Commission VS Hourly Wage

I have been practicing dental hygiene for just about 1 year now. I am currently making an hourly wage however I just got word that the dentist I work for is changing his way of compensation to commission. I am a little concerned about this new way of pay and am looking for information from people who are currently paid in this way or have been in the past?!? What are the pros/cons of this way of compesation?!? What would you say your average rate of pay is and what is your percentage of commission? Also do you earn a base pay? Thanks for anyone that can help out!

I have worked for base plus commission and commission only. I like base plus better even though typically it ends up being a little lower daily but you are still getting the base pay whether patients show or not. If you are in an office that has a lot of no shows or allows pt's to cancel at the last minute commission is not good. You can be there all day for next to nothing. If you are in an established office with a good front desk person you can make serious money. One plus is when you work on commission if you don't have a patient you don't do anything. You can leave the office if you want to. Don't make the mistake of hanging around. Let them know how it is with the hygienist not on the clock. They need you there. Stock your own room or do your instruments and take off. If they still expect you to be part of the team, you're not. You get paid on production only. This is going to change the dynamics of your office.
If the dr is the one changing the pay he is probably anticipating you making less than you are now. Very seldom (in my experience) do dr's want to pay commission unless it's low. Although, a few dr's I know do commission only because the hygienist will work harder if she is worried about her own pay. Several hygienists I know have given up the commission route because of the economy and offices are having trouble filling the schedule. Hourly is less but at least you get paid for your time.
Just curious, how did you "get word" things are changing? If whoever told you is privy to that information they also know the particulars. If it was me I'd go to the dr smiling and ask what's going on. I'd ask why the change and what prompted it. Also you will want to know how he plans to pay you for required attendance at staff meetings or training days if you have them. You don't go for free. If the rest of the staff gets paid, so do you. Good Luck.

Hi Suzanne, Great advice, know what you are in for on commission! I personally, have never been a comis. D.H.. Unless you are a "real sales person", and in this economy it's hard to sell!, I'd look at hourly wage. How's work going? I'm still telemarketing myself:)*

Commission is the way to go. Today was a slow day for me. I only had 4 patients, but I still managed to pull in $430

I am currently working at a pediatric practice making $32/hr since I am fairly new out of school. My dentists said that we can be paid on commission if we choose too because he thinks it would be better for us. I started looking at my daily totals and think commission could be very good depending on the commission I was being paid. What is the average commission someone is paid if they are commission only or if they are commission plus base pay what is a typical base pay and commission rate. I am trying to decide what I want to do. Thanks!

ali in Lawrenceville, Georgia said: I am currently working at a pediatric practice making $32/hr since I am fairly new out of school. My dentists said that we can be paid on commission if we choose too because he thinks it would be better for us. I started looking at my daily totals and think commission could be very good depending on the commission I was being paid. What is the average commission someone is paid if they are commission only or if they are commission plus base pay what is a typical base pay and commission rate. I am trying to decide what I want to do. Thanks!

I get 34%.

what would be the base pay? what is the commission rate?

katherine in Richmond, Virginia said: what would be the base pay? what is the commission rate?

IMO this depends on what that Dr. and his practice and the economy make of the current RDH salary in that state. Ask around at other offices or friends that are RDH's how they are paid and what to ask for; you could also ask the Dr. in the practice if interviewing, but there, you won't know if it's the actual base pay...be good at figuring your commission rate too, if you choose to go this route. Some RDH's are super salespeople; but in this economy hourly pay, hourly pay plus commission...is a ....shoot. If you are in a practice that has a great/regular clientele and you know the value of the products you are selling to "get commission" and they BUY the products better for you, but take in to account all aspects of the patient base , the office/practice , etc...get my drift. GL

Hello everybody,

I'm an dental hygienist (with a bachelor of health) from the Netherlands, I want to move to the states (LA to be precise) and work there as an dental hygienist. I have a questions: does anyone know, when you work with commissions rate, and lets say you manage to make $800 in one day, how much taxes will go off? Because in Holland it's a lot, like 50%. And how are the job offers in LA? because there are a lot of dental hygiene programmes there...And do i have to do an exam because i have a dutch degree te be able to work in LA? In holland we also restaurate small cavities and the 1/2 year check-ups. Is this the same in the states?
I hope someone can answer my questions...thank you!

Hello everybody,

I'm an dental hygienist (with a bachelor of health) from the Netherlands, I want to move to the states (LA to be precise) and work there as an dental hygienist. I have a questions: does anyone know, when you work with commissions rate, and lets say you manage to make $800 in one day, how much taxes will go off? Because in Holland it's a lot, like 50%. And how are the job offers in LA? because there are a lot of dental hygiene programmes there...And do i have to do an exam because i have a dutch degree te be able to work in LA? In holland we also restaurate small cavities and the 1/2 year check-ups. Is this the same in the states?
I hope someone can answer my questions...thank you!

Kitty in Maastricht, Netherlands said: Hello everybody,

I'm an dental hygienist (with a bachelor of health) from the Netherlands, I want to move to the states (LA to be precise) and work there as an dental hygienist. I have a questions: does anyone know, when you work with commissions rate, and lets say you manage to make $800 in one day, how much taxes will go off? Because in Holland it's a lot, like 50%. And how are the job offers in LA? because there are a lot of dental hygiene programmes there...And do i have to do an exam because i have a dutch degree te be able to work in LA? In holland we also restaurate small cavities and the 1/2 year check-ups. Is this the same in the states?
I hope someone can answer my questions...thank you!

Regardless of where you move in the United States, you will be required to take new board exams. The written test, plus probably a clinical test with a live patient. You will have to check with that state's dental board as to the transferability of your foreign degree. In the US, hygienists are not allowed to drill teeth at this time, but there is a program in Minnesota that has just started a "dental hygiene practitioner" degree. It is a Master's degree level.

Hi, I am currently working for a dentist that used to pay me $37/hr and whatever I produced over $1000/day I got 30% of. It was working out pretty well for me but of course he wanted to change things once he actually had to pay me that 30%. So as of last August I started on commission and started doing assisted hygiene. I now get 25% of what I collect, not what I produce. I am curious to know if this is wrong. I've been searching on the internet and all articles say that you should get a percentage of what you produce not what you collect. Also, my collection numbers have been higher then my production so they say this is "unfair" and don't want to pay me it so they said they'd pay me 25% of production minus adjustments. Am I getting screwed here or what?!!!

I have worked both. What I have found is that dental professionals working in a commission based system tend to push Scaling and Root planing when it is not needed, in fact LYING and placing a deeper probing depth and doing (or pretending to do) a scaling and root planing procedure purely to get the money out of it. I've seen hygienists do it who had debt and a family to feed and would lie to make that extra buck. I've seen dentists do it. In my opinion health care should NEVER be commission based because you should be providing adequate care to everybody, not pushing care onto them. Plus, when I was working commission and saw co-workers do this, it made me literally despise the people I worked with and feel TERRIBLE that patients in my care were being taken advantage of. It is really disappointing to see that in a health care setting. In addition, I worked many snow days where patients didn't show up and I worked all day and went home with $20 or so in my pocket for a whole days worth. Its russian roulette and it is hard to explain to a bank you want a mortgage from that your income is commission based. Try to get a loan when your income isn't steady. Good luck

Carrie in Milwaukee, Wisconsin said: I have worked both. What I have found is that dental professionals working in a commission based system tend to push Scaling and Root planing when it is not needed, in fact LYING and placing a deeper probing depth and doing (or pretending to do) a scaling and root planing procedure purely to get the money out of it. I've seen hygienists do it who had debt and a family to feed and would lie to make that extra buck. I've seen dentists do it. In my opinion health care should NEVER be commission based because you should be providing adequate care to everybody, not pushing care onto them. Plus, when I was working commission and saw co-workers do this, it made me literally despise the people I worked with and feel TERRIBLE that patients in my care were being taken advantage of. It is really disappointing to see that in a health care setting. In addition, I worked many snow days where patients didn't show up and I worked all day and went home with $20 or so in my pocket for a whole days worth. Its russian roulette and it is hard to explain to a bank you want a mortgage from that your income is commission based. Try to get a loan when your income isn't steady. Good luck

thanks for the info. I personally would NEVER push procedures onto people that wasn't needed. I know that my boss however sometimes does. I try to make it so that that isn't the case but sometimes his "diagnosis" wins. I try to do whats best for my patients.

RDH in Calgary, Alberta said: Commission is the way to go. Today was a slow day for me. I only had 4 patients, but I still managed to pull in $430

hi there , how much should be the commission for dental hygienist,my dentist asked me he will give me 30 percent, but i just want to know if it is ok.just scalng, polishing , n fl.

deep in Calgary, Alberta said: hi there , how much should be the commission for dental hygienist,my dentist asked me he will give me 30 percent, but i just want to know if it is ok.just scalng, polishing , n fl.

should i be expecting a base pay??,,work would be once a week..

rdh in Calgary, Alberta said: I get 34%.

hi there , how much should be the commission for dental hygienist,my dentist asked me he will give me 30 percent, but i just want to know if it is ok.just scalng, polishing , n fl.

RDH in Calgary, Alberta said: Commission is the way to go. Today was a slow day for me. I only had 4 patients, but I still managed to pull in $430

should i be expecting a base pay??,,work would be once a week

Suzanne in Columbus, Indiana said: I have worked for base plus commission and commission only. I like base plus better even though typically it ends up being a little lower daily but you are still getting the base pay whether patients show or not. If you are in an office that has a lot of no shows or allows pt's to cancel at the last minute commission is not good. You can be there all day for next to nothing. If you are in an established office with a good front desk person you can make serious money. One plus is when you work on commission if you don't have a patient you don't do anything. You can leave the office if you want to. Don't make the mistake of hanging around. Let them know how it is with the hygienist not on the clock. They need you there. Stock your own room or do your instruments and take off. If they still expect you to be part of the team, you're not. You get paid on production only. This is going to change the dynamics of your office.
If the dr is the one changing the pay he is probably anticipating you making less than you are now.
so hygienst shdnt stay in office wen there is no patient fr them? wat other questions us shd be asking to know about the commision based dh job??

suzanne in columbus, indiana

so hygienst shdnt stay in office wen there is no patient fr them? wat other questions us shd be asking to know about the commision based dh job??

Kelly in Ontario, Oregon said: Hi, I am currently working for a dentist that used to pay me $37/hr and whatever I produced over $1000/day I got 30% of. It was working out pretty well for me but of course he wanted to change things once he actually had to pay me that 30%. So as of last August I started on commission and started doing assisted hygiene. I now get 25% of what I collect, not what I produce. I am curious to know if this is wrong. I've been searching on the internet and all articles say that you should get a percentage of what you produce not what you collect. Also, my collection numbers have been higher then my production so they say this is "unfair" and don't want to pay me it so they said they'd pay me 25% of production minus adjustments. Am I getting screwed here or what?!!!

That office sounds like a disaster. I would either put my foot down or get out of there. Generally, it sounds like commission is usually 30-35% of your production. I think you need to get something in writing or this Dr. is going to continue to take advantage of you.

Suzanne in Columbus, Indiana said: One plus is when you work on commission if you don't have a patient you don't do anything. You can leave the office if you want to. Don't make the mistake of hanging around. Let them know how it is with the hygienist not on the clock. They need you there. Stock your own room or do your instruments and take off. If they still expect you to be part of the team, you're not. You get paid on production only. This is going to change the dynamics of your office.

I think this is VERY bad advice. The idea behind commission is NOT to push procedures or products but to BE a team. Why do most hygienists think that they can sit back and collect huge pay when they are not doing anything to produce income for the business? (Please don't forget that even health care is a business - you don't expect to work for free and neither does the dentist). When you don't have a patient you should be helping the front fill your schedule so you can maximize your pay, treat as many patients as possible, get people off the wait list, help fill the doctors chair and create more recalls. It works for everyone but . . . if you take the position that you should just slack off when there is a no-show then the whole office suffers. Commission has the potential to create fabulous pay but you have to be willing to work for it. You CANT just sit back and expect everyone to cater to you. This is where the whole image of primadonna hygienists comes from.

Sullivan in Worcester, Massachusetts said: That office sounds like a disaster. I would either put my foot down or get out of there. Generally, it sounds like commission is usually 30-35% of your production. I think you need to get something in writing or this Dr. is going to continue to take advantage of you.

I have to agree, that office sounds a bit backwards. I also work on commission ONLY and on what I produce, not collect. I would NEVER agree to that because its out of your hands. Unless you walk your pt out and personally collect payment and or submit insurance claim, you are relying on someone up front to make your numbers. Now, there are some great team-oriented front office staff out there but in my experience, they seem to think hygienists are "overpaid and under worked" and therefor, don't work really hard at collecting for you. It sounds like your boss only wants it to be fare for him and not you. Don't be mistaken, you paid for schooling and therefor must be compensated on whatever you do (pano, sealants.... ) no matter if the pt pays for it or not! Be strong and good luck!

Just thought I'd weigh in...I have been working at an office that pays what we refer to as "production"...we stay away from the word "commission" because it tends to carry a negative connotation and can undermine pt./clinician trust. I am paid 35% of what I produce, not what is collected. I absolutely agree that wage should be determined by what services are provided, NOT by whether the money eventually makes it into the office or not. Sidenote: I am NOT paid for my time during staff meetings, which I find incredibly frustrating because our monthly FOUR HOUR staff mtg is mandatory. I feel stuck though because the general feeling is that the hygienists are being very generously compensated in our practice and that we shouldn't push it...I tell myself...well if the doctors are not being paid for their staff mtg time and they are viewing us as co-providers rather than hourly wage staff, why should I insist on being paid for that time? Like I should view it as a compliment or something...? I have to sit down and do the math, but I almost have to wonder if hourly rate would be better? p.s. my current daily production is usually between 1100 and 1500...any thoughts? Is this unfair?

Hello Ladies,
I need some feedback. My employer just offered me "self employment status, which will allow me to receive 35% of all my collections," as my hours are being cut back as there aren't enough patients to fill the days at my office. I'm full time (or was for the past 4 yrs) and was working between 32-40 hours/week but now it's closer to 20 hours/week. What is the difference between "production and collections" and what is it based on....does it include x-rays, dentist exam, scale/rtpl, polish, fl, OHI, or just a few of them?

Please help me out, my employer wants an answer by Friday! Thanks in advance!

PS. I'm currently on an hourly wage and my employer doesn't pay for ANY meetings EVER, thus we never have any staff meetings. I've been there for 4 yrs and only had one meeting. Needless to say our office doesn't run very well at all!

Collections all depend on if he actually gets paid by the patient. So you could produce $1500 a day but he may only get 1/2 of that from the patient or from insurance companies. So it's really hard to know what you are going to get paid by looking at how much you've produced for the month because usually they won't know what they've collected for the month until the month is closed out. So if you produced $1500 on the 31st of the month that money that is collected is usually part of the collections for the next month and so on. It all depends on when the money comes into the office either by the patient or the insurance companies. And you have to ask him what he is including on what you will actually get compensated for. Some say only prophy's, xrays, etc... but not exams. You have to know what he will include as part of your production. I hope that makes sense :)

Carrie in Milwaukee, Wisconsin said: I have worked both. What I have found is that dental professionals working in a commission based system tend to push Scaling and Root planing when it is not needed, in fact LYING and placing a deeper probing depth and doing (or pretending to do) a scaling and root planing procedure purely to get the money out of it. I've seen hygienists do it who had debt and a family to feed and would lie to make that extra buck. I've seen dentists do it. In my opinion health care should NEVER be commission based because you should be providing adequate care to everybody, not pushing care onto them. Plus, when I was working commission and saw co-workers do this, it made me literally despise the people I worked with and feel TERRIBLE that patients in my care were being taken advantage of. It is really disappointing to see that in a health care setting. In addition, I worked many snow days where patients didn't show up and I worked all day and went home with $20 or so in my pocket for a whole days worth. Its russian roulette and it is hard to explain to a bank you want a mortgage from that your income is commission based. Try to get a loan when your income isn't steady. Good luck

I'm on commission and what I noticed that when I temp sometimes., I do see the difference in tx. Meaning? Well I see a lot of patients being undertreated. 5-7 mm pockets in most post done in 2 u of scale. So as long as you are ethnical it should not matter whether you are on commission or hourly. In all the offices I've been too temping one or teo days. I see no perio exams and no probing. IN NONE of them. I'm on commission and I get the job done when it needs to be done. I've seen pt coming every 6 mnth for their routine hygiene not knowing they have perio.. And all of a sudden when I'm there, the dds says oh ya we need to send you to a periodontist. You've got gum disease. Oh come on this did not happen over night.

The commission varies between 35-45% depending on what is included in the deal. Oh and it should always be production. Just because front end doesn't collect should not be your problem.

Is it legal in ga to be commission only and have to stay all day even when no patients are booked for hours @ a time sometimes????

Do you mean salaried or commissioned? Commissioned means you are only paid per production or what you sell. Do they expect you to sell services or products as well? Salaried would mean even if patients don't show up you get paid. Hourly means you get paid by the hour you actually work (have patients).
I would discuss with the dentist what exactly they mean by commissioned based pay. Is that in addition to hourly or they are only paying you per patient? Per sales?

I find it very difficult to decide on this very subject with our hygienists. I value their abilities, patient care and I care for each of my hygienists deeply. That being said, I struggle with the commission/production percentage itself. Our office executive team has decided to place each hygienist on commission after they have worked for salary many years. I do not wish to reduce their pay, but I find that they do nothing to address the problem of keeping their chairs full and think nothing of chatting for the hour that a patient has cancelled or no showed in their schedule. I feel my hands are tied without them helping themselves, I have no choice but to place them on a lower % to account for this time. Any thoughts?

What are your receptionists doing to keep the hygienists busy? Do they have a list of patients who are available to come in on short notice? Do you know why you have so many no-shows or late cancellations? Do you have a procedure in your office for reminding patients of their appointments, and do you have any measures in place to bill patients for a no-show/late cancellation? Do you follow through with this? Are you booking patients with a history of being unreliable? If so, why do you do this? Is this a new practice trying to establish itself?
Have you spoken to these hygienists about your concerns? How can they "help themselves" if they don't know of a problem? It sounds like you may be blaming them in order to justify your actions. Do you have any standard operating procedures in your office that workers can follow? Is it in writing? Were your hygienists told at the outset what was expected of them?
As an office manager, it is YOUR job to be fair and impartial and to work for BOTH sides, both management and workers. Your actions sound punitive and that you are working more for the management than for the workers. If you “cared for your hygienists deeply” you would at least discuss this situation with them. Have you? If so, what was their reaction?

"I feel my hands are tied without them helping themselves"

What are your suggestions on how they can help themselves with no-shows and cancellations?

At our practice, the office manager has a list of patients who would like to be seen earlier than their scheduled appts and often come in when we call them with an opening.

As a hygienist, I've never been approached by my office manager as to how I can "help myself" regarding no-shows and cancellations so I was curious to see what your suggestions/ideas are.

I work as a dental hygienist in an office that pays commission only (33%). This does NOT include any profit on items we sell....chlorhexidine, etc----our OM states this is not something we are "DOING".) I do not mind commission because I am very well aware of how to be productive. Is it legal for myself and the other hygienists to have to stay and do other employees work (filing charts, answering phones, cleaning) when we do not have a patient? We always confirm our patients for the next day as well as do all of our recall cards and getting them in the mail. We get paid ONLY when a patient is in our chair. At times, we can go without a patients for hours @ a time. We are expected to stay. I am frustrated. Can you offer any advice?? Thank you.

RDHCJ in Boston, Massachusetts said: Do you mean salaried or commissioned? Commissioned means you are only paid per production or what you sell. Do they expect you to sell services or products as well? Salaried would mean even if patients don't show up you get paid. Hourly means you get paid by the hour you actually work (have patients).
I would discuss with the dentist what exactly they mean by commissioned based pay. Is that in addition to hourly or they are only paying you per patient? Per sales?

COMMISSION ONLY, no patient in chair, no pay, but expected to stay and do front desk work, or clean, or ??? Even when we already confirm our patients for the next day and do recall cards. What is frustrating is when we are done doing this and have no patients, we are made to file charts, answer phones....things the 2 girls that work front desk get PAID for. Discouraged.

Independent in Calgary, Alberta said: I'm on commission and what I noticed that when I temp sometimes., I do see the difference in tx. Meaning? Well I see a lot of patients being undertreated. 5-7 mm pockets in most post done in 2 u of scale. So as long as you are ethnical it should not matter whether you are on commission or hourly. In all the offices I've been too temping one or teo days. I see no perio exams and no probing. IN NONE of them. I'm on commission and I get the job done when it needs to be done. I've seen pt coming every 6 mnth for their routine hygiene not knowing they have perio.. And all of a sudden when I'm there, the dds says oh ya we need to send you to a periodontist. You've got gum disease. Oh come on this did not happen over night.

U cannot do SRP if there is no bone loss....you can SAY u did it, but the ins co will kick it back.....pre-auth should always be done before completing srp---that way office and hyg KNOW it is a legitimate procedure needed and everyone gets paid!

Dental Hygiene in Spring Green, Wisconsin said: I have been practicing dental hygiene for just about 1 year now. I am currently making an hourly wage however I just got word that the dentist I work for is changing his way of compensation to commission. I am a little concerned about this new way of pay and am looking for information from people who are currently paid in this way or have been in the past?!? What are the pros/cons of this way of compesation?!? What would you say your average rate of pay is and what is your percentage of commission? Also do you earn a base pay? Thanks for anyone that can help out!

BASE PAY BASE PAY BASE PAY! commission (in my eyes) should be a plus however you work this out with him. Look back at your daily schedule tally of production and see what hes trying to do. Dont cheapen your hardwork.