#917: The Art of Maximizing the EFDA

Dental A Team Podcast

Tiff and Dana discuss the ideal ways to utilize expanded functions dental assistants (EFDAs). They provide different ideas of how an EFDA can effectively fill in gaps, address scheduling SNAFUs, why state regulations need to be taken into consideration, and more.

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Transcript:

The Dental A Team (00:01.464)

Hello, Dental A Team listeners. We are back at you. Dana and I, Dana, thank you for being here with me today. I'm so excited to see you. How are you on this lovely, lovely, still morning? Yes, morning.

Dana (00:14.474)

God, I'm doing pretty good. I'm excited to be here. I like this. I know you're always like, I love my time with Dana. It's equally reciprocated. So I'm excited to get a little extra Tiff time today.

The Dental A Team (00:21.101)

Thank you.

Thank you, me too, me too. We really need to, I was thinking this morning, as I was getting ready for work, I was like, my gosh, we need to schedule the Seven Falls hike in Tucson because it's getting cooler, we'll say. So yeah, we need to find a weekend that we can get down there, you can get up there, and we meet, it's almost in the middle, right? So, awesome. Okay, hiking is my jam, you know that, we'll get that scheduled and...

Dana (00:42.731)

Yes.

The Dental A Team (00:49.771)

We're going to spend some time together today. We've already recorded one podcast and I cannot wait for that one to release. I think it was fantastic. Doctors. was really good. We just did it about coding and making sure that systems are accurate and billing is accurate and billing representatives, making sure that you're getting the support you need from your doctors within that coding accuracy department. So go listen to that. If you haven't listened to it yet, I do love all of our podcasts. I think that they're all fantastic, but

We like to hear it from you guys too. So whatever you think, whatever you need, if there's ever ideas that you guys have too that you're like, gosh, I would love more information about this. Do you know anything? One, ask us at [e-mail] We're always here to help answer questions or give ideas. But if you've got podcast ideas, like we are open to them. literally, the consulting team goes through and we pick the topics and we try to think of the things that you might like. And I honestly think sometimes we might miss the mark on something. So.

Let us know if there's things that you want more information on or things that we could dive into further for you, because we're here for that. Also drop a five star review. Let us know what you think down there as well, because we do love hearing about it. I love sharing podcasts, Do you ever share a podcast with your friends? I have a very specific friend group that's podcasters, and we very specific podcasts that we share. Do you have one of those in your life?

Dana (02:10.75)

Yes, I do. And I always joke around and say, if I start sending you podcasts or even sometimes like funny Instagram things, like you've made it to my inner circle.

The Dental A Team (02:18.672)

Yeah, I totally agree. I saw a the other day that was like, it's a full-time job. I'm here for it. You're welcome. And it was like sending memes all day to my best friend or something like that. And my best friend is a stay at home mom. And so I sent it straight to her. She's like,

You're welcome. I'm gonna log on at the end of the day and I'm like, my gosh, got a lot of things in here. Yeah, but I do, I love sharing the podcasts and sometimes I'll share a podcast and they're like, gosh, I can re-listen to this. I'm like, I don't know. Like sometimes I just re-listen to podcasts and I get nuggets and tips that I didn't catch before or it hits a little bit differently. And I know I've gone back and listened to years later a podcast and been like, wow.

I didn't even realize it could have meant this or now I'm in this space of my life and it's completely applicable. And I think about that on my free time, I listen to much different, I listen to leadership and life coaching style podcasts and I do sprinkle some dentistry in there just to stay up to date. But it made me think this morning too, these podcasts that we do.

Sometimes we've got startup doctors or two years into owning the practice or associate doctors who maybe don't own their own practice yet or maybe they don't want to own their own practice but they're super new, listen to a podcast and then fast forward five years, we've been doing this podcast for a long time you guys, going back and listening to it from a different perspective. Today I'm a different person than I was five years ago when I first listened to it.

It made me think about that this morning. I love podcasting, I love pulling you guys into the podcasting world and getting this time with you. And it really made me think about how different stages of your life things are just gonna hit a little bit differently. So I wanted to take that minute to just remind everyone to go back through. We've got a million podcasts. Share with your friends, share with your family who's in dentistry. Like how many of us, right, have some sort of family member who's also in dentistry that could use the information?

The Dental A Team (04:19.771)

Just a quick reminder, and today's topic is super fun. I am not an EFDA. I will put that out there. I'm not an EFDA, but I'm a dental assistant at heart. I will say it every single time. I just said it on the last podcast. I love dental assisting. It just makes me so happy. It fulfills my soul. So today, Dana, I thought it would be really fun to take a little adventure down the road of what an expanded functions.

dental assistant within a practice might look like. And I think this is a good space for teams and for doctors, a good podcast for doctors to really get some ideas on what that could look like within their practice. Now doctors, will say and listeners out there, not every state sees an EFDA for what another state sees them as.

So a lot of the things that we're going to talk about, remember we consult practices from coast to coast. We are all over the country. And so we've got tidbits and pieces that we picked up from different practices all over different states. So caveat to today, I want you to go check what your state's requirements are, what your state's legalities are, what they can or can't do before taking anything we say and implementing it right off the bat, right off the bat, unless you already have that information. Really easy place to go is your state dental board.

ADA usually has some interesting facts on per state. So just go double check those beforehand. So that's my caveat, but Dana and I both have worked with a lot of practices who do utilize EFTAs. It's a wild wild west out here, so we don't require the EFDA, but we do have that available here and you can do more with it. You can do the coronal polishing and things like that here in Arizona, but it's...

sadly not yet required in Arizona. I think it is getting pushed towards that way. But I wanted to pick your brain a little bit Dana on some things that you've seen maybe just within different practices across the country. We don't have to like state specific them or anything, but how have you seen chair, know, chair side wise with a doctor and after really be useful to the dentist and the practice for maybe even practice flow.

Dana (06:29.374)

Yeah, so I there's two ways that I think are super common. And I do think that, like knowing, like you said, knowing your state regulations, exactly what you're after can and can't do will kind of help you choose which way might work best for your practice. And there is the first way is they really have their own column, right? And the doctors hop in where doctor is needed. And then the flip side of that is there isn't a separate column for them. They just follow the doctor.

So I think it just kind of depends on how much they can do independently based on state laws as far as which one you choose. But those are the two most common structures that I see. And I think that...

Again, we wanna maximize the way that we utilize them. The other thing that I see is EFTAs being used a lot for assisted hygiene because if they can coronal polish, that's just another avenue for them to be able to help in a different way, help to boost production too and just see more patients.

The Dental A Team (07:19.283)

Yeah, thank you.

The Dental A Team (07:29.703)

Yeah, I agree with that. I was thinking the same thing with hygiene and I was actually thinking as you were talking about like their own provider column or utilizing that provider situation where the doctor's kind of almost the assistant following the assistant, right? It makes me think of your hygiene schedule because if you've got an assisted hygiene schedule or even just two or more hygienists, your doctors are going in for what they need to for their exams. So it's kind of similar I think to...

practices and team members get a little hung up on the scheduling piece and like wrapping their minds around it because you're kind of like Reworking how you thought about an appointment you learned how to schedule an appointment you learn the X's and slashes and the block scheduling but now we're like totally warping what you knew and adding a new caveat but if you think of it in that like assisted hygiene or Double or triple hygiene where the doctors coming in for the exams. It's kind of similar the doctors coming in for

their pieces, right, for the drilling and the decay removal while the assistant stays there just like the hygienist would stay there and finish the cleaning, et cetera, the assistant staying there and filling the tooth back in and finishing it out. So the doctor would come and go and follow the assistant more as a provider. So I do have, I actually have an interesting like smash of all of that information. I do have a practice in a state in Tennessee.

that she's a fantastic dentist and she has like these insanely great ideas and she's always smashing things together. She actually took a hygienist, had a hygienist EFDA. So she had a hygienist go get her EFDA and now she truly is like a provider column because she's doing hygiene and she's doing EFDA out of that column, out of her chair in her room. So it's kind of cool because when practices do that, I have a few practices that are maybe not hygienists, but doing that

kind of column in that chair, that process for like a provider of a few offices that are doing that. And it's almost like you can then look at it as you would an associate or that fifth hygiene. Like how much is this column, how much is this chair able to produce based on what my UFDA can produce and not just what my doctor. So then my doctor column, like my doctor heavy column over here can be those big long.

The Dental A Team (09:46.101)

crown appointments or root canals or whatever. And while he or she is able to break and go do what they need to do in my assistant, my EFDA column, they go pop over and do that and my EFDA finishes it. It's almost as if my EFDA is a provider there and can provide that column's worth of production. So it really helps you, think, when you do it that way to be able to split it out very easily. And then Dana, you mentioned the assistant following the doctor.

that's kind of the same as it is now, but you would need that other assistant to be there if the other one, like you've got two assistants calling the doctor, but that one makes it, that one I think is probably the easiest version for the scheduling aspect for people to digest because it's more similar to the way we naturally already learned how to schedule. So I think that's probably the most common one that we see.

Dana (10:22.368)

there.

The Dental A Team (10:41.62)

And then the hygiene one, I love that, the assisted hygiene, because yeah, coronal polishing, most of them can coronal polish and most states allow that, but again, double check that for you. But I do, actually have a practice that seriously struggles with hygienists. Like they're just in an area that is impossible to get and keep a hygienist. It is so hard. So what they've done is they've actually completely changed the model of their practice and we're still testing it.

We're only a few months in, so do not drop everything and change everything unless you have already been on this train and you're ready for it, but I'm not suggesting you drop everything and change it. Hygiene is difficult right now. I will put that out there. And we need more hygienists, so everyone out there listening, if you wanted to be a hygienist, go be a hygienist. need more of you guys. But this practice is really struggling in their hygiene department, so what they did was they actually got rid of the normal hygiene model, and the doctor

is the hygienist and the doctor, but he's got his FDES who are running the hygiene schedule. So he'll actually have like full hygiene only schedule and he'll run three or four columns of just hygiene. And it's actually super similar to a pedo practice scheduling. So there are smaller appointments and the assistants are doing most everything. He goes in and scales and does the exam at the same time. And he pops out and he's just running around like a pedo doctor would from room to room doing the scaling and the exam.

So that's actually been super beneficial for their practice because then they'll do three days of hygiene, two days of heavy treatment because they've got now four assistants. And so they can run assistant-driven columns on treatment days. And then his column, he can run two chairs on his with two assistants and then two assistant-driven columns.

where his F-Dos can be over there doing whitening, they can do impressions or scans for night guards, all of those pieces. So smashing all of those worlds together, he is exhausted, I'm not gonna lie. He's still trying to figure it out, because he's running around like a chicken. But it is a kind of cool smash between that Peto style of scheduling and then going back to that GP style of scheduling for those F-Dos.

The Dental A Team (13:00.019)

I know you have lot, have practices spread out all over the place too. What have you seen practices doing? Those were kind of like examples, even similarly, but what have you seen in your practices, them really be able to utilize those F-DOS4 within all of their treatment?

Dana (13:03.21)

Yeah.

Dana (13:15.86)

Yeah, I love that you pointed out, Pito, because that is a great space to utilize an EFDA because assistants are doing a lot of the hygiene, but when the assistant can do the sealants and do the night guards and even do some of the restorative, you know.

The Dental A Team (13:25.984)

Yeah.

Dana (13:30.812)

after the preps are done, jump in and do that. So, PETO is a great avenue where you can really maximize an EFDA. So, if you're a PETO practice, consider at least having one EFDA on your clinical team because you really can maximize what they can do, especially, I mean, kiddos were trying to crank and burn out those sealants pretty routinely on those kiddos. And so, having an EFDA that even they can be scheduled specifically in their column for that, that's a really great way to maximize it. I do agree on those power hygiene days. I've got a lot of practices

that are doing the same thing where it's a power hygiene day. We are bringing in as many hygienists or assistants as we can and doctor and team are cranking out as much as you can there. And I like the assisted hygiene model and even if you're not in pedo, right, to be able to have them say, hey, no, let's go in overflow. Let's do your whitening today. Hey, no, let's go into overflow. Let's get that night card started. Like they can maximize and expand on what's already on a hygiene column. And if you're just a practice where like your restorative side

The Dental A Team (14:14.005)

You too.

Dana (14:30.668)

is busy and you are booked out so far, consider bringing in an EFDA who can run their own, like essentially have their own column that you hop in and out of while you're seeing your patients to really be able to maximize the restorative need in your patient base.

The Dental A Team (14:44.576)

Yeah, absolutely. I love that you said that about pedo with like the sealants and things, because I was actually in one of my favorite practices not that long ago out in Atlanta. She's a pedo dentist and it is just like, I love pedo practices. I just get so, I feel like a child when I'm there and like, my gosh, I'm so excited. And it's so much fun, but it's moving so quickly. And the front office gals, the scheduling, they slid in like.

some sealants on a hygiene day, right? Which is like a no-no in this practice and in PETO, like if it's a hygiene day, it's fricking hygiene. And if you're not, don't have F-dos or hygiene doing the hygiene and doctors, it's a no-go. You don't do this, right? So they slid in some sealants because it was break, was spring break, of course. And doctor was like, I'm not really sure how you expect me to get this done. And in my brain, I was like, wow, that's wild to me that she's responsible for the sealants and that

I didn't, in that moment I was like, my gosh, she doesn't have someone here to do the sealants for her. That blows my mind, right? So was like, we gotta get this fixed because if a kiddo is here, a kiddo is ready, a kiddo needs sealants, bust it out. 15 extra minutes to get those sealants done is way better than reappointing, bringing them back, getting them settled in again, getting them prepped, like.

All the children love going to this specific practice. I'm not gonna lie, they love coming back. She's fantastic. But that's not always the case. So if you are a pedo practice or just even a pedo practice that schedules out really far and this patient needs sealants, it's really fantastic to, like you said, be able to just be like, yeah, let's just pop over here. This, know, EFDA over here or this high jumps over here is gonna get these sealants done for you while this person moves on to their next patient or that patient, that person can stay with that kiddo.

give that expanded service while someone else takes the next patient because you're all kind of doing the same things. And I know in pedo model, there's more dental assistants typically than there are hygiene. It's very rare that we see hygienists working in a pedo practice. So having those FDAS on hand is gonna be super beneficial. Maybe one, maybe two, depending on how busy you are, to really bust some of that stuff out. I think that is brilliant.

Dana (16:58.23)

Yeah, and I've had a lot of general practices switching right, like we talk about sealants all the time, especially to hygiene. Like that's just a great add on for hygienists, even in adults. But I've got a lot of offices where they're switching adult sealants to flowable. Well, the hygienist can't really do that, but guess who can? And then it makes that transition super easy. We can find it in hygiene, we can do it while they're there for their hygiene appointment, but we're able to do a flowable or something that maybe the doctor prefers. So I just think, think about

The Dental A Team (17:03.319)

Yeah. Yeah.

The Dental A Team (17:11.225)

Bye.

Yeah.

Dana (17:26.804)

the things that you would love to incorporate or where you might have just a gap as far as a need for it. And if you're a practice that does that, if you're a practice that's like, I just need somebody to kind of fill in those gaps here and there and FDOT is a great solution oftentimes to the obstacles that we're running into.

The Dental A Team (17:46.251)

I totally agree. My doctor for years was like, this is so frustrating because I would prefer flowable over the sealant material because it doesn't chip as easily, but he was the only one that could place it. So I agree that is brilliant. And I think whether, whether your state allows the APTA space to really be driven like that, to really be utilized, effectively, start thinking about those things that maybe even a regular dental assistant could take from your plate.

that you're holding onto that doesn't require that extra schooling or education or letters on their name. Start looking for those spaces. Pedal, general practice, oral surgery, like surgical assistance. There's a lot of stuff they can do too. And a lot of things that assistants can do that we forget to utilize them for and then we get behind or we get stuck.

you know, stuck on something. know a lot of my associate dentists, our sticklers, still about their temps. I walk into practices and I'm like, why are you making a temp right now? Like, this is insane. This is why you have dental assistants. And the dental assistants over there twiddling their thumbs like, have nothing to do all day and I don't feel important. And you know, I'm not valued. And it's like, get your butt out of that chair, doc. What can she do to help support you? Or what can he do to help support you to give that patient an even better experience and to get you moving so that that next patient's experience

Dana (18:42.038)

Yeah.

The Dental A Team (19:05.716)

isn't negatively impacted just because you're spending time doing things that you don't have to. So, EFDA or not, I think it's really important to look for those areas where a dental assistant can be super supportive. Dana, have you had a lot of practices that have been in search of EFTAs and struggled to find them? Or I feel like my practices that can utilize EFTAs, like they're out there. They're finding them fairly easily and able to get them.

into the practice right away, but what have you experienced with that with the hiring search for Aftis?

Dana (19:38.646)

Yeah.

I mean, I definitely think that they're out there. think practices can find them. And then I think if you can't get set, like if there is an assistant that you absolutely love in your practice, who you're like, she's just as a chair side master, or he just is so fantastic. Consider reaching the topic of looking for growth, right? Are you looking for growth in your position? Is this something that you would consider? I think we could implement it really well in the practice. And it's something that I think you would be great at. I think that that's an easy space to look within your practice if you can't find someone out there because oftentimes,

we've got that fantastic personality, that amazing chair-side go-getter, that if we had the conversation with them, it's something that they'd consider.

The Dental A Team (20:16.892)

I totally agree, I think that's brilliant. I actually have a doctor here in the valley that did that and I was like dang, this gonna be everybody. He had like three assistants go and he's like my life's about to be so easy. I was like sure, we're okay. Yeah, so I do agree, I do agree. All right guys, hope, dentist, I hope you found this super valuable and I hope it gave you at least some ideas or sometimes we kinda just feel stuck or lost or like I just need like.

Dana (20:26.633)

I love it.

The Dental A Team (20:39.682)

something lost in the hygiene world, like whatever it might be. I hope there was a tip or a trick in here that helped you. For my FDAS out there, you guys are fantastic. For my dental assistants out there, you guys are fantastic. My heart is with all of you guys, my hygienist, front office representatives, like I hope everyone found something super helpful and valuable within this podcast and I want you to share it with each other.

especially when it comes to the scheduling. It does get little wild. It's just a little hard sometimes to bend our minds to understand what it is we're looking for. So Dana, I think action items, number one, check your state requirements and your state laws. Like what are you allowed to do with an EFDA? And number two slash three is really explore the idea and figure out where could you add more value to your patient's appointment.

reduce your time or not, at least not increase it utilizing an APTA or a dental assistant for more than what you might be right now. Dana, is there anything else you can think of? feel like those are like the two main shebangs right now. Like think about it, figure out what you can do, think about what you'd want to do, and then implement, figure out how to implement within your practice. Yeah, awesome.

Dana, thank you so much for being here today. Your ideas were fantastic. I know you've seen so many different things in all the practices you work with. And I know that with your virtual clients, you worked a lot on the scheduling model. So thank you so much for having that knowledge and for being here with me today and letting me pick your brain. I adore you and I appreciate and value your time today. Awesome, everyone. Thank you.

Dana (22:12.768)

Thanks so much.

The Dental A Team (22:16.539)

Go leave us a five star review. I wanna know if you enjoyed this. Doctors, I really wanna make sure that this stuff is really hitting home for you, that it's something that's super valuable for you. So reach out to us, [e-mail] Let us know if you loved it. Let us know if there's more information that you'd like or if you're trying this model already and you've got some, you know, some stop holds, some holdups, some walls you're hitting, whatever that might look like, reach out to us. We're always here to help. [e-mail] and we will catch you next time.