what i wish i knew as a new DH graduate
As I work with students weekly, I am often asked the questions, “what advice would you give a new graduate?” Or “looking back, what do you wish you knew as a new graduate?” Since graduation, I can certainly say I have grown significantly and continue to learn as I progress in my career. However, there are some things that I really do wish I would’ve known as a new graduate that I feel would have helped me have more of a voice in the spaces I worked. The following are three areas that I wish I would have had a better understanding of heading into my first clinical job out of school.
I. Negotiating wages
When I was a new graduate, all I really knew when it came to negotiating wages, was to look at the average hourly rate for a hygienist in the area I was going to practice. When this question was asked in an interview, I would simply respond by saying, “Based on the average hourly rate in this area and my level of experience, I would like (x amount).” Then the dentist(s) either would agree or negotiate a little lower. Being a new graduate, I was desperate for a job and as long as I felt good about the office, I was mentally okay with taking a lower wage if that is what was presented. Looking back, there were some things I could have changed about this mindset.
First, I would most definitely look at the area I am going to practice to gain an understanding of the hourly wage. Second, if the dentist agrees (or rebuttals with a lower hourly), I would either accept or decline (depending on how you feel about the hourly wage) AND ask for a 90-day review. This is KEY. At the 90-day review, you’ll be able to look back at your performance and see what you have been producing for the office monthly. You can ask for a printout prior to your 90-day review meeting, of the past three months reflecting your production. Taking into account that the industry standard at this time is your production per hour should be 3x your hourly wage. This means that hypothetically, if you are making $50/hour, you should be producing $150 per hour on average. So, depending on your production for the past three months, you can now have some leverage when negotiating your wage. If you are producing much higher than your initial hourly agreement, then you can discuss for a higher hourly. Using the numbers to your advantage is extremely beneficial when negotiating wages and is something that any office should be able to provide you with. Third, depending on the office setting you are working in, I would discuss a base plus bonus/production incentive. This would involve you receiving a percentage- typically around 33%- of the procedures you complete that produce money for the office. Most offices will calculate your hourly wage for the month and compare it to your wage plus the bonus/production. If you met your bonus, you would receive that amount and if you did not meet your bonus, you will at least receive your hourly amount. This is important to consider as well, especially if you are in an office that performs frequent high producing hygiene procedures.
II. Communicating with your doctor(s)
Remember that in any office setting you enter, you are a provider, just like the doctor. As I mentioned previously, you are producing for the office and diagnosing/making treatment plans for your patients. With that said, it is important that you are a valued team member, and your voice should always be heard. Having a working relationship with your doctor(s) where you can consult on treatment plans and ask questions is beneficial for both you and the doctor. Not only did I wish I would have known how to better communicate with my doctor about my dental hygiene diagnosis, but I wish I would have learned the value of co-diagnosing when communicating with my doctor. Sitting down with your doctor and asking them to show you examples of what they are looking for when they do their dental exam, such as fractures, large existing restorations that need replacing, when they recommend a crown, decay, etc., is highly valuable. This creates even better communication between the two of you and supports an efficient team-based approach. For example, if you see a fracture on #31-D that has an existing DO amalgam that is shadowing/leaking, you will want to know that in this situation, your doctor is going to recommend a crown. That way, you can have this conversation with the patient during your hygiene appointment, maybe take an intraoral photo, and then your doctor won’t have to spend so much time going over this during your dental exam. It is not your job to diagnose these things, but it creates a more efficient and educational experience/appointment for the patient when both you and the doctor are on the same page.
III. Autonomy in the office- asking for new instruments, etc.
When it comes to ordering new instruments, maintenance on equipment, and incorporating new equipment in the office, finding out if you have a voice in this is something I wish I would have known as a new graduate. Looking back, I did not have all the instruments that I ideally wanted when I started my first clinical job. I just went with what was given to me and did the absolute best I could with maintaining them through routine sharpening. I did have a say on when they needed replacing, however the same instruments were ordered when needing replacements. Having the right instruments and equipment that you are most comfortable with will ensure that you can do your job adequately. How are you supposed to even remotely perform well if instruments have almost no working end or Cavitron tips are severely worn? Advocating for yourself and remembering that you are a provider is critical as a new graduate. Just because “it has always been done that way” does not mean it can’t change when you step foot in the door. If an office feels confident enough in having you care for their patients, they will certainly support you in any instrument or equipment requests that you make.
Being a new graduate does not make you any less capable than the other hygienist in the space you are applying to work. Being confident in yourself and reminding yourself why you are there- to provide oral health care to patients that need you- is critical when entering a new space fresh out of dental hygiene school. Keeping the aforementioned items in mind will show that you are serious about the job and that you want it to be a good fit long term. Dentists face their own challenges daily, especially if they are in a place of practice ownership. Finding the right dental hygienist can be challenging, so making it easier on the dentist by clearly defining your expectations up front as a provider will ensure ease of communication and a positive working relationship immediately.