8.3.12 Issue #543 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Nancy Caudill
Senior Consultant
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How to Schedule New Patients Effectively
By Nancy Caudill

A new patient wants to get his/her teeth cleaned and is scheduled with the hygienist for 90 minutes. The doctor then visits the new patient in the hygiene chair, along with the hygienist. So - what is wrong with this picture?

First, I am going to assume that your state's dental guidelines assert that all patients must be diagnosed by the doctor regarding the necessity of radiographs, what kind are needed in order to make a diagnosis, and then necessary radiographs are to be prescribed by the doctor. In order to accomplish this, the doctor must sit down with the patient and perform an oral evaluation. How many times does your assistant take an x-ray(s) before you ever see the patient? Probably many times. Instead, the patient should see the doctor first, either in their chair or in the hygiene room for an introduction. They should receive a view of the medical history, and an oral evaluation of the purpose of prescribing necessary radiographs.

Hygiene or Doctor Side?
This is a practice philosophy and there is no “right or wrong” but let’s review a few thoughts before you make a decision. If you schedule new patients that want their teeth cleaned on the doctor’s schedule first, the doctor’s assistant will be responsible for taking the prescribed x-rays and blood pressure. In order to schedule properly, it should be determined exactly how much time is needed to perform the tasks by the assistant prior to the doctor’s return to the operatory to complete his/her comprehensive exam. Once the exam is completed and the treatment plan is created, the patient will then be seen by the hygienist for a professional cleaning (if it is warranted) or education relative to their periodontal state. The hygienist should support the doctor’s diagnosis and reinforce the need for the next appointment, as indicated by the assistant when the patient is escorted to the hygiene room. “Mrs. Jones is ready for you, Cindy. Dr. Smith has recommended two fillings on the upper left side for her first visit.”

In this scenario, the preliminary fact-finding steps are already completed by the assistant, and the doctor and the treatment plan can be proposed at that time. Some dentists, however, prefer not to evaluate the teeth if they are “dirty”, as it makes it harder to make a diagnosis. The use of other diagnostic equipment is also difficult to impossible since the occlusal surfaces are not free of plaque.

The second option is to schedule the patient on the hygiene side and allow 20-30 minutes for the doctor to spend with the patient for their consultation. Keep in mind, however, that the doctor still must come in and perform their initial oral evaluation in order to prescribe the radiographs, as well as make a diagnosis regarding the patient's periodontal tissue. The hygienist will then proceed to complete her fact-finding tasks such as using the intra-oral camera, intra-oral digital photos, and periodontal charting. If the doctor has given the green light for her to perform a professional cleaning, she can proceed with that step until the doctor returns to complete the comprehensive exam and prepare the treatment plan.

If the patient has periodontal disease, the patient must be informed and educated regarding how to treat and control the disease. A debridement could be performed if the calculus prohibits the completion of a successful periodontal chart. At that point, the patient is scheduled for their next visit, depending on the treatment plan by the doctor.

The big question is always the same - what to do if the patient is periodontally involved? The practice should have a protocol that is followed by the hygienists regarding how to proceed with a patient that is diagnosed with periodontal disease.

Do I Block for Time on the Doctor's Side?
If the preference is to schedule the new patient with the hygienist, it is also imperative to block time on the doctor's schedule to allow time to conduct the comprehensive exam in the hygiene room. This step is quite often missed in many offices. As a result, the doctor will leave the patient they are working with to conduct the exam, leaving their patient waiting for 20-30 minutes. Now the doctor is behind in his/her schedule and has no way to make it up. This is poor customer service for the patient in the doctor's chair. Had the time been blocked at the beginning or end of the hygiene appointment for the exam, there would not have been a patient waiting in the doctor's chair.

Develop a plan with your team to better manage the scheduling of your new hygiene patients. Determine what will work best for you, but have a plan. Simply scheduling them with the hygienist and leaving your patient at some point while you conduct this longer and more complex exam is not efficient. Keep in mind that “children” don’t need as much time. Determine at what ages various times are needed and when blocking on the doctor’s side is not necessary if the patient is scheduled on the hygienist’s side.  This is especially true for children.

If you would like more information on how McKenzie's Consulting Coaching Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com

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