Riding the next wave to practice success

Oct. 1, 2003
Should I add another team member? How many times have you struggled with that question? It is a powerful one that brings with it the reality of added practice overhead.

by Patricia L. Flanagan, RDH, BS, and Stephen L. Langlois, DMD

The Treatment Facilitator

Should I add another team member?
How many times have you struggled with that question? It is a powerful one that brings with it the reality of added practice overhead. But what would it be like if your practice were to add one person who would help to ensure the following outcomes?

• Increased case acceptance
• Fewer patients necessary for the same production goals
• Higher-value comprehensive care
• Stronger patient-practice relationships
• Decreased stress

And how about if this team member could be brought on at a zero net cost to the practice?

This article will help you recognize the value of adding a "treatment facilitator" to the team as the dental practice moves toward offering more comprehensive care. Our practice did it, and we continue to see the benefits!

Creating a practice that values comprehensive care is a win-win situation. Patients win because they receive care that serves them better and is more in line with what they perceive as valuable. The doctor and the practice win because this model allows the team to participate in a more meaningful, beneficial type of work. And meaningful work means happier, more fulfilled team members.

But why is it so hard to move a practice in this direction? Most of the problems can be attributed to time, or more precisely, a lack thereof. The intense workload that most clinical and administrative staff members have leaves little time for them to spend with patients in worthwhile communication.

Patients often come to a practice (or are already in a practice) with an incomplete understanding of their dental health and with an uncertainty of what dentistry can offer them. Frequently, they have not experienced goal-setting processes for their dental health. It is only after a dentist truly understands a patient's wants and needs and helps him or her (when necessary) to clarify these ideas, that a patient will feel "heard" and be willing to accept complete dentistry. But this takes time!

If the main barrier to providing comprehensive care consistently is lack of time, how can any practice overcome this obstacle? Shifting to a new model and adding a treatment facilitator can make all the difference. The facilitator takes on the responsibility for follow-through, clarification, and closure with patients. You have a person who can take care of the loose ends. This is the area all well-intentioned practices want to complete but often omit due to competing commitments. The primary responsibility of a facilitator is to act as the liaison between the practice and the patient. But how does this work?

One very important role this person can play is that of a new-patient coordinator. We all know how important first impressions are. The dialogue that takes place when a potential patient first contacts the office sets the pace for the future relationship we have with this person. Unfortunately, in most dental and medical offices, this important conversation is handled by the receptionist, who is also busy multitasking to handle the flow of incoming and outgoing patients along with other responsibilities. As a result, this conversation may be interrupted, or may inadequately answer questions. The patient may perceive the exchange to be rushed, setting the stage for a failed relationship. If, however, when the potential patient contacts the office, the phone call is referred to the new-patient coordinator, uninterrupted time can be dedicated to this person. A successful new-patient encounter is assured because both parties have a clear understanding of what to expect. This is even more important in comprehensive-care practices where the initial visit may be different than what the patient has experienced before. In some offices, the new-patient coordinator also works side-by-side with the dentist during the initial visit. The patient receives an added level of comfort upon seeing a person with whom a connection has already been made.

There are many other areas in which a facilitator's skills can be helpful. The relationship with existing patients strengthens as we learn to slow down, listen, and make sure we are meeting their needs. The clinical team does well to perform exceptional clinical care with gentleness and sensitivity. But with the time constraints of the schedule, it may be difficult to communicate on a meaningful level with patients, especially regarding more complex issues. Questions often arise that require significant time to answer. A facilitator can partner with the clinical team to alleviate this stress when he or she enters the conversation at the end of an appointment, at a scheduled consultation, or even during a telephone consultation.

As a practice begins treating patients more comprehensively, the need for interdisciplinary care increases. This requires careful planning on the part of all doctors involved. When the patient is ready to proceed, the general practice assumes the position of "quarterbacking" the steps — a large responsibility that must be handled well. With the dentist's guidance, the facilitator can handle correspondence between the restorative dentist and other offices, as well as help coordinate appointments. Everyone wins with a smooth process and clear expectations. Patients are confident that their care is being managed with professionalism and efficiency. The doctors find that there are fewer surprises with their interdisciplinary-care patients. A side benefit of the improved information exchange between the restorative practice and specialists' offices is an increase in referrals from specialists who appreciate this level of communication.

The benefits of a treatment facilitator are many, but how do we pay the salary? True, the expense of another employee may prevent some offices from proceeding in this direction. However, increases in treatment acceptance rates, fees generated by providing higher-value services, and productivity more than offset this expense. However, it still may seem too risky for the conservative doctor. Beginning with a hygienist who can work part-time clinically and part-time as treatment facilitator is one way to provide enough additional income to cover the extra salary. As time goes on, and the doctor gains confidence in this position, the clinical time can be reduced with a corresponding increase in time dedicated to facilitation, as needed. If a practice already has someone who is a skilled communicator, another way to ease into this model is to allocate one or two days a week for this person to work solely on these issues. This requires undivided time, however, and cannot be accomplished during downtime between patients; it is necessary to schedule either full days or half days for this purpose. Schedule new patients and treatment consultation visits only when the facilitator is available. The rest of the facilitation time can be spent coordinating treatment and performing other facets of the job that lead to practice growth.

As a practice moves toward a more comprehensive-care, health-centered model, a huge need arises to slow down and really communicate with patients. All patients have the right to know what they can expect when they venture into our practices. The new-patient experience becomes a patient-focused, co-discovery, goal-setting process that enables the patient to make informed choices and move toward optimum oral health. Existing patients have the same opportunity to choose complete dentistry. Having a facilitator onboard allows this to happen and serves the practice, patients, team members, and dentist well. Patients will feel "heard" and know they have someone they can contact who understands their care. Greater treatment acceptance results.

Practices run more smoothly because patients proceed with commitment. The weeks unfold with less stress due to a full schedule, fewer emergencies, and the doctor being able to do the type of work he or she desires. As you've seen, adding a skilled communicator in the role of facilitator is a great way to make this happen.

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