Specialists and the General Practice = A Special Relationship
In the course of comprehensive phase treatment, it is possible that a patient may require the services of several dental professionals. A General Dentist may need to use the services of an Oral Surgeon, Periodontist, Endodontist and an Orthodontist to complete one patient. In order to place any dental prosthetics, whether it is for esthetics or function, it must be on a healthy and stable foundation.
For a General Dentist, crowns, three unit fixed bridges, removable partial dentures and full dentures are forms of treatment usually accepted by patients, because they have been the standard of care for many years and insurance companies pay for these services more often.
When a patient decides to move up to implant supported prosthetics or cosmetic full mouth reconstruction, the environment changes. If the general dentist has not had advanced training in surgical placement of implants, the patient is referred to an Oral Surgeon or a Periodontist for the surgical stage of the treatment. Sometimes, depending upon the complexity of the case, a Prosthodontist may also be added to the team, either as a consultant or as part of the reconstructive team. Another important member of the treatment team is the lab technician. The lab technician, often overlooked, but is critical for the success of any prosthetic case. Giving the lab technician as much advanced notice as possible for upcoming cases ensures that the case will be back on time for the next phase or delivery.
The trust that the General Dentist has worked hard to develop can be shattered if the patient’s experience at the specialist’s office is negative. It is important to establish a protocol before sending a patient to the specialist’s office. The patient is naturally hesitant to go to see a specialist because of fear of the unknown. Fearing what the specialist will say or want to do keeps many patients from making that important step. Explaining to the patient what will happen at the appointment and that you and your team are there for support every step of the way is not only correct but kind.
It is vitally important that the General Dentist have a close working relationship with the team of specialists. A visit to the specialist’s facility, to observe treatment and to ask questions as to how his/her patients will be received and treated, should be accomplished prior to sending patients there for consultation or treatment. Getting to know the personalities of each specialist and their teams will help to prepare the patient for his/her appointment.
Some specialists may be better equipped to deal with the “high maintenance” type patient than others would be. Some doctors are skilled clinicians but may not have the “chairside manner” the patient is accustomed to in the General Dentist’s office. Patients may or may not tell you of a bad experience for fear of being labeled a “troublemaker.” Always contact referred patients to see if they are satisfied with the outcome of their visit to the specialist.
Patients like to know that they are being sent to someone that their dentist trusts to do good work. It is wise to tell patients that they will have to ask the specialist’s Business Coordinator about insurance or financial policies as they may be different from the referring dentist. The specialist’s Business Coordinator should be given information from the referring dentist as to how this patient would best be communicated with regard to these matters.
After the patient is sent to the specialist, the general Dentist and/ or the Treatment Coordinator monitors each phase of treatment and keeps in contact with the specialist and the patient. Reserving time for the next phase of restorative is recommended to prevent scheduling glitches.
The Treatment Coordinator is important in this process as patients often stop in the middle of a phase, due to an unforeseen event or a miscommunication, and do not call to reschedule. This is common after a trip to the Endodontist. Once the pain is gone, the patient may postpone the next step in the necessary treatment sequence. The specialist office should inform the General Dentist when this happens but it is up to the General Dentist to keep in contact with the patient through each stage to completion.
Being a patient advocate is usually the responsibility of the Treatment Coordinator. If the patient calls in with any questions regarding treatment, the call would be transferred to the Treatment Coordinator. Having one person in charge of answering the patient’s questions and concerns builds cohesiveness and trust.
Getting together over lunch is a great way for the General Dentist team and the Specialist’s team to get to know each other better and to discuss the best methods of patient care.
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