New Patients in the Doctor’s Schedule
In my last article, we looked at different scenarios when new patients are scheduled in the hygienist’s schedule first. This time we are going to look at the new patient being scheduled with the doctor first. There are some patients that insist on scheduling an appointment for a cleaning, even though they are a new patient to the practice. In some states, it is illegal for the hygienist to see the patient first, and the doctor will come in and do a cursory exam before the hygienist gets started.
When new patients call, are they really telling the front office person that they would like to schedule “just” a cleaning appointment, or is this the perception of the front office person? It may be possible that the new patient does not know the terminology, therefore they automatically ask for a cleaning. The front office person should be explaining to the patient on the phone that: “In our office, we like to schedule new patients with the doctor first. This will enable the doctor to take time with you and really see what your wants are and what is needed. However, if you would like to schedule a hygiene appointment after your comprehensive exam, we are thrilled to do that for you.”
The verbiage above may be changed to better fit your office and personality. However, there are two specific items in this verbiage that are important:
These two points tell the patient that what they want is important, that the doctor is going to spend extra time with them, and that you will schedule them for a hygiene appointment. You have not told the patient specifically that they will be scheduled for a cleaning. So if the patient ends up needing to have four quadrants of root planing, they will not be expecting a cleaning.
If the patient is scheduled with the doctor first and will then be going to hygiene, it’s important to schedule enough time between the two appointments to allow the financial coordinator to go over the patient’s treatment plan and financials. When scheduling back-to-back appointments with a new patient, you do risk the chance of them not keeping their appointment. You do not know the new patient’s history when it comes to accountability with their appointments. The other disadvantage with back-to-back appointments is that if the patient needs to have four quadrants of root planing and they are not expecting treatment, you may lose the hygiene appointment they scheduled. However, this could happen even if they are scheduled in hygiene first.
One of the biggest advantages to scheduling new patients in the doctor’s schedule first is that the doctor will be enabled to establish doctor/patient rapport. How the new patient exam is handled is crucial, as this is a huge part of the trust relationship you are building with the patient. This is where it becomes very important for the doctor to listen to the patient’s wants and address those first. Then it is the hygienist’s turn to inform the patient about what they need. Listening to the patient, observing the patient’s non-verbal communication and enabling the patient to co-diagnose as often as possible is key.
During the exam the doctor should be explaining what s/he is looking for, what the hygienist is doing, and what the findings are - even if they are within normal limits. This means informing the patient as you are doing an oral cancer exam and showing them the normal findings as well as the abnormal. Even if it is tori or linea alba, when you tell a patient the normal findings, you are building trust. This way when you show them something that is not the norm, they are better educated themselves.
The same is true when it comes to the restorative exam that is done with an intraoral camera. Take pictures of normal findings, so you can show them the difference compared to what may be abnormal in their mouth. If a tooth needs a crown because the filling is broken, take a picture of not only the large filling that needs a crown, but also of a filling that is small and does not need anything or that needs to be replaced with a filling and not a crown. Then teach the patient the difference.
Doctor, you may want to consider doing the restorative portion of the exam first with the intraoral camera, as this will help build trust quicker than the periodontal portion. Seeing is believing, and once the patient sees the pictures and is better educated, the periodontal exam will be icing on the cake. Another advantage to scheduling new patients with the doctor first is that the patient will know what to expect at the next appointment, and why. They will also know the financials, and as a result there will be no threat of the patient feeling pressured into treatment.
It is up to each individual practice to determine how new patients are scheduled. There are many things to consider before making this important decision, such as the socio-economics of the population around your practice location. Remember that information is power. Keeping track statistically of how many patients do and do not keep their appointments based on what they want vs. what you schedule them for will help you make an informed decision. After all, the new patient is a valuable part of your future, and a possible referral source.
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