# Handling emergency patients

Nov. 1, 2002
At Levin Group, we use a mathematical approach for building schedules based on a series of formulas, which allows our clients to maximize their productivity and profitability.

Roger P. Levin, DDS, MBA

At Levin Group, we use a mathematical approach for building schedules based on a series of formulas, which allows our clients to maximize their productivity and profitability.

However, patient emergencies can wreak havoc on a dentist's scheduling system. What exactly is an emergency? Webster's dictionary defines an "emergency" as an unexpected, serious occurrence or situation that urgently requires prompt action. Add to that definition something that can cause a dentist's daily nightmare — especially if the practice's scheduling coordinators are inexperienced in handling emergency patients.

#### When patient emergencies arise

Dentists face two types of emergencies: mild and extreme. An extreme emergency is a serious, oral health-threatening situation that requires a dentist's immediate attention. A mild emergency, on the other hand, is a less serious situation that requires attention, but not immediately. In other words, mild emergencies can usually wait.

About 95 percent of all emergencies are mild. When your scheduling coordinators begin to understand the difference between mild emergencies and extreme emergencies, your nightmares will begin to subside.

#### Getting a grip on emergencies

• Never ask patients, "Is this an emergency?" Instead ask, "Is this an extreme emergency?" and ask them to explain the situation. Provide your scheduling coordinators with a list of situations you consider mild and those you consider extreme. If your scheduling coordinators are unsure about a particular situation, instruct them to check first with your dental assistant.
• When a patient contacts your office with an extreme emergency, quickly direct that patient to your dental office. However, you can always buy an hour if necessary. For example, you do not need to ask the patient to come over immediately or say, "How soon can you make it to the office?"

Instead ask, "Can you be here within one hour?" You now have one hour of scheduling flexibility, plus another 30 minutes after the patient enters the office. That gives you a total of 90 minutes of immediate scheduling flexibility.

• Train your dental assistants to handle the major diagnostic portion of emergencies. Have them meet patients, clarify the situation, perform any prep work — such as taking radiographs — and brief you about the problem. You will save time and be better prepared to assist your patients.
• When emergency patients visit your office, buy more scheduling time by giving them an anesthetic. Once you understand the diagnosis, explain to the patient why an anesthetic is necessary and answer any questions. Now you have gained approximately two hours of additional scheduling flexibility from the time of the initial call.

Sixty-five percent or more of a dentist's daily production occurs in the morning. Therefore, if your scheduling coordinators schedule emergency patients during the morning, you will never achieve your maximum daily productivity and profitability. You also will quickly become frustrated, stressed, and fatigued. To avoid this, make sure your scheduling coordinators schedule minor emergency patients during the afternoon when you have ample time to treat them without upsetting your previously scheduled patients.

Don't build emergency time into your schedules. Other than in endodontic and oral surgery practices, it does not make sense to "build in" emergency time. We have found that the majority of saved emergency time goes unused. As a result, you will lose four to seven days of production time per year, which translates into an enormous loss of revenue.

Roger P. Levin, DDS, MBA, president and CEO of The Levin Group and the Levin Advanced Learning Institute, provides worldwide leadership in dental management for general dentists and specialists. Contact The Levin Group at (410) 654-1234.

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