Hygienists as Entrepreneurs – Part 1

April 17, 2023

Hygienists as Entrepreneurs – Part 1.

The definition of an entrepreneur: One who organizes, manages, and assumes the risk of a business.  

A successful hygienist must view herself as an entrepreneur in the practice.  The dentist, as an entrepreneur, must shoulder tremendous financial and clinical responsibility.  It is incumbent on the hygienist, as the second most highly trained individual person in the practice, to bear this responsibility and the operational and clinical management of the hygiene department.

The hygienist’s attitude and self-image are the cornerstones of a successful practice.  Is the hygienist a health care professional, or merely someone who is trained to clean teeth?

What is the hygienist’s philosophy statement about the services provided to patients?  Is this statement in harmony with the dentist’s?

The hygienist must be a mature, caring professional who takes the individual needs of each patient to heart and who does everything possible to assure herself that no patient leaves the practice with untreated dental disease.

One of the most exciting areas for broadening hygiene responsibilities is in the management of patient health and mastering the necessary communication techniques specific to achieving this.  Hygiene tasks will become routine, but patient responses will always be new and unpredictable.

The greatest value a hygienist gives to a dental practice is her ability to motivate the patients to accept treatment and increase case acceptance.

As the only other primary caregiver in the practice who has prolonged access to the patient, the hygienist has a responsibility to their patients to motivate them to accept needed care.

It is important to know that a patient must buy the services of the practice to insure a healthy dentition.  Ethically, we must sell needed dentistry to patients who may not perceive the need.

Many patients are in denial about their need for dentistry.

Unfortunately, many patients will only accept care when it is covered by their insurance.

Regardless of the patient’s rationale, it isn’t permissible to allow patients to postpone treatment until the situation degenerates into a serious problem.  Patients are the losers when you cannot communicate the need and non-clinical benefit of the dentistry diagnosis.

Ask any dental professional if it is their responsibility to eliminate or prevent dental disease, and they will say “yes.”  However, this is not occurring in many dental offices because dentists and other team members do not know how to motivate patients to say “yes” successfully.  

Instead, dental teams rationalize their inability to sell dentistry properly by claiming that selling dentistry is unethical.  In reality, what is unethical is allowing patients to leave the office with untreated dental disease.  Therefore, it is critical that you do everything within your power to influence patients to accept recommended treatment.

The influencing cycle includes eight steps:

  1. Determine the patient’s need vs. want levels. Usually, dentistry is not essential.  Therefore you are competing with vacations for the dental dollar, not other dentists. A diagnosis that uncovers a need isn’t enough. You must build value for treatment so patients will want it.  This is done by asking needs development questions which the patient must respond to with the benefits for him/her of the proposed treatment. Needs alone are not enough to motivate patients, especially if there is no pain.  To get the wants, you must identify the non-clinical benefit operating for this patient.
  2. Listening to patients’ answers to these questions. Active listening is important.  Patients will only listen to you if you have listened to them first. Active listening encourages patients to elaborate on what they mean.
    1. Ask the patient a question.
    2. Let the patient answer the question without any interruption.
    3. Repeat a paraphrased version of the answer back to the patient to show that you’ve heard them.
    4. Include any emotion or logic that you’ve heard that you may use to build your case for treatment acceptance.
    5. Ask another question to draw more information from the patient.


Six Ways to Listen

  1. Concentrate 100 percent on the speaker
  2. Use body language to tell the speaker you’re listening. Lean forward, keep direct eye contact, stay two to three feet from the speaker, and nod your head yes to show understanding.
  3. Use words of encouragement during brief pauses to keep the speaker talking.
  4. Relate in your own words what the speaker has just said.
  5. Interpret what you’ve heard for clarification.
  6. Acknowledge what you’ve heard without agreeing.

Determine dominant motivators and concerns.  Patients base their decisions for dentistry on emotion and justify them with logic. The dental team must accomplish two objectives:

  • Discover the patient’s motivator through active listening to need development questions.
  • Relate the dental diagnosis to the emotional motivator so that patients see value in the recommended treatment.

Unfortunately, the team tries to influence the patient through logic emphasizing the clinical reason to have the treatment performed.  If you don’t use both logic and emotion, the patient won’t say yes.

Patient motivators are always documented in a standard place in the chart.  These are from the new patient experience and are reviewed at the morning huddle.  New information will be written in the chart.

Some emotional motivators:

  • Esthetics
  • Function
  • Health
  • Avoid pain
  • Avoid future expense
  • Protect past investments
  • Guilt
  • Peer pressure
  • Status
  • Prevention

The most common objections are:

  • Time
  • Pain
  • Money
  • Fear
  • Embarrassment
  • Anger
  • Frustration

It is best to tie the consult to one or two dominant treatment hot buttons.

Now the hygienist should describe the treatment based on the one or two more dominant hot buttons and how treatment will solve those problems.