I was prompted to write this column because dentists want quick fixes to problems - fixes they can immediately implement. The purpose of this column is to isolate specific, commonly occurring problems, and provide techniques that you can immediately implement to correct them, resulting in sudden, positive changes in your practice. Many of the problems that dentists struggle with have viable solutions that have worked for so many practices that there is no reason why anyone should have to endure them. Take the question we hear from almost every dentist we counsel:
“Although we send postcards and make confirmation calls, patients still cancel their hygiene appointments left and right. They don’t seem to attach any importance to hygiene. What can I do about this?”
Many patients view the hygiene visit as “just a cleaning,” and not a priority item in their lives. No wonder the industry average for hygiene cancellations and no-shows is 28 percent! At Pride Institute, we set goals for our doctors of a cancellation/no-show rate of under five percent. We achieve this by building value into the hygiene appointment. This is done in several ways.
First, the hygienist engages the patient in “purposeful conversation.” By that, we mean conversation designed to reveal the patient’s dental motivators and concerns, including his or her long-term, oral-health goals, commitment to oral health, dental IQ, financial concerns, etc.
Another way to build value is to have the hygienist explain everything he or she does to the patient and why. For example, oral cancer screening. When it is done tacitly, the patient does not know a valuable service is being performed. The same holds true for periodontal probing. By educating the patient about the meaning of pocket depths and periodontal disease, the patient attaches far greater importance to the exam.
The hygienist needs to correct the patient’s perception when he or she fails to see value. For example, if a patient says, “I don’t need X-rays; I haven’t had a cavity in years,” the hygienist needs to respond, “Cavities aren’t the only reason we take X-rays, Mr. Clark. They also detect bone levels, cysts, lesions ...”
The hygienist also builds value through a debriefing session with the patient at the end of the appointment, explaining what services have been performed, what home care is required, and what will be done at the next appointment, stressing the importance of each procedure. Pride offices send patients home with a “continuing-care slip” outlining these things.
As a result of these “purposeful” conversations that the hygienist has with the patient, data is in the charts that can be used to encourage the patient to come in, should he or she call to cancel an appointment. The appointment coordinator says to the patient, “Let me pull your chart, Mrs. Jones. I see that when you last saw Susan, she was concerned about bleeding in the lower right quadrant. How is that doing?” Pointing out to the patient conditions that need to be monitored reminds him or her of the importance of keeping the hygiene appointment. It also is helpful for the hygienist to speak to the patient. The hygienist might say, “Mrs. Jones, do you remember we discussed the infection in your lower right gums? I’m concerned about risking bone loss and tooth loss if we don’t monitor you carefully.”
Hygienists who work closely with their dentists and learn how they perform a diagnosis can be extremely important in supporting restorative care. We find that 60 percent of a practice’s restorative care can come from the hygiene department when the hygienist alerts the patient to dental conditions that the doctor may recommend for additional treatment. The hygienist also answers the patient’s questions or objections prior to the periodic exam. This is another way to build value into the hygiene appointment.
The vision you create for your hygiene department will be transferred to your patients and will determine how much they value their appointments. You can transform a continuing-care department that is a diamond in the rough into a shining gem of your practice - one that not only provides exceptional periodontal care, but also reinforces the patient’s relationship with the practice, gains commitment to long-term oral health, supports restorative care, and more. This will go a long way toward reducing cancellations and improving your patients’ oral health.
Amy Morgan is chief executive officer and lead trainer of Pride Institute, a national dental-management company which provides consulting services, educational seminars, patient charting, and staff training materials. To ask Amy a question for this column, visit “Ask Pride” at www.prideinstitute.com or call Pride Institute toll-free at (800) 925-2600.