The Self-Employed Dental Hygienist

With so many choices available now to newly accredited dental hygienists, there’s been an uptick in the numbers who are flexing their entrepreneurial leanings and opting to work for themselves.
The services they might deliver are as varied as the environments they choose to work in. Self-employed dental hygienists might:

• decide to set up as a consultant
• rent space in a dental office
• provide services to two or more dental offices
• only want to work with elderly patients, scheduling rounds each day at different retirement home locations
• offer mobile oral healthcare services to remote areas where dentists are scarce and patients have never seen a hygienist before
• be exceptional salespeople who earn commission-only on the products they sell

You get the picture – the sky’s the limit.

Those who want to be their own bosses entirely might want to consider taking some business or marketing courses or working with a business planner to develop a successful niche market model. Whatever they do, they should also work closely with a lawyer to ensure all types of risks or possible liabilities are known and planned for.

But if they still choose traditional mainstream oral healthcare service delivery, that is, to work from a dentist’s office, they need to ensure the terms of any contracts they sign clearly spell out their self-employed status. As the Canadian Dental Hygienists Association points out, Revenue Canada’s interpretation of someone’s employment status rests upon one small and otherwise insignificant word – for – and how it is used in context with the words “contract” and “service.”

• “A contract OF service sets up an employer-employee relationship”
• “A contract FOR services sets up self-employment”

If you are asked to sign any contract when you intend to be your own boss and you are not clear on any of the wording or clauses it contains, see a lawyer to ensure you understand fully what you are committing to.

In general, your contract should dictate the terms you want and agree to fulfill. Terms of service should be spelled out, for example:

• If workspace or a “chair” will be rented or supplied
• Who pays for other equipment and supplies and what those charges should be
• Exactly what services you will provide and how and when you will provide them
• What your fee for service will be. Is it based on time or procedure?
• If your services are to be exclusive or you are free to provide services to other practitioners too
• At who’s discretion should certain services be provided, yours or the dentist’s

Again, those are just some examples, there are many more to consider.

There are other facets of self-employment you need to think about too. These include common business expenses or responsibilities but they will “make you or break you” if you’re not prepared or set up to handle them. Such items might include:

• Malpractice insurance
• Health insurance premiums
• Remittance of your income taxes and government pension plan contributions
• Keeping your accounting up to date, particularly billing and accounts receivable

A great accountant or perhaps even a small business concierge service that includes all of the more mundane tasks of the self-employed may be valuable to you.

Do your research and homework. Talk to others who operate this way so that you make an informed decision on whether self-employment is right for you.

Last, don’t hesitate to call on other professionals when you need them. Your expertise is valuable but so is theirs, perhaps invaluable on your road to independent dental hygienist success.