A few weeks ago I came across an interesting article entitled, “The myth of cross-training”, by Shirley Gutkowski, RDH, BSDH. The article essentially argues against the concept of cross-training dental employees across “departments” (e.g hygiene department, front desk department, etc.).
Most hygienists disagree
The article was shared on one of the popular dental hygiene Facebook groups that I frequently check, which is how i found it, and the comments from the other hygienists were quite brutal. The vast majority disagreed with the article. Shirley came across somewhat hyperbolic, and I don’t agree with her 100%, but I do agree with what I think is her general message in the article. Unfortunately, I think too many hygienists missed that message.
Dividing labor is very important
The division of labor is a very basic economic concept. The western world has produced tremendous wealth and innovation since the Industrial Revolution in large part because people were, and still are, able to specialize in certain skills and knowledge. We’ve all heard the phrase, “Jack of all trades, master of none”. Well, that may still work for a few people in today’s world, but generally speaking, it will not work for the vast majority. People, including dental people, need to specialize.
Skilled vs. unskilled
Every position in a dental office is a skilled position. Every position requires many years of education, training and/or experience to become a master in that position. Every position also requires continuous experience and learning to maintain that master level. There are plenty of unskilled, or relatively unskilled tasks, in a dental office that everyone can, and should do, no matter what position one holds, including dentists (e.g. taking out trash, putting away supplies, turning on the compressor and vacuum pump, etc.). There are also many skilled tasks that overlap between some “departments” like taking x-rays, sterilizing instruments, making an appointment, etc. that can also be done to help out other “departments”. Cross-training in the dental setting becomes an issue, and I think this is what Shirley was really getting at, when the goal is to make a dental hygienist into a dental assistant, or a dental assistant into a front desk person, and so on.
Bottom Line
All dental people should help each other whenever possible because we are a team, but very few dental people, in my opinion, should strive to become a jack of all trades and master of none. The only exception I can see is if the person plans to work in more than one “department” permanently. An example might be a dental assistant who assistants two days a week and works the front desk two days a week. But other than that it makes no sense to fully cross-train anyone if they have no plan to permanently work in more than one “department”.
I agree 100% with what you are saying, in that the main idea of the whole article may have been misunderstood by some. The idea of cross-training a dental hygienist isn’t necessarily “dumb,” but paying an RDH to do NOTHING is. I’m just being honest. However, it’s not what Gutkowski was “getting at.”
I believe the main idea behind her article was to point out that RDH’s shouldn’t be taking on the “prima donna” “I’m-too-good-to-take-out-the-trash” attitude. Gutkowski is pointing out that as RDH’s, we need to include ourselves as being an active member of the dental TEAM.
I’ve seen it all too often. I’m currently an RDA in hygiene school. I’ve seen both sides of the coin and I have to admit, I do and will appreciate RDA’s much more since I understand the ins and outs of both worlds that I have been afforded. RDH’s should be expected to help in various other places of the dental clinic, like sterilization, patient in-take, answering phones, etc…but not as a permanent position. That, I don’t believe, is “cross-training.” That’s just part of being a dental team member.
EDUCATION is something that, IMHO, Gutkowski minimized. Sure. RDH’s are “capable” of turning a room over or turning over their own chair, for that matter, but the comparisons she used were not effective because of her lack of mentioning education, not to mention production potential (which equals MONEY) that could potentially be lost if an RDH is expected to do the job of an RDA. Now if the RDH is an RDA as well, then I can understand, but again, it goes back to the financial aspect of things: Why would a dentist pay an RDH for RDA work? It’s not practical.
Gutkowski also posed the question: “So, if you’re a hygienist and you’re required to be cross-trained, what should you do?” My answer to that is, “Do hygiene stuff,” because in all truthfulness, you may get sent home. I’ve seen it happen. No work=no money. There’s “goodie bags” to prepare. There’s instruments to be sharpened. There’s instruments to be sterilized. There’s supplies to be restocked. There’s instruments to be organized. There’s drawers to be organized. There’s tray prep for the hygiene bay that can be done. There’s supplies to be ordered. There’s lab slips/orders to be completed and processed.There’s the patients’ med histories to be reviewed. There’s follow up calls to hygiene patients that had an SRP. Take x-rays. There is seriously so much that can be done on an RDH’s downtime. THAT is what I believe she is saying. Get busy, RDH’s! Gutkowski mentions a few of these tasks, too. But I don’t believe that is considered “cross-training.” It’s called “do your job and stay busy or GO HOME.” Don’t waste time. Be considerate of the dentist/corp paying you. Time=money and if you aren’t being productive, then go home. I know it may sound a little harsh, but it’s the truth.
Agree with you 100%. Gutkowski could have been more clear on her thoughts by not asking so many rhetorical questions. She has written some wonderful articles that have helped me tremendously over the years, but this one was not her best. This one sentence is getting to the point, but she could have easily gone further with this idea to make her point clearer, “If everything is running smoothly, and you find yourself with a missed appointment or a change in the schedule, use the time to really support the practice by building a new protocol or investigating a new procedure or product.” Unfortunately, by this point in the article I believe she had already lost most of her audience. It’s a shame because I think this could be a very enlightening idea for many RDHs in private practice.