Correspondence | Published:

Letters - ‘It is just not possible to do a great job’

BDJ Team volume 5, Article number: 18046 (2018) | Download Citation

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Dear Editor,

I would like to explain why I think, as an experienced dental hygienist, that longer appointment time slots are better all round and more profitable.

On an average day you see 14 patients in a 9-5 day with 30 minute slots.

With 45 minute slots you would see nine patients in the same amount of time.

With the longer appointment slots you would make the same money per appointment as the appointments would be charged appropriately and therefore the amount of money you would save seeing an average of 25 patients fewer per week is huge.

With an average of five patients fewer per day with no less remuneration on the appointment costs, the amount that would be saved at the end of each month is substantial. Even if the 45 minute appointment slot was charged at less than what one and a half 30 minute appointments would amount to, money would still be saved.

What would be saved in consumables in a single day based on having 45 minute appointment slots as opposed to 30 minute appointment slots is the following:

  • 16 pairs of gloves (based on a hygienist working alone without a nurse therefore at least three pairs of gloves per appointment for setting up ... gloves/operating gloves/cleaning down gloves/end of day emptying waste and changing bins etc)

  • 20 wipes (use at least four per appointment)

  • Five saliva ejectors a day

  • Tissues

  • Five bibs

  • Ten stera pouches

  • Five prophy brushes

  • Five TePes

  • Floss

  • Mouthwash

  • Five plastic cups.

What would be saved in general is the following:

  • Clinical waste bags

  • General waste

  • Sterilisation use and electricity

  • Paper and printing of treatment plans and receipts

  • Complaints.

When a dental hygienist works alone at the pace of 30 minute appointments back to back, the amount of things that go wrong due to rushing is vast and this ALWAYS results in either time lost (eg running to the steriliser for more equipment) or money lost (eg have to change gloves to pick something up or wipe something down that has been dropped due to the fast, relentless pace).

However, this stands for any appointment times that are back to back, as the slot is for the clinician and not for the patient. If patients are told that they will be getting ‘30 minutes’ or ‘45 minutes’ and the next patient booked in believes they will be in the chair at that same time the last patient has been told they will be treated until, it is very misleading and completely impractical.

Based on a 45 minute appointment slot, the patient should be told that they will be in and out within a certain amount of time if they ask (otherwise it is simply a ‘hygiene appointment’) but that the appointment is tailored to their needs and will be around 30-35 minutes. Of course if longer or less time is then needed then it is there to be taken and this is doing the best for the patient and will mean there are no complaints regarding time.

Dental hygienists want to provide the absolute best they can and the way that many practices are running the hygiene book, it is just not possible to do a great job as well as write thorough notes and follow all protocols required on time.

The patients would soon be happy to accept the appointment and cost difference when they experience the difference of having a smooth appointment with happy staff that are not rushing or stressed and they get the quality they deserve.

Once the appointments are set as a 45 minute slot each, the patients have been informed appropriately of their time, and the hygiene books are fully booked and for longer, the practice will run much more smoothly. Staff will be happier and they would be maintained for longer which is in the best interests of patient continuity of care. I for one would also be happy to work longer hours if this was the arrangement because it would not be so exhausting and stressful.

Unfortunately I am now looking for an alternative career which is very sad and this is because the work is becoming more difficult by the day with most appointments having been reduced to 30 minutes across London.

Name supplied, by email

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https://doi.org/10.1038/bdjteam.2018.46

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