08.11.06 - Issue # 231 Forward This Newsletter To A Colleague

Building Patient Rapport


Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Remember when you were a kid in school? You would go back to school after summer break and there would be new children that had moved into your area over the summer. How cool! A chance to make a new friend. You didn’t just push your way into their lives. You got to know them and to see if they were the type of person you wanted to run around with.

Well, nothing has changed over the years. The only difference now is that being the new kid is at work. Whether it is because you are a new hygienist to the practice or a patient is new to your practice. Building patient rapport is imperative.

Many hygienists will start at a practice and want to impress the doctor by treatment planning root planing, placing chemotherapeutic medicaments, or taking x-rays. That is great as long as the office protocol is being followed, and patient rapport is present.

I would like to tell a story about a patient that had been going to the same dentist for many years and really enjoyed the practice and the hygienist he had been seeing. One day he went in for his periodontal maintenance appointment and the new hygienist performed a periodontal probing. She immediately told him that the probings were deeper in the maxillary posterior teeth and that he would need root planing in these areas and multiple sites would need to have a chemotherapeutic medicament placed. He immediately explained to her that his home care had not changed at all, and he felt he was still doing the excellent home care that he had been doing in the past. He also asked why the pockets had gotten deeper. The hygienist did not have an explanation for him. Then he proceeded to ask the doctor, and the dentist’s reply was that he was getting older.

Then when he spoke to the financial person, four quadrants of root planning were treatment planned instead of two. The patient questioned why and the financial coordinator said that is what usually is done. He explained to her that he was only told two quadrants of root planing. The financial coordinator stated that they would start with the upper teeth and just keep the other ones on the treatment plan just in case.

The patient was very upset and frustrated with the practice he had been going to for so many years. Neither of these explanations were adequate to the patient. Therefore, he did something he never thought he would have to do. He sought a second opinion, and actually considered changing dentists.

How many patients do you lose because of this exact scenario? It could be more than you think.

Patient rapport is so important to build before presenting an involved treatment plan. Sometimes this happens immediately and other times it has to be developed.

 For instance, if the new hygienist would have explained to the patient, “Mr. Jones, in the years we have been treating you, we have been monitoring the condition of your mouth at each recall appointment. Although you have been brushing and flossing, there are areas that are continuing to show signs of infection and we are concerned that without treating these areas they will continue to get worse. (This is the perfect time to pause and see how the patient reacts.)

 This pause allows the patient time to react and possibly make a statement.

They may ask,” What do we have to do and when can we get started?” Great! You have patient rapport. Treatment plan the case and get started as soon as possible.

They may not say anything and give you a questioning look. You may not have built the patient rapport needed to get patient acceptance when it comes to the treatment plan, and it may be best to delay treatment.

The patient may ask, “Why have my pockets changed?” If this is the case, you do not quite have the patient rapport yet and it would be best to answer all of their questions and to possibly delay treatment. After answering their questions, the following information may be given just before dismissing the patient.

 “Mr. Jones, with your commitment to home care we may be able to experience improvement in your condition and see the infection decrease. If not, we will want to root plane the areas that are still infected. So, I will make a note in your record to evaluate your gums at your next periodontal maintenance appointment. If they are still in the same state of infection we will go ahead and have you back for root planing.” Now is the perfect time to go over home care and any specific home care regiment. Yes this delays treatment. However, we can treatment plan till our faces are blue, but if our patients end up going elsewhere or do not accept treatment it is not helping the patients or the practice grow.

Another way is to only treatment plan the two quadrants that this individual patient needs, do the two quadrants, and at the last quadrant appointment just mention, “Mr. Jones, we have finished root planing the two areas. We usually get good results by your good home care and the therapy we have provided. However, if the root planing does not give us the healthy results we want we will place a chemotherapeutic agent in the pockets at the re-evaluation or periodontal maintenance appointment. Should you ultimately need any surgical procedures, they are usually less involved because your gums are in much better health.”  Depending on what your office protocol is when it comes to treating periodontal patients will decide when and what the next appointment will be. 

Whether you are the new kid on the block or the patient is the new kid on the block, you will want to take the time to get to know them and allow them time to get to know you. Establishing patient rapport will help increase your over all patient retention.

nterested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

Interested in having Jean speak to your dental society or study club Click Here.

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