Dentist Linda Ma shares her views about dentistry -Milwaukee dental health

On May 5th an article was published called "The real deal about dental hygienists." Linda Ma, adentist in Arizona, had the courage to email the author and explained how she felt about hygienists.One statement Ma made was that if a hygienist's patients don't show up for appointments it isbecause they did not build their own customer base and that any hygienist can pick up the phoneand call patients.

Linda Ma DMD

In many offices the office manager and/or receptionists will not allow a hygienist to do this even if ahygienist offers to help to prevent openings in the hygiene schedule. The front desk does not wantthe dentist to know they are not confirming appointments so they tell the hygienist they can get itdone even if a hygienist offers to help. Linda Ma DMD also blamed the hygienists for having poorfinancial management if they were unable to pay their bills due to hygiene patients not showing upand being told to clock out by the dentist.

Dr. Ma agreed to answer questions sent through email for a story about her on Examiner. She wasborn in Pennsylvania and her parents were Vietnamese refugees and came to the United States withno money. Ma said that all of her schooling was in Philadelphia. If she wasn't a dentist she said shewould be working in finance or interior design. She and her husband have a practice together inTempe, Arizona. Ma wrote that she had student loan debt and invested 20 years of her life andmoney in dentistry and said that none of the team members had done that.

Dental hygienists in the United States usually have invested at least three years in going to collegeto become hygienists (unless they live in Alabama). Many hygienists graduate from a dental hygieneprogram with a large amount of student loan debt to pay back. Dental assistants usually attenddental assisting school now and most are also in debt when they leave assisting programs. Manyoffice managers have bachelor's degrees which come with a large amount of student loan debt to

pay back starting six months after they graduate. Linda Ma may not being hiring personnel strappedwith student loan debt but most young hygienists, dental assistants and baccalaureate degreeholders have debt to pay back after school. There are many hygienists, assistants and front deskstaff who also say they feel they have invested years into a practice and into dentistry even thoughLinda Ma may not be hearing that from her staff.

Here are the questions Dentist Ma answered:

1. Where were you born and where did you grow up?

I was born at Penn State College, Pennsylvania and I was raised in Philadelphia. My parents wereVietnamese refugees from the Vietnam war.

2. What did your parents do for a living and do you have brothers and sisters?

My father was a teacher and sold real estate on the side and my mom was a housewife. I have oneyounger brother and one younger sister.

3. Do you have children and pets?

I have a four-year-old daughter and two dogs.

4. Where did you go to high school, college and dental school?

I went to Central high school, Temple University, and Temple School of Dentistry. All inPhiladelphia.

5. How long have you been a dentist?

I graduated dental school in 2004 so I've been a dentist for 11 years

6. Do you have your own office or do you work for a corporation that owns many dental offices?

I have my own office which I share with my husband. Our office is called Smile Innovations.

7. If you had not gone to dental school and become a dentist what job would you want to do asidefrom being a dentist?

A career in finance or interior designer.

8. Do you have a hygienist?

Yes

9. What kinds of benefits does the hygienist have in your office? (retirement plan, healthcareinsurance, paid continuing education etc.)

We currently do not have any benefits for our staff besides free dental care. I personally train myteam.

10. How many employees work at your dental office and what jobs do they do?

We have three employees, front office, assistant, and a floater. We are still working on our team.Everyone shares responsibility.

11.If your hygienist is bringing in clients does the hygienist take them when they leave, or even get abonus on that production?

No, I asked my hygienist if she would like to be paid on production and she does not want to be paidthat way. I have given all my hygienists the opportunity to be better and all of them have chosen togive me an excuse on why they can't. I tracked all my patients because I do all the marketing so Iknow where the patients are coming from. The hygienists do not bring in patients but they helpcontribute to lose patients. I had a consultant run hygiene's numbers, and less than 3% follow-up for3 month re-calls for scaling and root planing, not to mention that most of her patients were prophieswhen stats says that more than 50% of people have periodontal disease, and only 3% was treated atmy office.

12. Do you clock in and out for patients, only collecting a paycheck for the hours you have patients?

My husband and I pay ourselves a $52,000 salary, which is way below what we pay our hygienist.We do not clock in and out but I can say that I have spent over 80 hours on my practice a week,invested over 20 yrs of my life and money, which none of my team members do. Both my husbandand I graduated with a $250,000 student loan each, so between the two of us that is $500,000 inexpenses which the hygienist does not share with me.

13. Who is to maintain the dental hygiene instruments and room if your hygienist is not paid for this?

Everyone in my office helps the hygienist maintain her hygiene room including myself.

14. Do assistants and front desk personnel clock out if there are no patients in the office?

No staff members clock out when there are no patients, but when the hygienist doesn't have apatient I expect her to call her patients to make sure her schedule is booked for the following days.She also clocks in a half an hour earlier to prepare for her day. And she does get paid for all thosehours. When we go on vacation the office is still open, I give the hygienist the opportunity to openher own schedule

15. Which staff position creates production?

Every team member creates production. The top producing production is the dentist the second is ahygienist and everyone is expected to help promote Invisalign, whitenings, toothbrushes, Botox andlaser dentistry. Hygienists are very entitled, and other team members resent them. I have had about4 hygienist in the last ten years, and I from my perspective, they only help themselves, not theirpatients or their team members.

16. Where have you gone on vacation?

I have been to many countries; Thailand, Vietnam, Japan, Indonesia, Germany, France, Mexico andCanada. Most major US cities; Seattle, San Francisco, San Jose, Orange County, Los Angeles, LasVegas, Salt Lake City, Colorado, Houston, Austin, Dallas, New Orleans, Miami, Orlando, Charlotte,Washington DC, New York City, Boston, Atlantic City, St.Louis, Chicago, Trenton and probably a few

more cities that I don't remember their names of.

17. What kind of car do you drive?

I drive a 2001 RX 300 Lexus.

18. What is your favorite thing about doing dentistry?

People, when they have a great result. I enjoy training my team and educating my patients tobecome better. Our goal is for patients to look good,feel good,and be healthy.

19. What is your least favorite thing about working in dentistry?

People. Well actually management, when team members don't take responsibility or when patientsdon't take responsibility.

20. Do you have a fish tank in your office?

I do not have a fish tank but I do have a waterfall that I designed into my office that goes fromceiling to floor.

21. What do you do for fun when you are not working as a dentist?

I like baking and decorating. Shopping is another fun thing for me. But my favorite by far isspending time with my daughter.

22. Do you go to church?

No but I am Buddhist. I practice karma. I try to be fair with my team and my patients.

23. Have you ever been to Wisconsin or Illinois? If you have been to either state tell me about it.

I have been in Chicago and in Champaign, Illinois. One of my good friends is the head chef topopular restaurant in Chicago. I visited Millennium Park, Navy pier, the Magnificent Mile. I'm a fanof the deep dish pizza. I am a vegetarian so I didn't try the popular Chicago dogs. I have been to thefood festival and went on an architectural tour. Chicago is one of my favorite cities.

24. Have you heard of Vermin Supreme? He is running for President on a mandatory tooth brushingplatform and a free pony for all Americans. What do you think about that?

I don't really watch TV or pay attention to the news because I focus more on reading andsurrounding myself with people but I did Google him and watched his video. I feel that the mediathese days are more negative than informative, and I choose not to participate. I do not involvemyself with drama or gossip. Whatever I can contribute to the world is more important to me thenlistening to other people's judgments and complaints. I try my best to create a positive atmosphereand help those that need my help.

25. What would you think if your office joined a Union?

What kind of union would we join? In Philadelphia there are labor unions and these unions werecreated for equal opportunity but the result was not equal opportunity. It is like communism in

Vietnam where the poor took from the rich so the power was exchanged and nothing changed. Theinjustice was reversed. Nothing was fair. Hence why my parents fled Vietnam. They lost everythingbecause they were educated and they came to the U.S. penniless. I am grateful for everything Ihave, and strive to be a better person daily. I try not to complain, and be as compassionate human. Iwould not join a union, but I can educate people to change and help other and better themselves.

I tell my staff the grass isn't greener on the other side. Stop looking at someone else's grass andwater and care for your own grass and then you'll have your own green grass. - Linda Ma DMD May12, 2015

Linda Ma sent some correspondence to the author that she had received after her email was postedat the bottom of the article "The real deal about dental hygienists." Here is what she sent to theauthor:

"From Chris Crannie Zimmerman

Hello Dr Ma, I noticed your response to an article on hygienists clocking out when patientscancelled. I appreciate your response but really wanted to share another perspective. I have been ahygienist for 23 years and now I am the practice manager of an office that had very low morale.

The environment was toxic and everyone was so discouraged. Our boss pays very well, pays bonusesfor monthly goals and offers a nice benefit package. The team was battling negativity for feelingunappreciated and my boss was frustrated. I slowly changed things around, but still working onthings. We had a few people we had to let go because they were very negative. We have met goal 7of the 9 months I have been there. It is proven the most productive employees are happy employees.

You stated that hygienists blame the dentist when patients cancel and that isn't the case. There aretimes when patients cancel and there has to be a strong policy in place with proper verbiage to tryto prevent cancellations and place value on appointments. It isn't anyone's "fault" but everyoneneeds to work together to keep the schedule full and when there is down time. Everyone should pulltogether to keep the schedule full. As a former hygienist, it was nice to have occasional down time tosharpen instruments, stock, clean and work on reactivation lists. The biggest thing is team work. Idon't feel any employer should pay staff to sit around and do nothing but if they are willing to workthen by all means they should be paid their agreed upon wage to do so.

I've done this for many years and I have worked in a lot of different environments and I feel stronglythat if dentists can grasp this they will change the dental field back into the wonderful career field itused to be. Place value in your team, respect them and they will help you achieve the success thatyou desire. Statistics show that patients trust the front office staff overall and next is the hygienistsand then assistants and lastly the dentist (they love you but still feel you are out for their money) sobuild that team that has unquestionable faith and respect in their boss and that will carry over to thepatients.

I am passionate about the dental field and about helping dental practices become the best place theycan be, where the dentists trust their staff and the team loves to come to work. I hope you receivethis with the encouragement and hope that it is sent with. Not many can afford to have their wagecut daily because of cancellations of patients. I wish you well in your practice it looks like you have abeautiful practice. Best of wishes and if I could help in any way I would be happy to Smiling facewith smiling eyes

Sincerely,

Cris

Dr. Linda Ma's response:

I agree with you on team work, but the article didn't discuss team work or responsibility andaccountability. From my perspective as a dentist, I treat everyone well. I know my patients, love andcare for them. I have practiced for over ten years and see how many hygienist do not impact theirpatients lives, therefore they have no patients. Cancellations can be minimized, and if no one on theteam takes responsibility, then yes, there will be no patients. When my husband and I started ourpractice, our hygiene schedule was full, and as we handed off our patients to the hygienedepartment, we had less patients. When we speak about negativity, hygienist are equally as negativeand non productive. Most dentist are not brave enough to fire those hygienist and staff memberswho do not contribute to their and their patients lives. If the hygienist feels the situation is unfair,there are plenty of fair jobs for them if they are willing to work hard and follow their passion likeyourself. Each individual creates their own destiny. I feel that the article didn't give insight to howmany hygienist do not play fair on the team, and have an expectation or entitlement attitude. Forexample, the blog stated how dentists go on vacation and doesn't pay the team. She forgot tomention that the dentist doesn't get paid either, and has made every Investment in their solopractice. The hygienist can pay for her own vacation making $60,000 plus a year. Or the fact thather $40 per hour is not enough when you have more than 2 cancellations in a day, which makes herpay $53.33/hr. How about how she complained about being subcontracted or commission based. Ifyou are commission based and hit your goals, you should make more money and become a value tothe office. I think what should be published is how many hygienist don't hit their goals and how theydon't affect their patients lives and how truly valuable they are to the dental office, not how horribleit is to be a dental hygienist working for a solo practitioner with no management experience. Thewhole article was pretty negative, and I feel that it gives more fire for dentists and patients not toappreciate the hygienist. We always love our hygienist, but when the hygienist has a bad attitude, Ido not expect the dentist she works for or the patients she sees will value her.

-Dr Ma

Cris

I couldn't agree more. One of the staff we let go was a hygienist that had a horrible attitude andspoke negatively to the patients about the dentist. Patients liked her because she was full of dramabut didn't diagnose perio and most of her patients ended up needing RPS. I had a lot of spoiled staffmembers that got upset with the dentist because he would roll his eyes out of frustration. Getting ridof two negative Nellies- changed the team. Thank you for responding and I do feel a lot of dentistsget a bad rap for lazy entitled staff. Again I wish you well! Sounds like you have a great outlook foryour practice. Smiling face with open mouth and smiling eyes

Sent from my iPhone"

Author's response to Dentist Ma after seeing this email:

"Thanks for sharing this. How are you doing on the questions I sent to you?

I do agree that some hygienists ask some weird questions and make patients very uncomfortable.Some hygienists don't talk to patients at all. I was temping at an office where the hygienist wouldhave made me uncomfortable as a patient. We could hear her in the next room grilling the patientabout why she didn't like her job etc. It was uncomfortable for me and the patient I had in my chair

at the time felt uncomfortable listening to it as well. The receptionist at that office was verydomineering and hard to get along with making it a deadly duo for any other hygienist coming in andprobably many of their patients. The receptionist alone would make me look elsewhere for a dentalpractice if I was a patient there. The hygienist was nicer but was under pressure to talk withpatients so she asked them extremely personal questions that everyone could hear. Then there arethe hygienists who are like some hair stylists. They talk to other staff members during the patient'sappointment but not to the patient very much. I may do a story on hygienists I have run across whiletemping and how that would make a patient uncomfortable in the future. Thanks for the ideas.

I may share this in the story I do about you.

Ann Day"

This is the email Linda Ma DMD sent to Ann Day about her article "The real deal about dentalhygienists" that resulted in the article above :

"I was unable to post this response to your article Hi, I am Dr Linda Ma DMD from Arizona, and I donot agree with your article. Dental hygienist who don't have a full schedule is because they do notbuild their own customer base, and depend on everyone else. They are the highest paid in the officebesides the dentist, and expect to get paid for not keeping their patients. When a dentist owner hasa failed appointment, he does not get paid, plus he has to pay for everyone else and then more aka;insurance, rent, supplies, utilities. Hygiene patients are supposed to be on a 6month schedule and ifthe hygiene does not have a solid schedule, it is not the dentist's fault. Any hygienist can pick up thephone and call their patient. Hygiene can also promote themselves in the office through word ofmouth. There are openings because the hygiene does not promote dental health or a commitment. Ifthe hygienist has financial problems, it is not due to the dentist, it is due to their lack of poorfinancial management. Hygiene's role is to help the doctor and patients. I have yet seen in thisarticle where hygiene appreciates the doctor or their patients." -smileinnovations@hotmail.com

Dentist Linda Ma shared her viewpoints about hygienists in that she thinks hygienists feel "entitled"which may be true for many dentists in the United http://kuzmetsovob.livejournal.com/1926.htmlStates. Many hygienists say they feel their pay is being cut any which way possible by dentists. Theemail Dentist Ma shared from a hygienist who is now the office manager is interesting because theauthor named Cris Crannie Zimmerman never stated why she stopped working as a dental hygienistand is now an office manager. It might be for some of the same reasons that were listed in the story"The real deal about dental hygienists." It would be interesting to hear from Cris CrannieZimmerman the real reasons she started being an office manager instead of a hygienist. If any ofDentist Linda Ma's past four dental hygienists care to give their take on Ma's statements ofhygienists being entitled or why they left her practice please contact the author using the emailbutton above. Many hygienists are interested in hearing about that.

Update 5/13/15 Author was contacted by Cris Crannie Zimmerman. Here is what she sent:

"Hi Ann,

I am responding since Dr Ma chose to post the private message that I sent to her. I chose to keep itbetween her and I, out of respect for my fellow hygienists and for Dr Ma. Since Dr Ma chose to putmy private message out there . I feel I need to say a few things for the rest of your readers. I'mthankful one of my wonderful fellow hygienists that knows me from a hygiene page, let me know myprivate message was on here. So feel free to post this in response. I would have done it directly onthe article but I apparently set up an account at some time and don't know my password.

Firstly, to the one that attempted to question me about doing my job as an office manager "byallowing a hygienist to get by without diagnosing perio." Apparently she missed that I said I hired inand got rid of a few people. Obviously, I had to work there long enough to see that this was going onand she was gone within 2 months of my hire date. (This was one of the reasons I private messagedfor that hygienists sake.)

Secondly, I belong to a hygiene site on Facebook that stays clear of hygienists like her. That is,hygienists that jump to negative conclusions and attack each other as if I wasn't doing my job. Thisleads me to the question you asked me about why I stopped doing hygiene. The thought process thatstarted me in that direction was herniated discs in my neck. I love dentistry though and it's all I haveever known or wanted to do since I was in the 6th grade. I started thinking about how things havechanged so much since I first started in dentistry. I loved my patients and did all that could toprovide the optimum standard of care and most of them became like family to me. Things indentistry have changed a lot. Hygienists, like the one mentioned above, began attacking each otherfor whatever reasons instead of coming alongside and being team players. I'm not sure if it became acompetition with others or that they felt they were better?

I tried to do all that I could with the team at the office I work for to try to help each of them changetheir perspective so that they could become the team we needed. I implemented a perio program tomake sure patients were being properly diagnosed. Out of 10 girls, two chose different paths. I'mpassionate about making the office a better work environment for the staff, patients and dentists. Ihave found that some dentists are receptive to it while others may have to find out the hard way.That has been the same with the staff.

As I told Dr Ma, it's proven that the most productive employees are happy ones. We have oneincredible team where I currently work, and I can't tell you how much It brings my heart joy to knowthat I have helped this to happen. The staff and the Dr. tell me often that I have made such a hugedifference. We have made bonus 8 out of 9 months that I have been there ( this month being ourlargest yet). My heart is to be able to do this in many practices. My goal is to go into dental officecoaching.". - Cris Crannie Zimmerman 5/13/15