Announcer:
Welcome to the Double Your Production Podcast with the Team Training Institute, the one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it, who are in the trenches, who know exactly what you are going through. And now your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs.
Wendy Briggs:
Hi everybody, this is Wendy Briggs. Welcome to another episode of our Double Your Production Podcast. Today we are going to be talking about the state of hygiene in the world right now. And I am so excited to have invited an amazing guest, a longtime friend, and one of our world-class hygiene coaches, Bertha Triche. Hi Bert. Good to see you.
Bertha Triche:
Hi Wendy. Good morning. Happy Good Friday, right? It's Friday.
Wendy Briggs:
That's right. Yeah. This is awesome. So Bert, let's give our listeners just a little bit of your story, how we met, how you ended up to be where you are today, and why doctors and hygienists should be listening to what we're talking about here today.
Bertha Triche:
So I, on Cinco de Mayo will be 43 years a hygienist, and I guess I was probably 25 years, Wendy, when I met you. I was in a practice and had been in that practice for 25 years with the same doctor working for him. And he told me every day I was a wonderful hygienist and I believed him. And then I was sitting in a seminar and Wendy was on the stage and she started talking about all of these preventive services and how to risk assess a patient. And it suddenly hit me and him. Well, we still had things to learn and there was a lot we could do with our patients that we weren't doing. We were only doing what we knew and I had only ever worked for him. So I only knew that world. And so immediately we ran and bought the DVD program, Wendy, back then it was on DVD and we implemented that within a week.
Bertha Triche:
And in the month we had doubled hygiene production. And then of course we had you come in and do a year with us and we tripled hygiene production at that point without even doing any more hygiene, no more hours, no more hygienists were hired. We just changed the conversations we were having with our patients and started offering them the opportunity to get in front of their disease.
Bertha Triche:
And it was amazing what happened. And consequently, you were watching and I was good at this, I got really good at it. And you started talking to me on some calls and then eventually at 31 years I was ready for a change and Wendy was waiting and she said, "You'd be great." And of course I was, I'm going down with this ship, I'm not leaving. This is where I belong. This is my home. But as fate would have it, life brings us to new places and I saw an opportunity to maybe go in a different direction and Wendy was standing with open arms and offered me the opportunity to be a coach. And that was 12 years ago, on the 11th, which is next week. So I've been working with Wendy as a friend and partner for about 12 years now, coaching hygienists, and teams, and doctors all over the country. And it's been amazing. Yeah. And the state of hygiene today is different than it was when I was in the dental practice. So I'm happy to talk about those changes a little bit with you today, Wendy.
Wendy Briggs:
Yeah. Well Bert, it's been great having you along and we've long called you our secret weapon. And the reason we call you that is because of your longevity in the profession and because of your willingness to take something new and apply it, you are super talented at helping stuck, seasoned providers, let's say it that way, because we want to make sure we don't have any angry comments. Seasoned providers open their minds to a new way of thinking and embracing the latest science, and the latest products and services that can really elevate them as they care for patients.
Wendy Briggs:
So you're really, really good at helping those providers overcome any blockages or where they get stuck. And I'll have doctors that say, "I don't know what you're going to be able to do. I'm really worried about this provider." And then literally a week after you go there, I get these texts from the doctors saying, "Oh my gosh, you're not going to believe what happened. We've turned a corner, all of a sudden we've got new life." And it's been really awesome to watch your growth as a provider, but now your growth as a coach and a mentor to so many of our amazing providers. So it's been awesome watch that.
Bertha Triche:
I think it that's related to a few factors. One, is the incredible way that you have written this content and the delivery of the information. I often have said the difference with you being my coach in creating this opportunity for me at the level that it has been, was that many other consultants had told us why we needed to do what we needed to do and then what, offer fluoride, offer sealants. But nobody gave us the how, right in the way that you teach the how. And once I got that piece, that's what really kind of made me dangerous as a provider. And now, teaching the how, right? Because the bottom line is, in my world, most hygienists want to do what's best for their patient. But because of the insurance where we live in, they try to have those conversations without the right skills and the right verbiage.
Bertha Triche:
And so the patients they know, and then they throw their hands in the air defeated because they don't get anywhere right? With the patient. They want to make it about the insurance. So being able to have that conversation standing on the science, that was another piece that was so critical to me. And being able to say, "This is not just us saying you have these problems, this is the science saying this is what happens to people who have your problems." I think brought credence to the whole thing and then enabled me to be able to learn how to talk to patients so that they'd move forward.
Bertha Triche:
Now with hygienists a little bit different, but the fact that I've been a hygienist for 43 years and at 25 years I had to learn a new dance is very credible to them. And it makes it doable. It makes it believable, and it makes it doable. And I think once they listen to me for a little while, they realize I do have a lot of experience just as you do. That's what spoke to me when you spoke is that this lady knows what she's talking about. This is exactly what we deal with at the chair. And so that makes it real. And so if I could do it, then they can probably do it. And I think that getting them to believe that it's possible is a large part of the success that I've had as a coach. And just the fact that I've been in the business for so long and still get excited about the fact that I can teach. I often say my what has changed, I'm not one-on-one with patients anymore affecting direct health with the patient, but I certainly do it through those hygienists that we're privileged enough to be able to coach and then it changes their care for their patients. So the what's different, but the mission's still the same. We change the dental health of the world. That's what we do.
Wendy Briggs:
And your reach is extended instead of just, your little community of Lutcher Louisiana, right?
Bertha Triche:
Right.
Wendy Briggs:
Your impact has ripples. So every hygienist we coach is able to impact all of the patients that they serve. And that's probably one of the most rewarding things that we deal with. But let's take just a minute and dig into our topic today because the topic that we're going to be talking about today, I think is so critical. The people that are throwing their hands up in the air right now in many practices across the country are the doctors. 'Cause there's been such a shift in availability of hygienists. We know really great dentists with the great culture and a great practice that haven't been able to hire or find a provider in their practice. But we also see an interesting element trickling into some markets of entitlement and almost impossible demands from the hygienist.
Wendy Briggs:
So I want to read a post that I saw on a dental group forum on Facebook just the other day. And we have obviously a very different perspective than many hygienists because we've been out in the trenches and we know what's possible. So things like this really upset me. I'm sure they do yours, but this was posted by a hygiene provider on a dental hygiene group page, and of course as it was screenshot and then shared to a dental group and it said, "Currently the standard rate for an RDH is $65 to $80 an hour. Do not accept less. $45 an hour was 10 years ago. Have you ever asked yourself why some offices have two to three hygienists with full schedules, but only one doctor who sees four to six patients a day? Because we make them money, don't sell yourself low, living expenses have gone up and so did the office fees."
Wendy Briggs:
So I see posts like that, and I'm instantly frustrated and irritated because in my opinion, that's such a shortsighted belief and it's giving all of the hygienists in the country a really bad reputation. For years, I've had to kind of dissuade the notion that we're divas and are primadonnas and we're demanding. And certainly, I'm not saying that there aren't people that are like that, but in our experience, we work with a lot of amazing providers who really do want what's best for the patient. And so this shift into, I guess me, me, me mentality away from what's best for the patient, how can we help our practice grow? Dentistry's a team sport has been really, really difficult for me to swallow as it has our doctors. So I wanted to have this conversation, hygienist to hygienist, coach to coach, high level producer to high level producer, and talk to our doctors that listen to this program about how they can combat this.
Wendy Briggs:
What options do they have to deal with this mentality of hygienists, number one. Number two, how do we deal with that? Especially in a market when hygienists are coming through the door asking for $65 to $80 an hour, and we know that's not sustainable. How do we deal with hygienists that are already compensated very well, that are demanding more or thinking they deserve more? So no matter what we compensate, they're not quite happy. I know you've had some experiences with that recently, Bert. So maybe just share some insights, some thoughts that you have about the state of hygiene today, the relationship between hygienists and doctors, and where do we go from here?
Bertha Triche:
So my initial thought is somebody who's demanding $80 an hour, and we know with the PPO compensations, it's a struggle for some hygienist to even get to a thousand a day and at $80 an hour on an eight-hour day, that's $640. In my world is no different than them gouging us with gas prices in a crisis situation like when we have hurricanes here in Louisiana and the cost of wood goes up three times because they can, because people are desperate, need it. So in that vein, that is so shortsighted, first of all, by the hygienist. And secondly, I get real concerned that we are shooting ourselves in the foot as a profession because I can see a day, and we have heard it where dentists are going to go, "Listen, I'm not going to have this in my practice. I'm just not going to have a hygienist. I can hire an associate, they can do the prophies and do the restorative in the same appointment. And that's a better deal for me. And I don't have the drama that goes along with that." So, that in my world, is very dangerous for us as a profession to be demanding these kinds of hourly wages.
Bertha Triche:
My work around with that and what I always saw as such a great advantage working with the doctor I did, and it was at your suggestion is have some type of incentive in place so that they do have the capability to earn that money, but it's based on a higher standard of care. I also get the primadonna mentality when somebody says, "Well, now I want $80 an hour to do the same thing that I was doing for $60 an hour, or $55 an hour and I don't want to do any more." And then the comment about, "Well, I've seen practices with three hygienists and one doctor and we're doing all the work and they're not, they see four patients a day." In my world-
Wendy Briggs:
First of all, I don't know a doctor that only sees four patients a day, right? No, I mean that's a pipe dream that doesn't happen.
Bertha Triche:
... And the other thing is what are we doing on our side to help grow that doctor's production, which is a big part of the treatment advocate role in what we teach and what we do. So instead of sitting back and going, well, we're making them all the money, so we deserve all the money. Why don't we look at what skills can we develop to help develop that side of the practice as well? So that the doctor is doing better and can do better. So that is such a me, me, me attitude and it destroys culture. That's the other thing. Dentistry is a team sport. I see that. I see this elevated opinion of who we are and what we do. And yeah, it creates resentment amongst the team members that we can sit back and demand that for doing the same work that we were originally being paid $45 to $50 an hour.
Bertha Triche:
And I don't think $45 is 10 years ago. I know many states where hygiene providers only make $28 to $30 an hour. It just depends where you are. So it is difficult for the doctors and I feel like that is a taking advantage of a bad situation in the shortage that has occurred because of COVID. And it's not fair to anyone, the team, the patients, I don't believe it's fair to the patients because they're not getting a higher level of care. They're only getting the same, which is the tooth scraping mentality. And then it's not fair to the doctor. I mean, I just had a conversation this morning. This is interesting. My cousin is a wheelchair salesman and he did great last year, but because Medicare and Medicaid have not kept up with the increased cost of building these wheelchairs, he's now, all of his benefits, a lot of them are being taken away. They're going to have to sign a new contract with a new salary adjustment because of the industry and what they're faced with. They're just not making money. Some of them have been declaring bankruptcy, reorganization bankruptcy because of this, and I see PPOs in the same way. They don't pay at the same level as private practice. So are we going to price ourselves outside the market is what my question would be? Be careful not to shoot yourself in the foot with that.
Wendy Briggs:
And I think that's a refreshing opinion, a frame of mind. And I can tell you that's what I feel. I fear that as well. And I hear that from doctors. There is resentment and we've long taught what goes around comes around. So we've long taught we love teamishness and we loathe selfishness. So for us, this goes against what we teach hygienists. If we really want to maximize our roles and create a bigger future for ourselves, we have to be focused on the impact of these decisions or these demands and what it has on our teams, and our doctors long term. And I can tell you that dentists have long memories. So if you step up and you go above and beyond for your patients, that's remembered and it's highly valued. We have to remind our listeners that most of the practices we work with really value their hygiene departments and they understand we become really capable partners in helping the doctors accomplish their vision.
Wendy Briggs:
And what I hate to see is, I hate to see our profession take a step back in all the ground we've gained in recent years in becoming a partner with our doctors and helping drive case acceptance and some of the things that you mentioned. I also think that if we're demanding so much an hour, now granted that I want to highlight just a few things. There are some areas of the country where there's needed to be a right sizing of hygiene wages. We're not talking about that. Right sizing the hygiene wage. I hate circumstances where I hear that new grads are getting $5 or $6 more an hour than people have been with the practice 15, 20 years. I don't think that's fair. So I think we can all agree that we're not talking about that. We're not talking about right sizing the wage. We're talking about people who are demanding far above what the going rate is for the area because they feel they deserve it.
Wendy Briggs:
That thinking of, I deserve this without having to elevate the services I provide, that rubs us the wrong way. And I've long said, be careful not to sell yourselves short. So there's another circumstance that I'm going to mention that during the height of COVID, there was a longtime doctor and friend of ours that had five locations whose all of their hygienists came to him and said, "We're all walking if we don't get a $10 an hour raise." All at the same time. And he called me in a panic. And ultimately what we did was we had a webinar with all those providers and I basically said, "Okay, you guys are demanding a shift away from your production-based compensation model that we had carefully constructed for you. Why would you sell yourself short like that? Why would you cap yearning potential at $10 more an hour? We have hygienists are doing far better than that with the production-based compensation incentives that we put in place. And we put those in place recognizing that for us, production isn't the goal. We know production is what comes and we do the right thing for the patient. So when we elevate patient care, the practice wins, the patient wins, the provider should share in that win also." So what we were able to help them see is demanding a $10 an hour raise per provider really was selling themselves short.
Wendy Briggs:
There's a classic video, good friend of our family, his daughter married Bryce Harper, who's one of the best major league baseball players on the planet. And I remember him being a young kid and he was in contract negotiations and some reporters said, "Bryce, they said, you might be getting an contract offer of $400 million." And he looked at him and went with all sincerity, said, "Why are you selling me short? Why do you think it's only going to be $400 million?" And I love that confidence, and I've never forgotten that, but I think in some ways when we demand a higher hourly wage than is sustainable, we are selling ourselves short. Like you said, we're shooting ourselves in the foot. We're not opening the door for improving the care we provide to patient being compensated on a production-based formula. That to me is where we earn a bigger future and we want to see hygiene providers earn a bigger future. Want everybody on the team.
Bertha Triche:
A woman should be making over $100,000 a year. They should be. Right. That is fair. Those of us that do this and do it at a very high level, it is worth every penny of that. The other thing that I think we don't look at well enough in the doctors provide benefits and your wage is so much more than just that hourly that you're paid. And so when you actually look at a production-based compensation above a line, right, goal plus something above the line, and then vacation time, sick time, some of them do, they pay for education, CE, they pay for numerous 401ks, those kinds of things, health insurance. So when you look at all of that, it's not just what we get per hour that the dentist costs, but it's a really hard thing for most hygienists to understand that, that it's bigger than that.
Bertha Triche:
And now there are those providers that do not, I mean those doctors that do not provide any additional benefit except for the wage. And I do understand that. And in that particular arena, I may want to ask for more as well, but if there are all of these factors that factor into what it is that I earn per hour, you have to give that credence. You can't just push that on the side and say, but "No, no, this is all I look at. This is what I look at. This is what my friend is getting down the street." Which is, that's a lot of this too. It's being driven by other practices. So when I have somebody who's looking at me going, "I'm making $68 an hour and I want more." I'm like, Hmm. Right. What are you going to do to earn that more?
Wendy Briggs:
It's $65 an hour plus an incentive plan. How do we come to the place where you feel like that's not enough? I don't understand that level of thinking.
Bertha Triche:
It's very scary when I think about it. And it is very self-motivated. Not team motivated and not patient or motivated, I don't think, certainly not, certainly not doctor motivated or owner motivated, and it's got to be all of it and how to combat that. I think having a culture where you have a mission statement, you have values, core values, and you talk about how those demands do not align with your core values as a team, I think is really, really important because the culture is the most important thing to me. It drives that day-to-day happiness in the practice of the team. And when somebody is usurping that or threatening that, in my world, we want to protect that at all costs because it's not fun to go somewhere every day where it's not a happy place. Right?
Wendy Briggs:
Work. Yeah. Yeah. That's a good point too. Bert, I would say for doctors listening, if you're in a situation where you feel like you can't afford what hygienists are making in your area, or you feel like the demands are growing without improvement in the productivity, I think it's time for you to maybe ask yourself a few questions. Have you considered investing in your hygiene department? When's the last time you have provided coaching or an opportunity for them to develop their skills?
Wendy Briggs:
The second thing is, hourly wage, in my opinion, isn't where it's at. It should be an hourly wage plus a production-based compensation model. And that's part of what we teach and we help to bring to our members because that provides a way for them to earn a bigger future. That's a couple things that you can do right away. The other thing is, like Bert said, if you haven't taken the time to craft your core values and lead with those, there's never been a better time.
Wendy Briggs:
Some of our business coaches will go and help practices do that. It's called a shared mindset day, where they actually help the practice identify what are values that are important to them, and then we begin the journey of helping the leadership on that practice, coach their team, lead their team, utilizing those values as you mentioned. Those are some things that you can do right now if you're in that tight spot where you feel like you can't afford to keep up with the demands of your hygiene department.
Wendy Briggs:
Secondly, Bert, what would we say to the hygienists that are listening that maybe think, gosh, I'm underpaid, I'm undervalued, I should be making more. There's a right way and a wrong way to create a bigger future for yourself. So I would say danger, danger. What would you say?
Bertha Triche:
I would say, well, if it was me and I was in that situation and I really wanted more, I would have a really heart-to-heart sit down. Here's the thing. Do I value where I work? Do I love the doctor that I worked for? Do I believe in his mission? All of that, right? I always did. I was 100% behind him. He was my best mentor and teacher, and I wanted to be there. So if I wasn't happy with something, communication's the key there. I would approach him and say, "Listen, I really need to make more money, but I understand the market that we're in. I'm willing to learn and change and grow. What can we do to give me opportunities to get better at what I do to help drive the restorative side of the practice, to have better conversations with my patients?"
Bertha Triche:
And I don't think there's a doctor owner out there who, if they had a hygienist who approached them in that way, would say, "I'm 100% behind you. I want to help you do this. Yes, yes, yes. I want you to have a bigger future." Every doctor we coach, I meet very few, if any, that say to me, "I don't want my hygienists to earn more money." They never say that. They always say, "I want a bigger future for my team members, not just hygienists, but the rest of the team as well. What can we learn? What can we change? What can we do to create that for the team instead of just putting our hand out and saying, I'm owed that." Because this is what the market is bearing at the moment. You've got to bring something to the table. It used to be very frustrating to me as a office manager when a brand new dentist out of school, would come to me and expect a larger wage than my dentist would make, right?
Bertha Triche:
And expect to be guaranteed that right out the box when they don't bring the same level of expertise, the skillset to the table. So I would say, work on your skillset, guys. Work on your skillset. If you're a hygienist out there who's wanting to earn more, there's so much you can learn. I was 25 years and thought I had it figured out, and then Wendy came along and I realized how much I didn't know at that moment. And look where I am now. I have this great job. And because I was willing to go where it was scary right into the unknown and make the change, it reaped me such a reward that I had never expected I was going to have. So get better, grow, be willing to make the changes and earn a higher living, not just put your hand out and expect it, because that's what the market is bearing.
Wendy Briggs:
Yeah, I love that. Burt, it's such a beautiful time to be in dentistry. There's so much negativity out there, and there's so many providers that think, oh, I'm trapped in the op. I can't get out of hygiene. The burnout's high, doctors and hygienists both. And I think ultimately this state of hygiene has contributed to that. The feeling of defeatism. It's never going to get better. I can't improve my circumstance, and I absolutely disagree with all of that. We know that we can avoid burnout or fix it by feeling challenged and being empowered and learning, continuing to learn more. I can't tell you how many hygienists I have come up to me and say, "I've never had such fun. I've never had or felt more rewarded than I do doing what I do now. Even though I'm working harder, I'm so much more satisfied with what I provide my patients at the end of the day." And I think that's what we should focus on as a profession. How to elevate the services we provide patients. Because when we often say that all ships rise, when the ocean rises, all ships rise. When we elevate patient care and we're doing what's best for the patient, we as providers are able to share in that joy and joy in the journey is what makes it all worthwhile. So-
Bertha Triche:
I was burnt out out when I met you, I really was. And it renewed my spirit and gave me a new focus. And I get that a lot from the hygienist that we coach. We'll get that in emails going, "Oh my God, thank you for what you did. I have a new spirit about what I do." And to me, that's worth more than any money somebody could pay me. Is that feeling that I go in and make a difference every day with these people and change their lives from a health perspective. That's a reward too.
Wendy Briggs:
We absolutely love that. Yeah, yeah, for sure. We love that. So I would say if doctors, if you're feeling dissatisfied, or anxious or worried about the state of hygiene in your practice, reach out to us. This is what we do.
Wendy Briggs:
Hygienists, if you want to have the opportunity to earn a bigger future, you can reach out to us as well. We have opportunities on both sides for providers to really step into their own and maximize the impact that they're having. And that's what we love about what we do. We absolutely love it. We love to say creating excellence isn't easy. If it was, everyone would do it. But what are the things that we bring to the table is we have proven systems that actually work in dentistry today. So Bert, it's been awesome chatting with you.
Bertha Triche:
Thank you.
Wendy Briggs:
I always feel renewed and engaged when we visit, and hopefully our listeners will have gotten some gems that they can take back and apply right away to improve the state of hygiene in their practices and across the world. We love it.
Bertha Triche:
We will survive this. This too shall pass. In my 43 years, I've seen a lot of paradigm shifts and changes in dentistry, and we've made it through all of them, and it will change and get back to a new normal. So I'm encouraged.
Wendy Briggs:
Hang in there, right?
Bertha Triche:
Yeah. Hang in there.
Wendy Briggs:
Very good. Well, thanks for joining us, Bert. Thanks everybody for listening to this episode of the Double Your Production Podcast. We'll see you next time.
Bertha Triche:
Thanks, Wendy. Bye
Wendy Briggs:
Bye-Bye.
