11.2.12 Issue #556 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Supporting the Doctor’s Treatment Plans
By Jean Gallienne, RDH BS

We have discussed the new patient many times in past articles, and different scenarios when it comes to scheduling the patient with the hygienist or doctor first. Many times, old beliefs encourage that the patient be scheduled with the hygienist first, because the patient calls requesting a cleaning. However, there are many advantages to having the patient scheduled with doctor first. Here are just a few:

1. The patient is not rushed through the appointment or the financial arrangements.

2. The high risk of not having everything diagnosed because the time allotted in hygiene is not enough time for the doctor to do a thorough comprehensive exam becomes minimal.

3. The doctor is enabled to establish rapport with the patient.

4. When the patient does have a hygiene appointment, the hygienist should be reinforcing the recommended treatment with the patient and continually educating the patient about why it needs to be done.

5. If root planing is recommended and the patient states they “just want a cleaning today,” then the hygienist may be prepared to educate the patient about why they need more than “just a cleaning.”  

Even if the hygienist does the probings and gets any needed x-rays first, the doctor should come in and chart the existing and diagnose the restorative portion of the exam. This will give the hygienist production for the time she spends probing and getting the x-rays, which may actually be more production than doing a “just a cleaning.”

During the time the hygienist spends doing the probings and co-diagnosing with the patient their periodontal health, the hygienist may also mention things that jump out or look suspicious, and what the treatment may be. For instance, if the hygienist sees that a tooth is missing s/he may say, “Mrs. Jones how long have you been missing this tooth in the upper right? Do you miss it when you are chewing? There are many things the doctor may be able to do to replace that tooth, but s/he will have to determine what is needed. If you have enough bone s/he may recommend you have an implant placed there, especially since the teeth next to it have never had any fillings in them.”

Having been in many practices, I have seen that the new patient exam is done many different ways and for many different reasons. It is up to the staff to educate the patients on the way your office does things.

There may be times when it is required that the scheduling coordinator educate the patient on the way your practice does their scheduling and why. They may tell the patient, “Mrs. Jones, at this practice we like to schedule the patient with the doctor first as he will do an oral cancer exam, and verify what type of hygiene appointment you need in order to provide you the best quality of care. We can schedule your hygiene appointment after your exam on that same day if you like.” Most patients are going to want quality of care, and they are still getting the hygiene appointment that same day.

Regardless of whether the patient is scheduled with the doctor or the hygienist, it is part of the hygienist’s responsibility to help educate the patient about the treatment the doctor has diagnosed, and why the doctor recommends it. In order to help the hygienist do this, it is recommended that when the doctor is diagnosing the restorative needs of the patient that s/he not only charts the existing, but also makes note of why the treatment is needed. For example, if the patient has a large MOD filling with mesial decay and the tooth needs to have a crown, then this should be included on the original treatment plan. This way the hygienist will not only be able to confidently educate the patient about their needs, but will also become more educated about the way the doctor diagnoses needed treatment and why.

It is recommended that this be done with any treatment that is recommended. This way, anybody can read the patient’s chart and know exactly what and why something was diagnosed. If your office is chartless, then it needs to be decided where this information will be noted. Are you going to scan every treatment plan in, no matter how big or small it is? Will you put it in the notes area for that tooth? Will it be noted in the clinical notes?

Will it be put in all of the above? The main thing is that everyone needs to know where to find the information, and that the information is in the chart somewhere.

No matter if the patient is new or an existing patient, any time the patient is diagnosed by the doctor as needing a specific treatment, the hygienist should be educating the patient about their needs - even if this involves giving the patient viable web pages to look at themselves. The more educated patients are about their needs, the more likely they will get the recommended treatment done and build a trusting, long lasting relationship with the practice. 

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program or call 877-777-6151

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