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Base pay plus commission

My dentist is offering me a job as a hygienist and she wants to try base pay plus commission. She’s never done it before and I have no idea how it works. In our office, the hygienist just probes, cleans and does pt education. The only thing we offer is their tx, Peridex and FLV. Anyone out there, how does it work? What percentages are used? What’s the average you make? What else does your office offer to increase production? Thank you!



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4 Answers

You should be making 35% of your production (anything that happens in your operatory – this includes radiographs), whether its straight commission or base pay plus commission. If you can see what the hygienist’s production numbers are now, that can give you a good idea of where to start with your calculations. I would also recommend that you check out your state’s employment department or bureau of labor website to find an occupational wage breakdown for hygienists in your specific area (much more accurate than salary.com or salary surveys I’ve seen) to again, see what hourly amount you should be shooting for. Means the dentist has never paid this way, it may be smart to request a review any where from 30-90 days working like this, in case adjustments need to be made. The simplest way to increase production is to simply properly diagnose perio. So many patients have perio, but are not being fully treated for it (receiving prophys) or are not on the correct recall (3-4 months instead of 6 months). Some dentists offer incentives to hygienists for patients who complete SRPs; I find this to be a slippery slope because you may start seeing dollar signs instead of accurately treatment planning for your patients. Other ways to increase production are whitening and selling electric toothbrushes, water flossers, fluoride treatments, Rx fluoride toothpaste, MI paste, etc. I’m not a big fan of “selling,” as we are dealing with peoples’ health, not selling them a car. I feel that if you recommend the best treatment and products for your patients, and if the pay structure is fair (equaling 35%), you should be hitting your production goals.

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I get paid production. When I was first starting out, they gave had a “safe” base rate, where if my production for the shift equaled out to be less than the base rate, I had that safety net. I now make straight production and wouldn’t have it any other way. You are in control of your pay. It’s a learning curve though. We sell H2Oral Irrigators, Sonicare, Air Flosser, and really easy ways to boost your production that our dentists let us get production for is fluoride treatments (especially for adults– this isn’t recommended often for some reason in other offices I’ve seen)and sealants are also a great preventive measure that are not recommended nearly enough… again… on adults too! I got a cavity in #12 occlusal for heavens sakes. NO one is safe!

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Unfortunately, the patient does not have the perio probings done on the first visit. The DA’s do the xrays (we still have films) the dentist does the exam, spot probes and then makes their tx plan. I’m thinking it’s because the office can bill two seperate exams to get paid for both (comprehensive and perio). I don’t get it because offices I shadow at, they always do it on first visit. I believe the idea though came from Lisa Weber RDH, but I could be wrong. As for production for hygiene, we only have Peridex and FLV. No electric toothbrushes, no Arestin, no air flossers. That’s why I’m confused as to how to build production. Thank you for your response!

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How would you even schedule a patient for the correct treatment without probe depths at the first appointment!? This isn’t even a sound protocol! If that’s all you have as far as patient products, there isn’t going to be much of a way for you to build production. Maybe that’s why the doctor wants to pay you this way; thinking they are going to be paying you less. This is a very tricky situation that I’m not sure I would personally like to be in. Good luck!

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