Comparison of student productivity in four-handed clinic and regular unassisted clinic

Although four-handed dentistry is routine in most dental practices in the United States, solo unassisted clinical practice is the norm for students at many North American dental schools. The objective of this study was to compare the clinical productivity of fourth-year dental students practicing in a four-handed model to the clinical productivity of those same fourth-year dental students practicing in a solo, unassisted mode at the University of Iowa College of Dentistry for the three academic years 2005-08. Students averaged 2.62 patient visits per day in the four-handed Dental Auxiliary Utilization (DAU) Clinic and 1.74 visits per day in the regular Family Dentistry Clinic. Charging fees that are approximately 50 percent of prevailing local private practice fees, the mean daily charges for services provided by individual students averaged $329 in the DAU Clinic and $190 in the Family Dentistry Clinic. The mean daily productivity differentials were 0.88 patient visits and $139. While students averaged 51 percent more patient visits and 75 percent higher charges daily in the DAU Clinic as compared to the regular Family Dentistry Clinic, the increased revenues might not be sufficient to offset increased expenses incurred in the four-handed clinical operation.