The Registered Dental Hygiene Workforce in Nevada

Transcription

1 Medical Education Council of Nevada Center for Education and Health Services Outreach University of Nevada School of Medicine The Registered Dental Hygiene Workforce in Nevada Tabor Griswold, MS John Packham, PhD Jake Burkey, MS MECON Health Workforce Report July 28

2 The Center for Education and Health Services Outreach (CEHSO) at the University of Nevada School of Medicine is home to a number of education and outreach programs serving communities and medically underserved populations across Nevada. A wide range of research, data collection, and policy analysis is conducted by CEHSO staff working under the auspices of several CEHSO units, including: $ Nevada State Office of Rural Health (SORH) $ Medical Education Council of Nevada (MECON) SORH coordinates a number of programs serving the health care needs of rural Nevadans, including the Nevada Health Service Corps, Nevada Rural Hospital Flexibility Program, and the Rural Obstetrical Access Program. A key function of the SORH is rural relevant data collection and research that supports health care providers and residents in rural Nevada, including the publication of the biennial Nevada Rural and Frontier Health Data Book. MECON was established by the Nevada Legislature in 23 to ensure that Nevada has an adequate, well trained workforce to meet the needs of all residents of Nevada. MECON has been charged with conducting health workforce research identifying the health workforce needs for the provision of medical services in Nevada. For more information about CEHSO programs, research and policy analysis, please visit the following website For more information about this report, please contact: John Packham, PhD Center for Education and Health Services Outreach University of Nevada School of Medicine Reno, Nevada (775) jpackham@medicine.nevada.edu

3 The Registered Dental Hygiene Workforce in Nevada Tabor Griswold, MS Center for Education and Health Services Outreach University of Nevada School of Medicine John Packham, PhD Center for Education and Health Services Outreach University of Nevada School of Medicine Jake Burkey, MS Center for Education and Health Services Outreach University of Nevada School of Medicine July 28 Copyright 28 Medical Education Council of Nevada

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7 Table of Contents List of Figures..ii List of Tables.. iii Overview and Purpose of the Study 1 Survey Methodology and Data Analysis.. 1 Demographic Profile.. 3 Education and Licensure.4 Employment and Practice.6 Career Planning and Job Satisfaction.11 Conclusions 13 References.14 Appendix Region Map and Questionnaire.15 i

8 List of Figures Figure 1 Gender of Dental Hygienists in Nevada by Region Figure 2 Age of Dental Hygienists in Nevada Figure 3 Race Ethnicity of Dental Hygienists in Nevada... 3 Figure 4 Net Annual Income of Nevada Dental Hygienists Figure 5 Nevada Dental Hygienists Graduates of Nevada Dental Hygiene Programs Figure 6 Nevada Dental Hygienists Trade School Region, by Workplace Region Figure 7 Top Five States in which Dental Hygienists Education Obtained by Nevada Dental Hygienists Figure 8 Top Five Schools at which Dental Hygiene Education was Obtained by Nevada Dental Hygienists Figure 9 Current Practice Setting of Dental Hygienists Employed in Nevada Figure 1 Practice Type in Which Dental Hygienists Are Employed in Nevada Figure 11 Type of Practice among Dental Hygienists Employed by Region in Nevada Figure 12 Dental Specialty Practice in Which Dental Hygienists are Employed in Nevada Figure 13 age of Registered Dental Hygienist Time Allocated by Activity Figure 14 Expected Employment for Dental Hygienists within Dental Practice Figure 15 Years Practicing for Dental Hygienists Figure 16 Average Number of Years in Current Employment Figure 17 Average Weekly Hours and Average Total Hours Worked From All Places of Work by Region for Dental Hygienists Figure 18 Years until Retirement for Dental Hygienists Figure 19 Years until Retirement for Dental Hygienists by Region in Nevada Figure 2 No Retirement Plans in Place... 1 Figure 21 Estimated Years to Retirement Reflected by Age Figure 22 Employer Sponsored Benefits provided for Registered Dental Hygienists Figure 23 Primary Reason for Relocation to Nevada (top 5 categories) among Nevada Dental Hygienists Who Arrived Within Past Decade Figure 24 Career Projection Until Retirement of Nevada Dental Hygienists, by Region Figure 25 Job Satisfaction Using Projected Change in Hours for Nevada Dental Hygienists Figure 26 Components of Job Satisfaction ii

9 List of Tables Table 1 Distribution of Dental Hygienists in Nevada by Region Table 2 Dental Hygienists Survey Responses by Region and Mode of Completion... 2 Table 3 Estimated Distribution of Employed Dental Hygienists in Nevada by Region Table 4 Estimated Dental Hygienists and Dental Hygienists FTEs per 1, Residents in Nevada iii

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11 Registered Dental Hygiene Workforce in Nevada Overview and Purpose of the Study Accurate information on the Registered Dental Hygiene workforce in Nevada is uneven and incomplete. Presently, no state agency is charged with collecting information on the current and projected supply and demand of dental hygienists in Nevada. The absence of comprehensive dental hygienist workforce data undercuts the ability of state policymakers, educational institutions, and oral health advocates in Nevada to make informed decisions regarding the future dental hygiene workforce needs of the state. This ability is allthe more urgent given the state s rapid population growth, well documented oral health care needs, and reliance on out of state institutions for the professional training of its dental hygienist workforce. In an effort to address these shortcomings, the Medical Education Council of Nevada (MECON) undertook a major analysis of the dental hygienist workforce in Nevada during Fall 26. MECON has been charged by the Nevada State Legislature to determine the workforce needs for the provision of health care services in Nevada and to make recommendations to the legislature on the status and need of health practitioners, other providers of health care, and other personnel of health care facilities or programs in Nevada. A statewide assessment of the dental hygiene workforce in Nevada is thus consistent with this charge. This report, The Registered Dental Hygiene Workforce in Nevada, presents the major findings of a survey of all dental hygienists with an active license to practice in the State of Nevada. A complete copy of the study s questionnaire is contained in Appendix A. A companion report, Licensed Dentists Workforce in Nevada, provides the principal findings of a survey of all Licensed Dentists in Nevada. The surveys were coordinated by researchers at the University of Nevada School of Medicine and University of Nevada, Reno. The study s questionnaires were constructed with input and guidance from key dental hygiene stakeholders in Nevada, including the Nevada Dental Hygienists Association, Nevada State Health Division, Northeastern Nevada Oral Health Coalition, and Truckee Meadows Community College Dental Hygiene Program. Survey Methodology and Data Analysis The sample frame for The Registered Dental Hygiene Workforce in Nevada is a list of the mailing addresses of the 1,46 dental hygienists licensed to practice in Nevada on August 29, 26, provided to the Medical Education Council of Nevada (MECON) by the Nevada State Board of Dental Examiners. All members of the sample frame were selected for participation in the survey, administered as a census. The geographic distribution of mailing addresses by region is shown in Table 1. The Urban South (Las Vegas) region contains the zip codes in urban areas of Clark County, including Boulder City and Henderson. Urban North includes Carson City, Reno, Sparks, and urban areas of Douglas, Storey, and Washoe Counties. Rural and Frontier encompasses the remainder of Nevada, including rural areas in Clark, Douglas, Storey, and Washoe Counties. Finally, Out of State includes all addresses 1

12 outside of Nevada. A map of the three principal study regions is contained in Appendix B. Table 1 Distribution of Dental Hygienists in Nevada by Region 26 Mailing Address Region Dental Hygienists with an Active License in the State of Nevada 26 Number of Total of Nevada Total Urban South Urban North Rural/Frontier Nevada Total Out of State N/A Total 1,46 1. N/A The census list was revised prior to statistical analysis by dropping cases for which an invitation to participate in the survey could not be delivered. The two most common reasons associated with that circumstance were that the respondent was deceased or that the correct mailing address could not be determined. The cases in the revised census list are referred to as valid cases within this report. Survey responses occur as participatory responses, in which the respondent completes the survey questionnaire, or refusals, in which the respondent acknowledges receipt of the invitation to participate and explicitly refuses to do so. The calculation of the overall response rate for this study has been performed by dividing the number of participatory responses by the number of individuals in the revised census list. Response rates by region and mode of completion (either mail or internet) are shown in Table 2. Cell counts represent the actual number of responses, and the cell percents represent the percent of responses overall. So, for example, 31 responses were received through the online instrument from respondents in the Urban North region, comprising 4.4% of total responses. Not shown, but calculable from the table is that those responses represent 13.7% of all responses from the Urban North region and 34.4% of all responses received online. Overall, over oneeighth of the surveys (12.6%) were completed on line and seven eighths (87.4%) were completed by mail. Table 2 Dental Hygienists Survey Responses by Region and Mode of Completion Region Valid Cases Total Complete Completed On Line Completed by Mail Number Number Number Urban South Urban North Rural and Frontier Out of State Total 1,

13 Demographic Profile Figures 1 through 3 provide a profile of the gender, age, and racial ethnic distribution of the dental hygienist population in Nevada. In 26, 98.2% of the dental hygienists in Nevada were female and 1.8% were male. Figure 1 Gender of Dental Hygienists in Nevada by Region 26 Female 98.2% Male 1.8% Figure 2 highlights the age distribution of the dental hygienist population in Nevada. In 26, one in three dental hygienists were between the ages of 31 and 4, and over two thirds (71.7%) of dental hygienists were aged 5 years or younger. The average age of a dental hygienist in Nevada was 43.5 years and the median age was 47. years. These age characteristics of the dental hygienist population are consistent with the finding presented later in this report that almost half (47.3%) of dental hygienists statewide expected to be in the workforce for more than ten years. Figure 2 Age of Dental Hygienists in Nevada 26 Dental Hygienists Age in Figure 3 depicts the racial and ethnic characteristics of the Nevada dental hygienist population. Statewide, most dental hygienists self identified themselves as White, 95.1%. This proportion was significantly higher than the total White population category in Nevada, 62.%. Conversely, the proportion of dental hygienists who self identified themselves as Latino was considerably smaller than the proportion of Latinos in the general population, 23.3%. There perhaps exists an opportunity for dental hygiene programs to actively recruit minority students to better serve the minority population. Figure 3 Race Ethnicity of Dental Hygienists in Nevada Mean Asian Black Latino Native American White 3

14 The distribution of gross annual income of Nevada dental hygienists for the 25 tax year is displayed in Figure 4. The median income ranged between $5, and $6,. However, 8.6% of dental hygienists reported earning less than $2,. Figure 4 Net Annual Income of Nevada Dental Hygienists 25 of Registered Dental Hygienists Income($1,) Of those dental hygienists surveyed, 82.8% reported an income from dental hygiene. Of those declaring income, 45.5% also reported having income in addition to their dental hygienist earnings. Education and Licensure Figure 5 depicts the proportion of working dental hygienists who graduated from Nevada Dental Hygiene programs or were educated outside of Nevada. Statewide, 35.6% of practicing dental hygienists are graduates of Nevada dental hygiene programs. Hence, the data suggests that almost two thirds of practicing dental hygienists in Nevada have moved here from other states or were trained in other states. As shown in Figure 5, the proportion of dental hygienists who are graduates of Nevada programs differ across regions of the state in a manner that is statistically significant (Chi square =.), with more Nevada graduates working in the Urban South region (45.5%), fewer in the Urban North region (23.%), and a similar proportion in the Rural and Frontier region (21.6%). Dental hygienists who were educated outside of Nevada comprised 77.% of the Urban North workforce, 54.5% of the Urban South workforce, and 78.4% of the Rural and Frontier region. An interesting and significant finding is the distribution of Nevada residents who returned to Nevada after being educated as a dental hygienist outside of Nevada, 45.2% in North Urban region (chi square <.5), 21.% in the South Urban region, and 33.3% in the Rural and Frontier region. Figure 5 Nevada Dental Hygienists Graduates of Nevada Dental Hygiene Programs 26 within Region Urban North Urban South Rural/Frontier Nevada Educated Resident Out of State Educated & Moved to NV Out of State Educated NV Resident A closer look reveals a highly significant relationship (chi square =.) between the region in which a Registered Dental Hygienist s school is located and the region in which a Registered Dental Hygienist s workplace is located. As shown in Figure 6, 73% of dental hygienists schooled in Nevada work in the Urban South region, almost one in four (22.4%) of dental hygienists trained in Nevada work in the Urban North, and 4.6% of those schooled in 4

15 Nevada work in Rural and Frontier Nevada, (chi square =.). Dental hygienists who were schooled in the Urban North, 96.3%, remained to work in the Urban North. Dental hygienists who were trained in the Urban South, 1.%, remained to work in the Urban South. There were no dental hygiene programs in rural Nevada. followed with Idaho and New York. Interestingly, dental hygienists were trained in 4 of the 5 states, including the District of Columbia. Figure 7 Top Five States in which Dental Hygienists Education Obtained by Nevada Dental Hygienists 26 Figure 6 Nevada Dental Hygienists Trade School Region, by Workplace Region NV CA OR ID NY Urban South Urban North RuralFrontier Nevada Graduates in Region Graduate Region Retention Out of State Workforce The strong relationship between the region of dental hygienist school and workplace region suggests that efforts targeted at increasing the number of dental hygienists students educated from the underserved areas of Nevada, such as the rural and frontier counties, may be particularly effective at increasing the number of dental hygienists in those areas. Figure 6 also highlights the extent of the recruitment from outside the state of Nevada, exceeding 7% of the workforce in two of the three areas. Figure 8 highlights the top five schools at which Nevada dental hygienists received their education. Over 35% of dental hygienists received their education from the Community College of Southern Nevada, over 5% from Truckee Meadows Community College, followed by Idaho State University, Oregon Institute of Technology, and Loma Linda University. In all, Nevada dental hygienists received education from 56 universities in 4 states including the District of Columbia, as well as foreign dental hygienists schools. Figures 7 and 8 provide information on the state location where Nevada dental hygienists received their education. Figure 7 indicates that more than a third of Nevada dental hygienists received their education in Nevada, over ten percent in California, five percent from Oregon, 5

16 Figure 8 Top Five Schools at which Dental Hygiene Education was Obtained by Nevada Dental Hygienists Community College of Southern Nevada Truckee Idaho State Meadows University Community College Employment and Practice Oregon Institute of Technology Statewide and regional estimates for the number of dental hygienists practicing in Nevada are shown in Table 3. Table 3 Estimated Distribution of Employed Dental Hygienists in Nevada by Region 26 Loma Linda University practicing dental hygienists (28.%) was much greater than the percent of population (18.6%) residing in that area. Finally, the percent of dental hygienists practicing in Rural and Frontier areas (8.3%) was lower than the percentage of Nevada residents populating those areas (12.5%). The estimated number of dental hygienists full time equivalents (FTEs) per 1, population by region and statewide is shown in Table 4. The FTE concept combines the number of hours worked divided with the number of personnel as follows. Based on the assumption that one FTE is equal to one dental hygienist working 32+ hours per week, total dental hygienists FTEs is calculated by adding all the hours worked by dental hygienists in Nevada and dividing by the number of dental hygienists in Nevada. The population estimates in the table are from the Nevada State Demographer. Region Licensed Registered Dental Hygienists Estimated Number Employed of Workforce Employed Urban South % Urban North % Rural/Frontier % Nevada Total % The data from this survey indicates that 559 of Nevada dental hygienists practice in the Urban South area, followed by 272 in Urban North and 64 dental hygienists in Rural and Frontier areas. In 26, there was significant regional variation in the per capita distribution of dental hygienists in Nevada. The distribution of dental hygienists in Southern Nevada (63.6%) was less than the proportion of the state s population residing in that region (68.8%). In contrast, in Urban Northern Nevada the distribution of Table 4 Estimated Dental Hygienists and Dental Hygienists FTEs per 1, Residents in Nevada 26 Dental Hygienists Region Employed (Estimated) Urban South Urban North Rural / Frontier Nevada Total FTEs 26 Population Dental Hygienists per 1, FTEs per 1, ,85, , , ,623, The Urban North region had the highest ratio of dental hygienist FTEs per 1, population (31.7) and the Rural and Frontier region the least (15.8), with a statewide average of

17 Figure 9 Current Practice Setting of Dental Hygienists Employed in Nevada 26 Corporate Owned Practice 4% 2% Educational Institution 5% Other Figure 11 provides information the dental scope of practice in which a dental hygienist is employed by region in Nevada. Respondents were given the option of selecting (a) general dentistry only, (b) specialty services only, or (c) general dentistry, with one or more specialty services, even if rarely performed. Figure 11 Type of Practice among Dental Hygienists Employed by Region in Nevada 26 89% Dentist Owned Private Practice Figures 9 and 1 provide information on the current practice settings of Nevada dental hygienists. The primary setting is the dentistowned private practice (89.%) with a small percentage, 4%, of practices being corporate owned, and 2% are education institutions. The balance of work settings, 5%, is fairly evenly distributed between non profit or publicly owned practice, local, state, or federal government with 1% comprised of a various number of non dental related businesses with several in the health field. In general, there was little regional variation in the distribution of dental hygienists across types of practice settings (except for those employed in nonprofit settings) or types of ownership. Figure 1 Practice Type in Which Dental Hygienists Are Employed in Nevada % 3.4% 52.3% General dentistry only General with specialty Specialty services only South Urban North Urban RuralFrontier General dentistry only General with specialty Specialty services only In each region, those dental hygienists who were employed in a general dentistry only practice outnumber those who reported that they worked in a dental practice which provided specialty services or some combination of general and specialty care. A significantly greater proportion of dental hygienists in the South Urban and Rural and Frontier regions practiced in both general and specialty care dental practices. This information suggests that the dental hygienists may benefit from continuing education opportunities targeting the types of specialty care required by residents of the North Urban region. Further research is needed to determine if such needs exist and how they might best be addressed. Figure 12 provides information on the types of specialty dental practices in which Nevada dental hygienists were employed. More than half of the dental hygienists reported working in a general dentistry practice, 52.2%. The next 7

18 largest group of dental hygienists worked in a general dentistry practice with one or more specialties, 44.6%. Of the dental hygienists working in a dental practice with one or more specialties, the majority work in a practice focused on endodontics (74.5%), pediatric dentistry (57.3%), periodontics (5.7%), and prosthodontics (48.9%). Figure 12 Dental Specialty Practice in Which Dental Hygienists are Employed in Nevada Endodontics Pediatric Dentistry Periodontics Prosthodontics Orthodontics and Dentofacial Orthopedics Oral and Maxillofacial Surgery Oral and Maxillofacial Radiology Dental Public Health Oral and Maxillofacial Pathology Figure 13 age of Registered Dental Hygienist Time Allocated by Activity 26 Figure 14 Expected Employment for Dental Hygienists within Dental Practice Urban North Urban South Rural Fronter Direct Treatment Prep or Cleanup Admin or Management Other Duties Dental hygienists were asked to provide their time allocation by activity. The primary activity was direct treatment as the reported results were consistently above 8% for all regions South Urban North Urban RuralFrontier Increase Stay about the same Decrease As displayed in Figure 14, the vast majority of dental hygienists anticipated their employment hours to stay about the same or increase. However, the expectation of fluctuating employment hours (either increasing or decreasing) was greater among rural and frontier dental hygienists. 8

19 Figure 15 Years Practicing for Dental Hygienists frontier region, showed a shorter length of service, averaging 5.6 years. Figure 17 presents the average hourly work week for dental hygienists. Of note, the data shows that rural hygienist worked less average hours at their primary place of work and totaled more average hours at multiple places of employment than their urban counterparts Figure 17 Average Weekly Hours and Average Total Hours Worked From All Places of Work by Region for Dental Hygienists 26 Figures 15 through 19 present detailed estimates about the dental hygiene workforce. Figure 15 shows that the largest percentage of the hygienists graduated from a dental hygiene program during the 199 s. The next largest segment between 25% and 3% graduated since 2. Over 6% of the dental hygienists have worked less than twenty years in their profession. Hours South Urban North Urban Rural Frontier Average Total Hours per Week Average Hours in Workweek Figure 16 Average Number of Years in Current Employment 26 Years South Urban North Urban Rural Frontier Figure 16 displays the average number of years that dental hygienists have been at their current place of employment. There was little variation between the urban regions, averaging 7 years. Dental hygienists, in the rural and Figure 18 shows statewide information on the planned years until retirement for dental hygienists. Figure 18 Years until Retirement for Dental Hygienists No retirement plans 1 5 years 5 1 years More than 1 years Figure 19 presents data highlighting the variance in years until retirement reported by the dental hygienists in the Rural and Frontier 9

20 region when compared to the North and South Urban areas. Figure 19 Years until Retirement for Dental Hygienists by Region in Nevada 26 age had the third largest percentage with no retirement plans in place. Figure 2 No Retirement Plans in Place South Urban North Urban Rural Frontier No retirement plans 1 5 years 5 1 years More than 1 years Under over 6 Age Categories Figures 2 and 21 highlight the constancy of the dental hygiene workforce. Figure 2 indicates that dental hygienists plan for retirement at all ages. Those dental hygienists under 3 reported the highest percentage of no retirement plans in place, 19.2%. Interesting, the over 6 years of Figure 21 displays the constancy of the dental hygiene workforce between the mid twenties and the early forties who plan to retire in 1 years or more. After the early forties, a trend exists to plan retirement in six years or less. The exception are those over 6, who perhaps are late to their careers or do not plan to retire. Figure 21 Estimated Years to Retirement Reflected by Age 26 Years to Retirement Age Only a minority of dental hygienists in Nevada receive employer sponsored benefits such as, health insurance and retirement programs. One in three received medical benefits from their place of employment. Figure 22 shows that a limited number of benefits accrue to a very small percentage of dental hygienists. 1

21 Figure 22 Employer Sponsored Benefits provided for Registered Dental Hygienists Medical Retirement Uniforms Continuing Ed Dental and/or Optical Paid Time Off Profit Sharing/Bonus Other Benefits Disability and/or Life Career Planning and Job Satisfaction Several questions in the survey are designed to extract information on work related trends, including incentives for relocating to Nevada and expectations regarding practice here. Also included were two measurement scales, each composed of several questions, to measure overall satisfaction of dental hygienists with his or her current job. Figure 23 Primary Reason for Relocation to Nevada (top 5 categories) among Nevada Dental Hygienists Who Arrived Within Past Decade Urban South Urban North RuralFrontier Spousal move Lifestyle or recreation New practice Return home/family here Lower household costs Figure 23 highlights the primary reasons for dental hygienists relocating to Nevada in the past ten years. The primary reason given by 42.6% of the respondents was that their spouse moved to Nevada. The survey results reveal considerable regional variation concerning reasons given for relocating to Nevada. Notably, 2% of those in the Rural and Frontier region indicated that returning home or lifestyle or recreation was the primary reason for relocating, as shown in Figure 22. This suggests that efforts to recruit dental hygienists for service in that area might benefit from an appeal based on rural training and recruitment using lifestyle and recreational opportunities. Job satisfaction as reported by the Nevada dental hygienists was measured using scales developed for medical professionals by researchers at the University of North Carolina, Chapel Hill. Job satisfaction is a measure of attitude regarding current employment. Career satisfaction can be derived by estimating the time that dental hygienists project they will remain in the dental workforce. Statewide, the percentage of the dental hygienists who had no plans for retirement (14.6%) averaged an age of 41.5, the percentage of the hygienists who 11

22 Registered dental Hygienists Workforce in Nevada planned to retire in one to five years (16.1%) averaged an age of 52, the percentage of hygienists who planned to retire in five to ten years (22.1%) averaged an age 48.7, and the percentage of the hygienists who planned to retire in over ten years (47.2%) averaged an age 38. It can be projected that over 6% of the Registered Dental Hygienist Workforce plans to be working longer than ten years. expected their workload to decrease (23.2%). Figure 25 also reflected the opinion of the rural and frontier dental hygienists expectations of their more fluctuating workload as reflected in larger increases in hours (13.%) rather than their hours remaining constant over the next five years (58.8%). Figure 25 Job Satisfaction Using Projected Change in Hours for Nevada Dental Hygienists 26 Figure 24 Career Projection Until Retirement of Nevada Dental Hygienists, by Region South Urban North Urban RuralFrontier Increase Stay about the same Decrease South Urban North Urban Rural Frontier No retirement plans 1 5 years 5 1 years More than 1 years Figure 24 reveals an important lack of significant regional variation in reported career longevity. The Nevada dental hygienists in the urban areas projected less time to retirement (.64%) as compared to their counterparts in Rural and Frontier areas (.71%). Dental hygienists were asked whether, over the next five years, the number of hours per week they expected to work would increase, decrease, or stay about the same. Figure 25 highlights that the vast majority of dental hygienists in urban areas reported that they expected to work about the same number of hours per week in the future (69.%), as compared to those who expected their workload to increase (7.%) and those who Job Satisfaction was evaluated through questions about the dental hygienists workplace and relationships at the workplace. Figure 26 details factors involved with job satisfaction, in 26, for Nevada dental hygienists. On a scale from to 1, where means high dissatisfaction and 1 means high satisfaction, these factors indicate a high level of job satisfaction with their working relationship with their supervisor (.94), they feel good about their job (.89), they have job security (.87), they feel good about working at their dental practice (.86), and that their wages are good (.86). There was less satisfaction concerning the recognition received about their work (.78) and management concern for them, (.68). The lowest satisfaction was reserved for the goodness of the work for their physical health (.64). 12

23 Figure 26 Components of Job Satisfaction Ratings Supervisor Compatibility Feel Good about Job Job Security Good About Practice Wage are Good Appropriate Use of Skill Close to Peers Urban South Urban North Rural Frontier Receive Caring Recognition Management Work is Good for Physical Health Conclusions The findings of this survey provide an improved understanding of many aspects of the dental hygienist workforce, including the social and demographic composition, employment characteristics, income and earnings, and job and career satisfaction of dental hygienists with an active license in the State of Nevada. With the most current information on the dental hygiene workforce in Nevada, the report provides state policymakers a wide range of statistically representative data. It is anticipated the findings of this report will be used by legislators, state agencies, and non governmental organizations to inform the development of public policy addressing the oral health and dental hygienist workforce needs of the state. These include, but are not limited to, the development of incentives for dental hygienists to practice in underserved areas of Nevada. 13

24 Registered dental Hygienists Workforce in Nevada References Dillman, D. A. Mail and Internet Surveys: The Tailored Design Method, 2 nd Ed. New York: John Wiley and Sons, 26. Lohr, S. L. Sampling: Design and Analysis. Pacific Grove: Duxbury Press, Pourat, Nadereh, Roby, Dylan,Wyn, Roberta, and Marcus, Marvin. Findings From the 23 California Dental hygienists Survey. Los Angeles: Center for Health Policy Research, UCLA, 25. Shugars, D. A., Hays, R. D., DiMatteo, M. R., and Cretin, S. Development of an Instrument to Measure Job Satisfaction Among Dental Hygienists, Medical Care 29 (1991): Williams, Eric S., Konrad, Thomas R., Linzer, Mark, McMurray, Julia, Pathman, Donald E., Gerrity, Martha, Schwartz, Mark D., Scheckler, William E., Van Kirk, Judith, Rhodes, Elnora, and Douglas, Jeff. Refining the Measurement of Physician Job Satisfaction: Results from the Physician Worklife Survey, Medical Care 37 (1999): Konrad, Thomas R., Williams, Eric S., Linzer, Mark, McMurray, Julia, Pathman, Donald E., Gerrity, Martha, Schwartz, Mark D., Scheckler, William E., Van Kirk, Judith, Rhodes, Elnora, and Douglas, Jeff. Measuring Physician Job Satisfaction in a Changing Workplace and a Challenging Environment, Medical Care 37 (1999): Linzer, M., Konrad, T. R., Douglas, J., McMurray, J. E., Pathman, D. E., Williams, E. S., Schwartz, M. D., Gerrity, M., Scheckler, W., Bigby, J., and Rhodes, E. Managed Care, Time Pressure, and Physician Job Satisfaction: Results from the Physician Worklife Study, Journal of General Internal Medicine 17 (2):

25 Appendix Region Map and Questionnaire 15

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27 Nevada Dental Workforce Study - 26 Dental Hygienists Survey Questionnaire Medical Education Council of Nevada University of Nevada School of Medicine 411 West Second Street / Room 11 Reno, Nevada (775) Current Employment The following set of questions ask about your primary job that is, the job in which you spend the greatest number of work hours. 1 Are you currently employed in the dental field? Yes Skip to question 3. No 2 What is the principle reason that you are not currently employed in the dental field? (select only one response) Retired Not Employed Student Working in another field (specify field):.. Other (please specify): Skip to question Which of the following best describes your current practice setting? (select only one response) Dentist-owned private practice (full or part-time, solo or group) Non-profit or publicly-owned community-based practice Corporate-owned practice Educational institution Local, state or federal government Other (please specify): 4 Which of the following best describes your current practice arrangement? General Dentistry only Skip to question 6 General Dentistry, with one or more specialty services (even if rarely performed) Specialty services only 5 Which specialty services are provided? (Select more than one if appropriate) Dental Public Health Endodontics Oral and Maxillofacial Pathology Oral and Maxillofacial Radiology Oral and Maxillofacial Surgery Orthodontics and Dentofacial Orthopedics Pediatric Dental Periodontics Prosthodontics 6 Please provide the city, state and zip code for your primary practice. City... State... Zip Code... 7 What is your job title? Job Title 8 Which of the following best describes your current employment status in your primary job? Regular schedule (same hours each day), 32 hours or more per week Regular schedule (same hours each day), less than 32 hours per week Varying schedule (various hours or days), 32 hours or more per week Varying schedule (various hours or days), less than 32 hours per week Temporary (short-term) employment only 9 Do you receive benefits such as medical coverage and retirement from your primary job? Yes No Skip to question 11.

28 1 If you receive benefits, which of the following benefits do you receive? Major Medical insurance Dental and/or Optical insurance Retirement plan Uniforms Continuing education Other (please specify): 11 In the past year, what has been the average number of hours per week that you have worked at your primary job? hours per week 12 Please estimate the percentage of your paid work time that is spent in each of the following activities. ( enter % if none) Direct treatment of patients Preparation or cleanup Administration or managerial duties Other (please specify): 13 In the past year, how many weeks did you not work, for any reason, such as a vacation? weeks 14 How many years have you been employed at your primary place of employment? years 15 In the past year, what has been the average number of hours per week that you worked in total (combining the hours from all jobs if employed at more than one job)? average total hours per week Education and Licensure 16 Please select the highest educational degree you have earned? High School Diploma or G.E.D Associate Degree Baccalaureate Degree Masters Degree Doctoral Degree 17 What is the name of the dental hygiene school from which you graduated? 18 In which state is the school located? State What is the year in which you graduated from dental hygienists school? MM YYYY 2 Did you complete an internship? Yes No 21 What is the name of the facility at which you performed your internship? 22 In which state is that facility located? State What is the state in which you were first licensed? State What is the year in which you were first licensed? YYYY 25 Please enter the number of states other than Nevada in which you are licensed. (enter a if none) states Career 26 How many years have you been employed as a dental hygienist? years 27 How many years have you been employed as a dental hygienist in Nevada? years 28 If you moved to Nevada from another state in the past ten years, what was the principle reason you moved to Nevada? (select only one response) Not Applicable - did not move to NV recently Lower household costs Lower business costs or fewer regulations Career advancement in new practice Career advancement within current practice Spousal move Lifestyle or recreational opportunities Study for educational objective Other (please specify):

29 29 Please indicate how strongly you agree or disagree with each of the following statements by checking the appropriate box. Disagree Neutral Agree Don t Know I get along with supervisors All my talents and skills are used I feel good about my job I receive recognition for a job well done I feel good about working at this dental practice I feel close to the people at work I feel secure about my job I believe management is concerned about me On the whole, I believe this work is good for my physical health My wages are good Are you planning for retirement in? No retirement plans 1 5 years 5 1 years More than 1 years 31 Over the next 5 years do you expect that the number of hours per week you work will: increase stay about the same decrease Demographics 32 Are you a resident of Nevada? Yes No (specify state): 33 What is your gender? Male Female 34 What is your year of birth? YYYY 35 Are you of Spanish/Hispanic/Latino ethnicity? Yes No 36 What is your racial background? (Note: multiple selections are allowed) American Indian or Alaska Native Asian/Pacific Islander Black/African-American White/Caucasian Other (please specify): 37 Please select the range below that includes total personal income for the year 25 from: All Sources Less than $2, $2, - $39, $4, - $59, $6, - $79, $8, - $99, $1, - $119, $12, - $139, $14, - $159, $16, - $179, $18, - $2, More than $2, Comments are welcomed. Please include any comments on a separate sheet of paper. Dental Hygiene