The practice has two offices and each office has its own pediatric dentist - there is no going between practices.
The first office (A) is very busy, runs 3 columns which consists of a column of restorative and two columns of hygiene. The dentist there sees all the restorative and does all the hygiene (no hygienist). His daily production is the sum of all three columns of which he get 100% credit towards his production. This includes exams, prophys, F-, x-rays. A typical day might consist of 30 patients (10 restorative and 20 hygiene). Making up numbers lets say his average daily production is $5000 per day (which is also the production for the entire practice). Based on the above formula he gets paid on average $2200 per day.
The second office (B) is also very busy, runs 3 columns which consists of a restorative and two columns of hygiene BUT he uses a hygienist who is paid $300 per day. Hygiene at this practice is very busy and he takes a fair bit of his time doing checks. This doctor gets credit for his operative and $40 per hygiene check. The prophy, F- and x-rays get credited to the hygienist who is not paid on production and that money disappears into the practice. A typical day might consist 45 patients (10 restorative and 35 hygiene). The total production on average for this practice is $7000 per day of which the doctor gets credited for $3500 and is thus paid $1520 for the day.
As an aside, where the production from the x-rays and F- goes all depends on who did the prophy. Patient sees the hygienist, the assistant takes x-rays and the prophy and F- are done by hygienist, hygienist gets full credit minus the exam. Same patient comes in and is scheduled in the doctor’s column, same assistant takes x-ray, doctor does prophy, F- and now doctor get full credit for visit including x-rays.
My questions:
1. Is this an unfair system here that the doctor overseeing the busier and more productive practice is getting paid less?
No. The doctors in each practice are getting paid for what they produce, correct? Doctor in practice B has an easier day if they have hygiene doing the prophys. Doctor in practice A is doing their own hygiene, working harder, getting paid more. Makes sense to me. What doesn't make sense is why the doctor in practice B isn't seeing 20 restorative patients per day since they're not doing the hygiene????? Then they'd make more!
2. Is it unreasonable to credit the doctor in the busier practice with x-rays since he is ultimately the one who reads them and assistants take them?
Most practices give credit on x-rays to those that take them. Simply because the doctor in the busier practice isn't busier than the doctor in the other practice and therefore, makes less. This doesn't mean you should start looking for ways to pay them more, you should look for ways to make them MORE productive!
3. Do you have any other ideas for compensation with these two scenarios?
Seems to me what you're doing is fine and fair to each, why change?
I guess what I'm getting at is this system makes it more advantageous for the doctor in practice B, whose practice currently produces more, to fire the hygienist and produce less money overall by seeing all the patients himself. Why would the owners of the practice want that to happen?
Wow? Why on earth would a doctor WANT to fire a hygienist to do their own hygiene in a busy practice? If the practice is that much busier, the doctor in practice B needs to stop getting on the internet and fill their column\chair\rooms with dentistry from all those patients.
Seems to me the reason why the doctor in practice A is only seeing 10 restorative patients per days is because they're too damn busy doing their own hygiene, if they weren't doing hygiene wouldn't they have MORE time to do MORE dentistry? Maybe there aren't enough chairs!
Maybe I’m in left field with this, anyone else seeing this differently?
Just looking for ideas.
Thanks
This post first appeared on Dentaltown.
Send your questions to Tim Lott, CPA, CVA at tlott@dentalcpas.com
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