Thursday, May 16, 2013

Beware of Phantom case acceptance

Do you ever find yourself suddenly thinking about a patient you diagnosed several weeks ago—the one who agreed to your plan for a quadrant or smile makeover? Whatever happened to her?

Well, she may have said yes to you, but somewhere between the operatory and the front desk that “yes” became a “maybe,” so she didn’t book an appointment. Eventually, she lost interest in the idea and now she’s avoiding her re-care visit because she’s still not sure. This scenario occurs far too frequently in dental practices everywhere.


Doctors are fooled by “phantom” case acceptance while patients (and ideal treatment opportunities) are silently slipping away, often lost forever. It’s one thing to pursue new patients, but as long as these case opportunities are falling through the cracks, you’re taking one step forward and two steps back.

This is where the right strategies are important. Decisions and commitments about clinical care should be made at chairside. This is where value has to be created and where it has to be brought home. In situations where you need support for these large cases, bring the financial coordinator and the appointment coordinator into the operatory. Communicate with them in front of the patient what the patient needs and have them finalize with the patient and appoint it right there. Or after your explanation, the patient can go with them to the consultation room. The main thing is to ensure that the baton is passed correctly so it is not left up to the patient to complete the process.

Patient retention will always be the secret of success in a dental practice. When you can stop the cases you have in your grasp from getting away, that’s when you really start to make strides. It’s the most fundamental cornerstone of leadership, and it isn’t hard to accomplish. It’s just a matter of implementing a few key systems to ensure that every patient receives comprehensive value, every patient leaves complete for payment and—most important—every patient leaves with a firm appointment to return.

Friday, May 10, 2013

Clinical Photography

Taken from Spear Education
We have implemented routing photos as part of our new patient appointment for a few years now.  I consider this a vital part of baseline records, just like perio charting, radiographs, etc. We charge a fee for the photos and show them to the patient as part of a tour of their mouth.  It always raises an awareness of issues which they may not have previously considered, and helps us document many conditions in the mouth that are hard to adequately notate in narrative.  The photos become even more valuable  with time as they provide a record of any changes that have taken place.  We periodically update the photos,  about 3-5 year intervals, just as we do with a panorex.
Posted: 09 May 2013 10:29 AM PDT
For a long time I used to naively reason that I don’t take clinical pictures as often as I should because I need to invest in product “X.” I thought when I have all the necessary armamentarium, I’ll be able to take clinical pictures consistently.
I’ve realized that the key to taking routine clinical pictures was not the armamentarium or my lack of discipline. There was an absence of a systematic approach. If you find yourself in this bind, I propose that you look at the following four key aspects. Implementing these may bring about the consistency you have been looking to achieve.
1. New patient exam protocol: Taking a full series of pictures should be a standard part of every new patient exam. Every clinician who has done this for a year or more will tell you how this investment is well worth the effort. If you try to cherry-pick cases for pictures, your guesses will be wrong at least 50 percent of the time. Once you have a workflow in place, this exercise will take no more than 10 minutes. You’ll soon find out that skipping the process of taking photos to save 10 minutes is not worth at all.
When the operatory is set up for the new patient exam it should by default have the “Photography tub” which would have everything needed to accomplish the complete picture series. This includes the following:
§ Camera
§ Mirrors
§ Retractors
§ Mirror warmer (We use an electric heating pad.)
§ SD card
2. Staff training: Invest time in training your chair side assistant and hygienist to take these pictures. Clinical pictures with mirrors are usually convenient with an assistant; however, one operator can take other photos. If the staff is taking the patient photos, you know it will be done with consistency.
3. Picture management: Having a smooth workflow of managing the pictures ensures that the valuable pictures taken are put to effective consistent use. Try the following protocol:
• Use one memory card for each set of individual patient photos.
• Transfer photos on an iPad or other tablet by an SD card reader. Tablets can be a great tool to talk about the clinical findings during the exam as described here.
• Transfer the pictures to each patient’s chart and an external hard drive.
• Back up photos on an off site back up drive.
4. Slideshow preparation: Train a team member to place the pictures in a specific established sequence into slideshow presentation software like MS Power Point. You can add and modify this basic slideshow further based on a particular clinical situation. But a staff member can easily complete the initial arrangement since it is a simple repetitive sequence of steps for every slideshow preparation.
These keys will help in the following ways:
• At the end of each exam appointment these steps will allow for a quick “show and tell” [by loading images on a tablet] and you can give the patient a tour of the mouth and draw their attention to the clinical findings you discovered during the exam.
• If you decide that you want to invite the patient back for a separate consultation appointment, you will have a basic slideshow draft ready for a quick edit and presentation.
• Consistent picture taking will help you build a library of “before and after” pictures of your own cases. You will not find yourself apologetically looking at a wonderful completed anterior esthetics or implant case thinking, “I wish I had a ‘before’ picture to go with this beautiful looking ‘after’ picture.”
Vivek Mehta DMD, FAGD, Visiting Faculty, Spear Education. Follow him on Twitter @Mehta_DMD.

Monday, May 6, 2013

" I've never met a dentist with an MAGD who has gone bankrupt." Dr. Howard Farran

Great article from Dr. Howard Farran on what winners do and losers don't.