Are You Missing 75% of Your Patients?
I have a little story problem for you. “Dr. Jones” runs a typical dental practice. His staff includes him, two treatment coordinators, two business administrators, and one hygienist. He estimates that hygiene production represents about 25-35% of total practice production and periodontal scaling and root planing represents, oh, roughly 30-35% of total hygiene production. And he is proud to say that the practice brings in some 20 new patients every month. That’s one number he is certain of.
As this story about a problem goes, the full-time hygienist works four days a week, sees eight patients per day, and 128 patients per month. But here’s where things get a little fuzzy. If the practice is retaining patients through a solid recall system, the hygienist should be seeing 148 patients per month on average. That means a single hygienist would have to work 9.25 hours per day to provide hygiene care for 148 patients per month. So what’s really happening in Dr. Jones’s practice?
In actuality, the practice isn’t gaining patients. It might be maintaining. While it may see 20 new patients per month, an equal or greater number of existing patients aren’t returning. If they were, Dr. Jones would have had to hire another hygienist, at least part time, a long time ago. Typically, one hygienist working four days per week can accommodate a practice with an active patient base of roughly 800.
Time and again practice owners are so blinded by the dazzle of new patients that they neglect to consider how expensive it is to lose even a fraction of the patients already in the practice. And, frankly, many of you don’t believe that you’re losing patients. But when was the last time you ran the past-due recall report or tracked the number of no-shows and recalls (which should be no more than 30 minutes per day)? And therein lies another part of the problem in this story.
Patients are drifting away from Dr. Jones’s practice, in part because they don’t fully appreciate the value of hygiene care. Yet it’s the hygiene department that is a primary production feeder for the doctor. The hygienist is the chief educator and trusted advisor. She/he is charged with helping patients to understand the value of lifelong oral care. The hygienist is the head cheerleader for the doctor, reiterating the importance of pursuing the doctor’s recommended care. Whether Dr. Jones realizes it or not, his hygienist is his production partner.
But it doesn’t stop there. The hygiene department is responsible for ensuring the periodontal health of the patients. Yet while some 75% of American adults have periodontal disease, the vast majority don’t know it and are not being treated for it. Amazingly, it is estimated that as few as 3% of all dental patients had claims submitted to insurance for payment on periodontal procedures. How can that be if some 75% of adults have periodontal disease? Plain and simple, practices are not conducting periodontal probing on their patients. In Dr. Jones’s practice, he’s a little ahead of the curve as they are submitting roughly 5% for periodontal care – a far cry from the 30-35% that he guesstimated.
One third of hygiene production in every dental practice should be in interceptive periodontal therapy. That is the industry standard. Dr. Jones’s practice (as well as many others) has not only an opportunity but a responsibility to integrate interceptive periodontal therapy into the hygiene protocols. But Dr. Jones is worried. How will patients react? Certainly, this is a valid concern. After all, any time a practice changes its protocols, it’s likely to generate questions and even concern from existing patients. But when it comes to periodontal disease, the evidence is clear.
Study after study has linked oral health to overall health. The case is so compelling that one would have to ask, are you really fulfilling your responsibilities as a healthcare provider if you are not routinely providing periodontal assessments? Only you can answer that.
But back to the patients, how should Dr. Jones or any other dentist/dental hygienist handle it when the patient gets that quizzical look on her face and asks, “Why hasn’t this procedure been done before?” My advice: Seize this opportunity to write a new and far more compelling story for the patient on the powerful evidence linking the impact of oral health on overall health and the value your practice provides in protecting him or her from disease.
Interested in speaking to Gene about your practice concerns? Email firstname.lastname@example.org
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