2016 Annual State of Dental Hygiene survey: Part III

With any profession, there are awesome aspects to the job but also downfalls and points of concern. So what are hygienists thinking about the dental hygiene profession?

To find out and as a way to evaluate the state of the dental hygiene profession, Modern Hygienist conducted its first Annual State of Dental Hygiene survey.

This non-scientific, anonymous survey covered topics from the basics of hours worked per week and pay structure to factors that contribute to on-the-job stress, burn out and how often hygienists are allowed to replace their instruments. In part three of the three-part series, we explore the survey results.

Parts one and two of the survey can be found by clicking here and here.

Stress and burnout

On-the-job stress

Hygienists were asked about which factors contribute most to on-the-job stress. Respondents were asked to check all that apply.

Answer Options

Response Percent

Response Count

There were many “Other” responses, with some very similar themes. From ethical issues causing stress, to the front desk and office manager being the biggest source of stress, to a whole host of problems with employers/doctors.

The first continuing theme was stress at the office due to the office manager and/or front desk. Some of these responses included: difficult front desk not respecting the time I need with patients; insufficient time given for appointments; difficult and unprofessional office manager and/or front desk; office manager cramming patients into a 20-minute time slot then getting mad because I can’t help the other team members out; front desk who has no training in dentistry setting the schedule inappropriately; dentist’s wife is office manager so not much front office duties get done - I have to see patients and do all billing; office manager with no dental training micromanages me as a trained hygienist; openings in the schedule and front desk is on Facebook not doing anything about it; and overbooking by front desk/office manager. Multiple times it was mentioned that the doctor’s wife being the office manager is the leading cause of stress.

The second continuing theme was stress caused by the dentist/employer. Some of these answers included: constantly falling behind schedule due to doctor’s poor time management skills; employer wants me to do more with less and less time; boss shows no appreciation; boss is a good dentist but a horrible employer; boss is an alcoholic; boss that’s all over the place and not focused; doctor will not adapt to new research and protocols; doctor only cares about production; poor pay, no benefits, no lunches, no raises, compensation is not adequate compared to patient load which all causes stress; doctor wanting quantity over quality; doctor allows insurance to dictate treatment; lack of leadership from dentist; lack of management and accountability by doctor; lack of respect to employees by the doctor; doctor exhibits favoritism; and boss has no business sense which causes a major amount of stress in the office.

While these aforementioned stressors are not fun to be dealing with by themselves, many hygienists are stressed in the office due to illegal and unethical practices by the dentist. Several of these responses included: unethical billing; doctor over-treats or under-diagnoses; being asked to do things under indirect supervision which is against my state’s practice act; illegal delegation of duties to employees who are untrained and uncertified; doctor “watches” disease instead of treats; must clock out for no shows; and employee safety/OSHA concerns are causing stress. While I could write a full article on each of the stressors listed under this question, when it comes to malpractice, neglect, insurance fraud, OSHA violations, and any illegal acts, I must chime in. If your concerns have been brought up to the doctor to no avail, it is your duty for the protection of the patients, to report to the State Dental Board. By no means am I saying we should turn into tattle-tails, however when there is a line of ethics that is being crossed the Board has no way of knowing or doing something about it unless it is reported. My dad always told me, “You may have not committed the robbery, but if you drove the getaway car knowing what went down, you are just as guilty, ethically-speaking.” Don’t allow yourself to be guilty by association, please do something about it if not for yourself, for your patients.

Other recurring themes causing stress included: additional duties such as selling is stressful; high production goals; office drama/politics; temping and facing incomplete chart notes; frequent turn over in employees at my office; co-workers not pulling their weight; dental assistant thinks she’s my boss; not having support from co-workers; and many stated that physical pain from being a hygienist causes stress. Lastly, a poignant answer to what causes the most stress for one hygienist was being treated as a piece of equipment instead of the professional I am. To say it is depressing to type this is an understatement.

It was then asked if you consider your typical day-to-day level of stress manageable. 92.4 percent of hygienists stated yes it’s manageable and 7.6 percent stated it wasn’t manageable.

Burn out

Do you feel burnt out?

Yes

A little bit

Not at all

Response Count

Health and mental state

Health of hygienists

1=extremely healthy - 5=extremely unhealthy

Answer Options

1

2

3

4

5

Rating average

Response count

How often do you experience periods where you feel physically exhausted, listless, and unable to cope?

Answer Options

Percent

Response Count

Response total: 3043    Rating: 2.62

How often do you experience periods when you feel emotionally exhausted, like you’ve given all you could?

Answer Options

Percent

Response Count

Response total: 3043     Rating: 2.77

How often do you experience periods of reduced interest in outside activities, decreased or increased appetite, unusual sleep patterns, fatigue, feelings of worthlessness or guilt and/or an overall depressed mood?

Answer Options

Percent

Response Count

Response total: 3043     Rating: 2.55

Perfectionism

Do you consider yourself a perfectionist?

Answer Options

Percent

Response Count

Response total: 3043    

Hygienists were further asked how they demonstrate any perfectionism they have. Attention to detail; being very thorough with each patient; leaving no stain or calculus; quality of care; everything has to be perfect in all that I do; OCD tendencies in all I do; clean/organized/orderly operatory; I need things to be done a certain way; constantly double and triple checking my work; infection control; time management; chart notes; and in structure and protocol were the most common answers.

Other responses included: whatever it takes attitude, I always go above and beyond; always do the job I would want someone to do for me or my family; exhibit perfectionism as a means of control; always prepared and proactive; believe in doing things right, I won’t quit or settle or cut corners; radiographs must be diagnostic; I always try to do a better job today than I did yesterday; rule follower; type A personality; I do not like any errors at all; I get frustrated/stressed/down on myself when I can’t do something just right or if things don’t turn out how I planned; don’t leave work until everything is done; and I do not like to start anything that I cannot finish to my standards and do not like to rush: perfection paralysis.

There was an area for respondents to comment. The comments pretty much mirrored the previous question. The exception being the most commented topic was the negatives surrounding corporate dentistry and greed outweighing patient care.

Conclusion

This survey has shown a great divide in how hygienists feel about the profession. While some hygienists feel very rewarded by the appreciation of their employer and their relationships with co-workers, others biggest frustration is their employer and/or co-workers. There’s also a gap in hygienists recommending dental hygiene as a career too. What is very clear is the saturation of the dental hygiene job market, the lack of benefits and raises, and many hygienists not being provided with the proper equipment and instruments to provide proper care to their patients. Realizing these issues is the first step to change. As hygienists, we need to stand up for what is fair not only for ourselves, but our patients. This begins with each individual dental hygienist. I want to thank everyone who took this survey. Your answers were honest and eye-opening.

This article is the third in a three-part series of survey responses. Parts one and two of the survey can be found here and here.