Issue link: https://beckershealthcare.uberflip.com/i/1472872
25 BECKER'S DENTAL + DSO REVIEW // VOL. 2022 NO. 2 THOUGHT LEADERSHIP especially revenue generated from den- tal hygiene care, have actually declined due to inflation. These fees were already often at loss-leader low levels to begin with. Numbers of insurance companies have held their fee schedules static or near-static for many years. Plus, added COVID-19 infection control safety mea- sures elevated overhead expenses and time to process patients through a hy- giene operatory. Dental practice owners had tough choic- es to make. Some were in a demograph- ic in which they could raise fees to cover the actual overhead expenses for these hygiene services, but not many. Others elected to run their hygiene staff on an assembly line treadmill. If enough pa- tients were run through the process quickly enough, regardless of favorable patient outcomes, production revenue could keep up with overhead outlays. Concurrently, salaries for hygienists were held to the status quo. Naturally, profes- sional hygienists burned out. Many have left the dental industry forever. Holli Perez. Co-founder and Chief Mar- keting Officer of DirectDental: Prior to 2020, the dental field was already suf- fering from a shortage of hygienists. The pandemic definitely exacerbated it. Not only did many hygienists leave the field completely, but the hygienists that con- tinued to work are putting their health and families before their careers. The hygienists that are willing to work won't work more than three days a week. Reasons why they are leaving the work- force or working part-time: • Their health — many don't feel com- fortable returning to work either due to COVID-19, the vaccine mandate or just their mental health. • They decided to stay at home with their kids — several hygienists I have spoken with haven't returned to work or returned their children to school. They are now homeschooling them. • Left the operatory — many found ca- reers outside of dentistry or stayed in dental but either started their own business or broke into sales. • Retired early — a huge amount of my hygienists simply retired. It is predicted that dental practices are going to continue to struggle with hir- ing hygienists for years to come, which means offices should: • Offer pay above the average rate and post that at the top of the job listing. • If you need to hire someone for three or more days a week, try splitting it between two or more hygienists. • Offer benefits to your hygienists. • When you get an applicant, call and text them right away. • Have a fast hiring process; don't let another office scoop them up. • Work with your local schools and recruiters. Mina Kim, DDS. Bryant Park Dental (New York City): Many dental hygienists who were close to retiring decided to leave during COVID-19. They have the most exposure to airborne pathogens on the dental team. Hygienists also say they feel overworked and undervalued by their practices. There is a smaller sup- ply of hygienists and greater demand. This disparity is leading to difficulty in recruiting hygienists. Charles Rim, DDS. Oregon State Hospi- tal (Salem): Early in the pandemic, fed- eral, state and local regulatory agencies recommended dental facilities to post- pone elective procedures, surgeries and nonurgent visits, and prioritize urgent and emergency visits and procedures until further notice due to dental health- care personnel being at very high risk for exposure to COVID-19. In response to the early pandemic recommendations, oral health facilities provided limited dental services or temporarily closed. With limited supply of personal pro- tective equipment and dental services, many DHCP left the workforce involun- tarily and voluntarily. As the job market is stabilizing with ample opportunities and higher pay attracting DHCP to find work elsewhere, oral health facilities will continue to experience challenges with recruiting and retaining DHCP, including dental hygienists. Robert Boff, DMD. Ramsey (N.J.) Fami- ly Dental: Insurance reimbursement for procedures performed by the hygien- ist aren't keeping up with hourly pay demands. Dentists are being forced to shorten hygiene appointments and/or cut back on services performed to create a profitable appointment. Hygienists are being forced to work harder and faster, resulting in a less rewarding work expe- rience. Not being happy with the daily work experience is chasing hygienists away from the dental workforce. As far as recruiting, we're seeing more dental offices poaching hygienists from their current offices. Dentists are desper- ate to find a hygienist and will offer what- ever it takes to hire one, even if they are currently employed. DSOs are bigger and can offer more in the benefit pack- age than most solo practitioners can pro- vide … very hard to compete with that. Flavia Lamberghini, DDS. Apple Dental Care (Chicago): The dental hygienists leaving the workforce could have sever- al multifactorial explanations that started long before the COVID-19 era, child-rear- ing responsibilities being the first reason listed in a 2007 study, followed by health reasons and pursuing a different career. COVID-19 has just aggravated the situ- ation, with dental hygienists being one of the most exposed roles when we talk about virus transmission. Dental practices are experiencing chal- lenges in recruiting any type of help these days, with dental hygienists prob- ably being the most required job in the field. A combination of hygienists leav- ing dentistry in high numbers together with dental hygiene schools not gradu- ating classes at the same rate as dental schools has aggravated the situation and made the shortage more noticeable. David Keller, DDS. Granite Dental (Van- couver, Wash.): I believe two forces are combining. Initially when COVID-19 struck, there was a lot of information that seemed to indicate that the clinical practice of dental hygiene would be very risky to hygienists. As more data comes out, that risk appears to have been over- stated. Nevertheless, to many dental hy- gienists it is simply easier to step away from the profession, especially when the short- to medium-term loss of that income doesn't cause too much discom- fort. The second force was how dentist/ owners responded to the COVID-19 concerns raised by team members. Hav- ing concerns not responded to in a posi- tive way again gave a valid reason to step away for a time and consider alternatives to the current working environment.