11 May 2016  •  Practice Management  •  3min read By  • Sheila Scott

The Death of the Hygiene Referral Fee

I’ve always been uneasy about practices paying associates a portion of hygiene fees, just because they refer patients. They don’t get paid a referral fee for referring endo or oral surgery, do they? And surely almost all patients should or would benefit from seeing a hygienist – shouldn’t all dentists be referring almost all patients for the good of the patients’ health anyway?

But I’ve been researching this topic for a few months now and associates, principals and their accountants tell me that associates just won’t refer patients unless there’s ‘something in it for them’.

Well, sorry folks but I think the hygiene referral fee is definitely out of order these days. In the past, I’ve helped clients calculate the fee to reward their associates for referral, but I refuse to do so now.

It’s not just me. I’ve seen at least one letter from a defence organisation to a principal which unequivocally recommends that a referral fee is NOT paid. I believe that this may be because any hint or possible interpretation of a ‘reward’ for referring a patient could fall foul of Standards for the Dental Team, issued in September 2013.

See 1.7.6 here

I’m now suggesting to my clients that I’d rather their associates were kept on a higher percentage, rather than have a hygiene referral fee paid (and when I work out the sums, it seems that the referral fee in most practices where there are excellent patterns of hygiene attendance, is equivalent to around 2% on an associate arrangement). So, if you need to change an existing arrangement, and don’t want a riot on your hands, this might be how to soften the blow.

We need to keep all dentists encouraging their patients to attend hygiene visits. We all know that dentists ‘doing it’ just isn’t the same as patients in regular hygiene programmes. Dentists only very rarely achieve the same improvement results as regular hygiene. There’s a world of difference between a ‘scale and polish’ and a few words of advice on plaque removal, the help of which I essentially think of as ‘dental health behavioural counsellors,’ who might also remove the hard plaque as an aside on the road to getting or keeping their patients healthier. Of course, the old NHS-private matter raises its ugly head again, but that’s for another post.

NB Managers and Principals: Do also make sure you strip out the hygiene portion of your membership plan payments to you before allocating your monthly Practice Plan fee to your associate – the hygiene part of the payment doesn’t belong to them!

About the author: Sheila Scott is no plain business consultant – she’s got over 20 years’ experience being a coach to dentists and their teams, not to mention the whole host of qualifications she’s got under her belt, namely: psychology, marketing, counselling and training, more recently expanding on the list by completing a mediation course!


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