Louis Malcmacher, DDS
I have been to many courses and read many articles about the comprehensive examination. I have heard and read that the comprehensive-examination appointment should take at least one hour. This appointment is really a combination of education, motivation, selling, and actual diagnostic examination and tests. I have also read that the one-hour comprehensive examination will impress patients to the point that they will accept whatever treatment recommendations are made. Many lecturers on the dental circuit say that the only way patients will accept a major treatment plan is with this examination.
Now don't get me wrong. I fully believe in the comprehensive examination, and each of my patients receives such an examination as a new patient and at every recall hygiene appointment. However, my examination does not take one hour, even when it includes a full-mouth series of X-rays and diagnostic casts. My philosophy is that I can meet a patient's exam needs — fundamentally and aesthetically — in a few minutes.
What I believe is missing from the comprehensive examination that dentists read about is one very important question that should be asked of the patient before we do anything else, including the comprehensive examination. This simple little question — "What can we do for you today?" — is the single most important determining factor in whether that patient will elect to have simple treatment or agree to a major, comprehensive treatment plan. I cannot tell you how many patients I have had over the years who have been to other dental offices where the dentists require a comprehensive examination before they do anything else. These doctors then present the patient with a major treatment plan when all the patient wants the dentist to do is make a couple of teeth look better, relieve their pain, or have a filling replaced. You see, people will only go ahead with comprehensive treatment when they are ready, not when you are ready!
We will do comprehensive examinations and complete diagnostic testing on patients when they ask for it. The first question out of any of our staff member's mouths is, "What can we do for you today?" Once we have established what the patient's chief need or want is, we'll give that person a short treatment plan to address those needs. We'll ask the patient if he or she would like us to do a comprehensive examination and present some of our thoughts about other possible treatment plans. But, we will only do this when patients ask for it and when they are ready. It is downright silly to waste your time and the patients' time by going in this direction if the patient is not ready to go there. We like to give people what they want — not what we want. Once you give people what they want, and you provide a good service, they begin to trust and value your office. That is the perfect time to ask patients if they would like a more comprehensive treatment plan and to discuss other options. To assume that every patient who walks in your door only wants the "best" that dentistry has to offer — and to present a major treatment plan for which the patient is not at all ready — is an absolute recipe for disaster.
It is time to start listening to our patients and asking them what they want. Follow the patient's direction and, in the end, you will develop a trusting relationship and everyone will be better for it.
Many dental offices have lost the art of listening. Amazing things happen when you let patients talk, and you and your staff are quiet and learn to listen. Most of the time, patients will tell you exactly what dental services they want from you, how they want it, when they want it ... and then will talk themselves right into your treatment plan! We simply need to learn how to listen better and learn how to give people what they want.
Dr. Louis Malcmacher is an international lecturer and author known for hiscomprehensive and entertaining style.An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired his audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988.For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via e-mail at email@example.com.