Hygiene Appointments and Patients Who Don't Show
From USA Today, “Results out this week from a Gallup-Healthways poll of 355,334 Americans indicate that more than one third of the population, 34% to be exact, did not visit a dentist last year at all. A recent American Dental Association survey shows dentists incomes are dropping, too, and some dentists say patients who have lost dental insurance are asking about alternative payment plans or skipping appointments.”
This is not new nor should it be alarming, as it has always been a challenge to motivate patients to come in for routine dental maintenance visits. Often seen as elective by those who are driven by pain to seek dental care, the hygiene visit has been showing more dropouts than scheduled treatment in many practices across the country. Demographics and psychographics drive these figures as some offices are doing well with little change in production/collection statistics, yet others have declined as much as 30% or more. The small businesses that are the backbone of the economy in this country have had to downsize staff or in many cases, in order to keep their people on the payroll, have eliminated benefits such as dental coverage. Unfortunately this sends the message that dental care is elective or a luxury.
No two practices are alike and it is difficult to identify what is causing the weak areas unless a dental consultant comes in and does a thorough analysis of all business operational systems. Two very important practice statistics seldom known by the dentist or staff are the new patient numbers (those patients who have had a comprehensive exam, x-rays and professional cleaning) and patient retention percentage (how many active patients do you have returning and how many have left the practice). These should be analyzed quarterly and yearly.
From professional experience and research, there are certain protocols that must be followed in practices on a daily basis to increase the chance of survival in the toughest of economies. Each of these protocols takes leadership to introduce and train the dental team to implement in their daily routine.
One of the most important protocols is the message we send as a team to the patient coming in for a hygiene visit. Too much value is placed on a pre-appointed visit, because it is viewed as a commitment by the dental team. But often the patient pre-schedules because that is what is expected of them - and the real motivation to return is absent. If the patient does not show up after being confirmed and reminded, the team is upset.
It is not always about the teeth - it is about the effort made to connect to the patient and build rapport. It is the relationship as a healthcare partner that is missing. It is easy to break an appointment, but it is difficult to break a relationship. Every hygiene appointment deserves a “hello, how are you?” by the dentist and dental assistant, even if the patient is not due for an examination. Each time the patient enters the practice they should be treated like visiting royalty. Often the staff is so glued to the schedule and daily tasks that they forget why they are there - to serve the patient.
Whoever is performing the hygiene maintenance visit should treat that visit like it is the most important health care examination the patient is receiving this year. Most people that work in dental practices are “feeling” in their temperament types and want the patient to feel good - but don’t make them feel so good that they don’t come back: “You are doing great with your oral hygiene care, Betty, so we should see you back in six months. Make your next appointment with Bea at the desk.” Bea is then seen as responsible when the patient doesn’t show or cancels.
A message from the clinical team should be something like this: “Betty, it is always a pleasure seeing you and helping you to keep healthy and pain free. There are areas in your mouth that look great and I can see the improvement in the tissue. There are other areas that I would like you to pay particular attention to and spend more time with the brush and floss. Hold the mirror and I will show you. I think that you could go six months to your next professional cleaning and examination if you maintain your home care. I have noted some areas that I want to examine at your next visit. It’s important that you keep your scheduled visit with us so that we can continue to help you stay healthy. I am looking forward to seeing you again soon.”
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