The UnionsHow organized labor is lending a helping hand to dental hygiene

by Cathy Hester Seckman, RDH

Imagine, for a moment, these two scenarios. You'll recognize them, every hygienist does.

The first scenario is that it's that time of year again. Holly Hygienist gathers up all her facts and figures, all her nerve, and tiptoes hesitantly towards the boss' office to ask for a raise. Wait, he's on the phone. "Phew!" Holly thinks. "At least I tried. I'll catch him another day. Maybe."

The second scenario is that Hilary Hygienist has just been fired. The boss overheard two employees talking, and jumped to the conclusion that Hilary had been saying uncomplimentary things about him to a patient. Hilary thinks the boss was looking for an excuse to get rid of her, anyway. He didn't even let her tell her side of the story.

If you've ever felt overwhelmed and powerless as an employee, you're not alone. We've all been there. But here is a group of hygienists who have a rather unique working environment, and they're never alone. They're unionized.

The 69 hygienists employed at six Dental Associates Ltd. offices in Wisconsin are full members of Local 3382 of the American Federation of State, County, and Municipal Employees (AFSCME). The assistants at the offices also belong to AFSCME, and the clerical and billing staff are members of a steelworkers' union.

When Dr. John Gonis of Wauwatosa, Wisc., put out his shingle more than 30 years ago, all he wanted was a private general practice. "It was patient demand, really, that caused all this. For instance, I love children, but I don't like to work on them. I brought in a part-time pediatric dentist, and that grew the practice. Pretty soon I also had an orthodontist coming one day a week.

"I wanted to be able to provide all the services my patients needed in-house. I didn't want to refer them out all over the city. It's a one-stop facility that grew into a small dental hospital. Of course, it's not small anymore."

Today he employs pediatric dentists, orthodontists, prosthodontists, oral surgeons, endodontists, and periodontists.

"We never gauged how large the operation got," Dr. Gonis states. "We gauge what we're doing. We do our best for our patients, our organization, and our staff."

Hygienists Pat Becker, Faye Fowler, and Dawn Parys worked for Dr. Gonis in pre-union days. Their part of Wisconsin is heavily unionized, and it seemed natural to them to start talking about unionizing when they had concerns about parity among the hygienists.

"We had 14 or 15 hygienists at that point," Parys remembers. "One of our main reasons (for unionizing) was to try to coordinate benefits and make it fair for everyone, rather than having us go to Dr. Gonis as individuals. There's power in numbers, and it would equalize the field for everyone."

"Patients were educating us," Fowler continues. "It's a heavy union area, and they would come in and ask us why we weren't unionized. Several of them steered us in the right direction."

At the same time the hygienists were thinking about unions, Dr. Gonis himself was talking to union presidents in the area as part of his marketing plan. Several suggested that Dr. Gonis' own office should be unionized, and Dr. Gonis liked the idea, aware that it would be a good marketing tool.

"He came to us one day," Becker recalls, "and said, 'I have this great idea.' He didn't know it yet, but we had just signed our green cards."

A green card is a declaration of intent that an employee would like to join a union. Green cards are required by the Department of Labor before an election can be held to determine if a union will be formed.

The hygienists chose AFSCME, "because they're the best," states Becker. "A great majority of our patients are from there. No union that we know of had ever had members in the dental field, but AFSCME. is nationwide, and they did have health-care workers as members."

"We actually chartered," says Parys, "on Jan. 18, 1987. The assistants were with us."

At that time, Dr. Gonis employed about 30 assistants, and the hygienists needed their numbers. Fowler explains, "Fourteen or 15 hygienists were not enough. According to international union guidelines, we needed 45-50 members, 10 of whom would be officers. The assistants were more than happy to join us. They had been hoping they'd be invited."

The new members of Local 3382 elected officers and put a negotiating team in place to meet with management.

"Pat Becker and I were on that team," Parys says. "I think our first negotiation went very well. Don't forget, Dr. Gonis wanted a union. He wanted to show the labor organizations that his office was a fair place to work."

The team worked for months to clarify employment issues. "We gathered a lot of information," Parys says. "Before the union, we were not supposed to disclose our earnings and benefits to other employees, so there were some surprises. For instance, one of the issues that spurred unionization was the idea that your salary depended on your personality. I was hired in 1986 for more money than a hygienist who had been there eight years. And she didn't get as much vacation pay. She was a good hygienist, but maybe she was too timid."

Becker adds, "Before the union, we had to ask for raises on our anniversary date. We felt that just because someone was timid and afraid, it wasn't right not to get a raise. A couple of hygienists were intimidated, and they put it off, and they had not gotten raises for two or three years."

The hygienists and assistants ratified their first contract in March 1988. The length of each contract varies from two to five years, during which time each hygienist's job is protected by the considerable weight and influence of AFSCME.

As far as anyone knows, Dental Associates Ltd. is the only dental organization in the country to employ union members. A typical small dental office wouldn't have the numbers needed to form a local, but the Dental Associates hygienists and assistants combined were able to make up the required 45-50 members.

Seventeen years later, both sides are still happy with unionization. "I'm more than satisfied," says Dr. Gonis. "We have a great relationship with organized labor. There are always issues, but we work closely with the union and with the issues at hand. We sit down and discuss it, and we've never had any problems."

Dr. Gonis is not allowed to hire a non-union hygienist who works more than 17 hours per week. That presented a problem to new hires who weren't used to the idea.

Melinda Irvin, a hygienist who has worked for Dental Associates Ltd. for seven years, didn't understand the concept at first. "I asked if I could work there as non-union, and they said no. It was really foreign to me. I didn't understand it, but I wanted a full-time job, so I joined. Now, I support the union."

Kathy Woloszyk wasn't enthusiastic about unions, either, and wasn't sure about the whole idea when she came to work there eight years ago. "But I totally agree with Melinda in supporting the union. Having a contract doesn't mean everything is ideal for us. Negotiations are about give and take. But I am still so glad to have that contract now." Woloszyk serves as the chapter chairperson and union steward.

Working under a signed union contract gives the hygienists freedom, they believe.

"My biggest issue is security," says Parys. "I can come to work and do my job, and I don't have to worry if my vacation will be cut, or if I won't be getting a raise. I can really give one hundred percent."

Becker likes the relaxed working environment. "As far as wages go, we all earn the same. It's not something you have to keep a secret. We have a solidarity, an openness, that allows us to actually get close. There's no rivalry. I don't think it's fair that if everyone is doing the same work, I should get more because I've been there longer. When hygienists have a few years' experience here, they should make the same wages."

Dr. Gonis and the members of Local 3382 signed a new five-year contract in May 2003. It's an impressive 30-page document that covers every issue from frequency of pay raises to jury duty compensation to 401K contributions.

It was the first time the union had called in a federal mediator during negotiations. "One of our main issues," says Becker, "was that we don't know how much longer Dr. Gonis intends to own our facilities. We wanted to make sure that if we signed a five-year contract, it would be recognized by whoever bought the practice."

With the contract in place, the hygienists are confident that their futures with Dental Associates are secure and protected. If they have a job-related problem, they aren't alone.

One of the most important benefits of a union contract is the grievance process. Fowler explains, "If a hygienist has a grievance, the first step is verbal. You bring your union rep to your supervisor for a meeting. If nothing is settled in Step One, then Step Two is done in writing.

"When the grievance is written and presented to a clinic management person, we expect a written response in a specific time frame. In Step Three, that written grievance would be given to me, the president of the local. The president would meet with a human resource person and a staff representative. At that point, we'd still be trying to work it out.

"If nothing is done, Step Four would be filing for national arbitration with the Federal Mediation Board. They review the grievance and vote."

Most problems, says Woloszyk, are solved at Step One or Two. "But if it's a termination and the employee feels the termination is unjust, we follow a slightly different procedure, going automatically to Step Three. Any problem with wages, hours, or working conditions goes directly to Step Three."

It's easy to see that the Dental Associates hygienists have a unique position in dentistry. Solidarity, job stability, peace of mind, openness, and security aren't words one hears a lot in our profession, but they recur over and over again with the Dental Associates hygienists. It's interesting to think about, isn't it?

Cathy Hester Seckman, RDH, is a frequent contributor who is based in Calcutta, Ohio.

With six locations across Wisconsin, Dental Associates Ltd. may be the largest private dental practice in the United States. Dr. Gonis has about 1,000 employees. Corporate offices for the clinics are in Burleigh, Wisc., where Gonis maintains an office. He no longer practices dentistry. A human resource staff, a marketing team, and other corporate employees also work at the Burleigh facility.

A hundred and thirty dentists work at the six clinics, along with the 69 hygienists and 236 assistants of AFSCME Local 3382. There is a central appointment center, but each individual clinic has its own front desk people and its own billing staff.

Patients in such a sprawling practice have a distinct advantage, believes hygienist Kathy Woloszyk. "In a small practice, if a dentist had a question about perio or ortho, he'd have to make an attempt to get hold of that specialist. Here, all he has to do is walk down the hallway. We've put educated minds together, and the patient gets expertise right away. Even if a patient moves away, many times they can still stay in our practice at another facility."

One might wonder if patients ever feel anonymous with so many employees, but hygienist Pat Becker says no. "Any patient has the option of asking for you or taking who's available. Many find comfort in seeing the same individual. I've been here 25 years in June. I have patients from 25 years ago who still see me now, and we have good rapport. And I can still feel comfortable asking them to see another hygienist when I'm on vacation. I don't have to worry about them."

Being in a large practice is also good for hygienists, says Dawn Parys. "There's less delineation of duties, and a lot of peer review. When there are that many hygienists, everyone knows what everyone else does. I thought I knew a lot, but I've learned so much more. All of us feed off of everyone else's years of experience."

In Illinois, the state dental hygiene association (IDHA) decided in 2002 that they needed to find a way to wield more political clout.

The IDHA sought out affiliations with other

professional organizations in the hope of getting ideas and mutual assistance. They contacted the Illinois Federation of Teachers (IFT) because the nationwide Federation of Teachers already had a history of fostering affiliate memberships for other professionals.

The IFT offered these things to the hygienists:

• Use of their professional meeting planners.
• Use of their lobbyists.
• Use of their lawyers.
• Use of their management staff.
• Use of their webmaster.
• A small benefit package that includes things like travel discounts and a life insurance policy.

In return, the IDHA agreed:

• To pay the IFT the fees it previously spent on lobbyists and managers.
• To provide expert opinions when the IFT is negotiating dental benefits with employers.
• To set up programs to train teachers to provide oral hygiene units to elementary and middle school students.
• To form relationships with IFT locals in their areas.
• To provide local help to support IFT political candidates.

Unlike the Dental Associates Ltd. hygienists in Wisconsin, the IDHA hygienists aren't unionized per se.

They don't have the right to strike or do collective bargaining - but each individual hygienist is considered an affiliate union member.

When the Illinois Dental Association (IDA) found out about the IDHA/IFT alliance, they formed a union watch committee, then they filed a complaint with a state professional licensing agency against the IDHA, its president, and its immediate past president. The IDA asked the state agency to revoke the licenses of the two hygienists.

The IDHA called the IFT, which unlimbered every gun in its political arsenal and succeeded in getting the IDA case dismissed.

The benefits of this affiliation for the IDHA are obvious. Illinois hygienists have political clout they never dreamed of, and they finally have a way to get the IDA to take them seriously. What does the IFT get out of it?

The simple answer is numbers. Adding more than a thousand voters to its rolls gives the IFT even more influence with legislators that they will use to their advantage, and to the advantage of the IDHA.

Historically, in any legislative dispute between dentists and hygienists, it's been clear that dental associations have more numbers, more resources, and more ability to influence legislative agencies. Affiliating with powerful groups like state teachers' unions may now give hygienists their first opportunity to play on a level field.

More information on the IDHA/IFT affiliation is at www.idha.net