Creating perfect recall

Are you familiar with the word "counterintuitive?" It means something that goes against what you think is correct - something that goes against your intuition. But, sometimes, things that are counterintuitive are the correct things to do, even if they feel wrong at first.

Paul Homoly, DDS

"Knock knock."

"Who`s there?"

"Duya."

"Duya who?"

"Duya scare `em or snare `em at the recall appointment?

Are you familiar with the word "counterintuitive?" It means something that goes against what you think is correct - something that goes against your intuition. But, sometimes, things that are counterintuitive are the correct things to do, even if they feel wrong at first.

In my experience, one of the most successful places to put counterintuition to work is during the recall appointment.

As practicing professionals, our intuition tells us that we should examine patients first, then recommend procedures on the basis of our examination. But the general public, weaned on a steady diet of auto-repair chains and their constant effort to "upsell" from the basic oil change to a full tune-up, is leery of this practice. Almost universally, people will view with suspicion any recommendation for work beyond what they initially asked for.

So, what`s a hardworking dentist to do? At the recall appointment, put your communication skills to work before you engage your clinical skills. Here are two important topics that you can talk about with most adult recall patients before you "look under the hood."

(1) Ask patients if they would like to talk about developing a lifetime strategy for dental health and appearance.

(2) Suggest an annual plan for recare.

Lifetime strategy

Asking patients if they`d like to talk about developing a lifetime strategy for their dental health and appearance is an important question. Patients who think in terms of lifetime plans are more open to our suggestions. If we go into the recall appointment looking for dental problems, we teach patients to stay away. Instead, ask them if they`d like to talk about how they can improve the appearance, replace, whiten, or seal their teeth. If you know your patient has missing teeth, then offer him or her the choice to discuss it before you start your clinical procedures. Patients are tired after their appointments and may be out of time and energy to talk.

Kim Ferdon, the hygiene assistant in the office of Drs. John and Julie Howard in Savannah, Ga., has a wonderful way of introducing lifetime care. She says, "Today I`m glad to clean your teeth, or would you like the choice of talking about how we can ..." Then, she offers them the procedures that match their needs - bleaching, sealants, tooth replacements, or cosmetic care.

Annual plan

Another topic to introduce before you start your clinical procedures is the annual plan for recare. This is especially important for patients who`ve just completed complex dentistry. The annual plan for recare takes the "every six month" mentality out of recare and elevates this appointment to higher therapeutic ground.

Dr. Mark Davis of Clearwater, Fla., creates annual recare plans for his patients. Dr. Davis says, "The first year after treatment, we watch patients carefully. We`ll clean their teeth and adjust their occlusion on an as-needed basis. We include the first-year recare fee for bite adjustments, cleanings, and products in the total treatment fee. After the first year, patients usually qualify themselves regarding which recare schedule most suits them. We dispense all the home-care products they need for a year. This way, they get the products they need without product-centered discussions every time they`re in."

Take action

Here are some ideas to create the "perfect recall."

Hygienists, ask patients if they`re interested in pursuing lifetime strategies for dental health and appearance.

(1) Dentists, for advanced cases, include the first year`s recare fees in the total treatment fee - .e., cleanings, bite adjustments, products, etc.

(2) Use your communication skills before your clinical skills. Patients have more energy and time to talk before you treat them.

Dr. Homoly is author of Dentists: An Endangered Species - A Survival Guide for Fee-for-Service Care. He has practiced restorative dentistry for 20 years. He has helped thousands of dentists implement reconstructive dentistry through his hundreds of continuing-education workshops and seminars. Dr. Homoly can be reached at (704) 342-4900 or via e-mail at phomoly@mindspring.com. Visit his Web site at wwwpaulhomoly.com.

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