would need to change?

“Find out if employees would ever consider coming back,” writes Miller-Merrell. “It could be that they just want to gain experience in a particular role, or may want an increase in compensation. Regardless, this is great information to have if different roles of interest open up.”

Come up with a plan

If it hasn’t been your practice’s policy to give exit interviews, you might want to reconsider. 

Go over the above questions, use what you like, toss what you don’t and feel free to add in individualized questions based on your practice. 

Next, figure out how you will administer these interviews. Face-to-face? Online survey? Mailed letter? 

Make sure you get everything squared away so that when your next employee either quits or gets fired, you’re prepared to administer the interview. You never know what you’ll learn! 


Examining a Daily-Rate-Pay for Hygienists

In their July Dental Economics article “‘Daily rate’ pay for hygienists” What could be wrong with that?” Rebecca Boartfield and Tim Twigg explore the concept of paying hygienists a flat rate for a day’s work.

“It’s a myth in the dental industry that a daily rate covers it all, reduced problems and even makes payroll easier” Boartfield and Twigg write. 

As non-exempt employés—which most of them are—hygienists must be paid for all hours they work. This is true, Boartfield and Twigg write, regardless of whether they’re paid, hourly, salary or a daily rate. 

“This is where dentists run into trouble with daily rate pay,” the pair writes. “It is common to believe that ‘a day’s worth of work’ can be any number of hours and all those hours will be covered by the daily rate.”

But Boartfield and Twigg say this isn’t true.

It’s important that the daily rate is defined, and if the employee works more than what is agreed upon, they must be paid more. 

“For example, you may have a daily rate of $400 for eight hours of work,” they write. “If the hygienist works nine hours, his or her daily rate must be increased due to that one extra hour of work that is not covered by the daily rate.”

Defining the daily rate should always be done in writing. If there is no overtime law in the state in which you practice, the rate can cover more than eight hours a day, however it must be closely tied to the hours the hygienist will actually work. For example, you can’t say it covers 10 hours if the employee usually works eight.

The pair go onto write that another misconception is that daily rate pay means eliminating the burden of tracking employee hours.

“Under both federal and state laws, employers must record the hours worked by nonexempt employees,” they write. “The method of compensation does not eliminate this requirement. Therefore, even with daily rate pay, hygienists must track their hours.”

Nonexempt employees are eligible for overtime, and overtime must be paid when an employee works more than 40 hours in a week under state law or more than than a certain numbers of hours a day under federal law per some state laws. 

Because of this, the pair writes, pay must be increased when overtime is worked, and overtime pay is time and one-half. So, if an employee makes $400 in a day, they would make $450 on a day in which overtime is worked.

While you are required to increase pay when employees work more, you are not required to pay a full daily rate when employees work less,” they write. “Thus, if an employee’s daily rate is defined as eight hours of work and the per- son works only four hours, the daily rate can be reduced to reflect the shortage of hours. If you plan on doing this, be sure this is clearly outlined in writing to prevent any misunderstandings.”

Because of the above information, Boartfield and Twigg ultimately question whether or not a daily rate pay should be used, as it seems to fail to accomplished what it’s intended to do. And Boartfield and Twigg even go as far as to say this kind of payment makes things more complicated.

“For nonexempt employees, nothing is more straightforward than hourly pay,” they write. “Daily rate has been misconstrued to be something that it is not, and all dentists would be well advised to revisit their pay practices going forward.”



Helping Patients with Dental Phobia

According to WebMD, between 9% and 20% of Americans avoid going to the dentist because of extreme dental anxiety.

I’m betting that if you’re reading this and you’re in the dental industry, you’ve experienced this multiple times in your career, and maybe even multiple times a day. 

In her DenstistryIQ article “How to help your patients overcome dental phobia,” Dr. Leslie Townsend explains the problem and gives possible solutions to best soothing nervous patients.

“Every dentist experiences this on an almost daily basis – the terrified patient who cannot relax, no matter how well you explain that you’re not in the torture business,” she writes. “It’s a problem that knows no borders.”

Townsend goes on to write that a fear of going to the dentist can be found all over the world. Researchers in India studied the fear that the sound of a drill produces in patients, a study of women in Brazil linked their fear to socioeconomic factors, and dentists in Turkey, Singapore and the U.K. are trying to figure out what clothing the dental staff can wear that will help comfort their pediatric patients.

Understanding the phobia

At the most basic level, Townsend writes, the fear could come from letting a stranger put their fingers in the patient’s mouth, which goes against survival mechanisms to protect sensitive gums and vulnerable airways.

But some people suffer from more specific fears–needles, drills, gagging, choking or pain–which is called dentophobia or odontophobia. 

“If patients confide in you about their anxiety – which will probably be all too apparent to you anyway – take a moment to try to understand what they’re afraid of,” she writes. “This will help you figure out the best way to help your patients cope.”

Townsend writes that just the simple act of asking about a patient’s anxiety will help them to relax, as it makes you appear more human  and interested in them, and less likely to hurt them.


According to studies, what you wear should depend on who your patients are. 

Townsend writes about studies conducted on children and their parents in Singapore, Turkey and the U.K. Both children and their parents in preferred that dentists wear personal protective equipment. However, children in Singapore and the U.K wanted informally dressed dentists, while Turkish children favored formal attire for their dentists.

The children in Singapore also preferred dentists of their own gender and ethnicity, but their parents mostly preferred young female dentists of the same ethnicity. The U.K. study found that children were more comfortable with a dentist of their own gender. 

“While you can’t do much about your ethnicity and gender, you can tailor your clothing to your clientele,” Townsend writes. “These studies also suggest that having both male and female dentists on staff could be good for business.”

Being a good dental role model

Townsend writes that those who have a dental phobia probably got it from their parents.

“With all the things going against us in our efforts to calm patients – pain, noisy drills, needles – the last thing we need is for parents to pass their dental fears on to their children,” she writes. “But this fear was probably passed down to them from their parents, and down the line, back to when their forefathers had one relative designated as the “family tooth puller.” Now that was painful!”

Townsend goes onto write that a Spanish study published in a 2014 issue of the International Journal of Paediatric Dentistryfound that fathers’ fears of dentistry had an especially strong impact on children.

So, how do parents raise fearless little patients?

Townsend suggests informing new patients of the importance of starting dental care early and encourage them to not share their own fears about the dentist with their children. 

Promote self care

Townsend thinks it’s important to help patients help themselves.

“Reassure them that all they need to do is give you a signal if they need more Novocain,” she writes. “Encourage your patients to close their eyes, put on headphones, and listen to whatever music calms them. Tell them to go ahead and zone out; you’ll squeeze their hand if you need to get their attention.”

If new patients call to schedule appointments and it’s apparent they have a dental phobia, she suggests to have your staff invite them in for a scaled-back getting-to-know-you appointment.

“Develop rapport, and they may become regular patients,” she writes. “Either way, by helping patients overcome their fears, you’ll have done your part for the greater good of humanity – or at least for humanity’s dental health.”