3.11.11 Issue #470 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Carol Tekavec, CDA RDH
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Help - My Dentist Gets Mad when I Call Him for a Recall Exam!
Carol Tekavec RDH

A hygienist recently sent me this email:

My name is Jenni and I have been working as a hygienist for Dr. G. for two years.  Every morning we have a team huddle and look at the schedule for the day. I mention which of my patients will need recall exams, and Dr. G. sees where they occur on the schedule. But then during the day, when I notify him that the patient is ready to be seen, Dr. G. makes us wait, or worse, acts upset when he comes to my room. What’s going on?

At first glance, it is hard to find an answer for this hygienist’s dilemma. It appears that the dentist is at best, unreasonable, or at worst, rude! But, like many problems, there may be more going on here than meets the eye.

Why would a dentist be “mad” at being called to the hygiene room to see a patient?  After all, the recall exam is an important time for identifying necessary restorative treatment; a vital function in a successful practice. If a patient-of-record’s needed treatment is not identified and subsequently scheduled during the recall appointment-when will this happen?

The answer may lie in the fact that the dentist is frustrated at being constantly interrupted during his day. Just when he is ready to finally find that last stubborn canal during an endo, or is in the middle of a difficult prep, the call comes for an exam. He may feel pressured to stop what he is doing and jump up for the exam. Or he may feel resentful of these repeated interruptions, and decide to finish up a procedure, making the hygienist wait. Either way, it is not hard to see how he might become stressed, therefore making the hygienist feel that she is making him “mad.”

Performing dentistry requires concentration, skill, care, and judgment. It is difficult to drop everything, switch gears, and take the time to deal with the required conversation and mental challenge of another patient, when one is intent on providing a service for the patient already in the chair.

What to do? One solution might be for the hygienist and the dentist to come up with a recall format and “hand-off” script that makes dealing with the recall patient a little easier.

For example: Jenni and Dr. G. can agree that during the first 15 minutes of the recall appointment, Jenni will inspect the patient for plaque and calculus, talk briefly about her home care routine, expose necessary radiographs, (as previously ordered and agreed upon at the last recall), perform an oral cancer screening, inspect the patient for possible restorative needs, take photos, discuss possible restorative needs with the patient, and then put in the call for the dentist’s exam. She can then proceed with the prophy.  When the call comes in, Dr. G. knows that Jenni and the patient are ready for his exam; but he also knows that he can respond to the call any time during the next 30 minutes.  When he is at a stopping point with the patient he is working on in his own chair, he can go to the hygiene room for the exam.

When he arrives at the hygiene treatment room, he utilizes a “hand-off” script that he and Jenni have agreed upon.  He might say, “Hi Mrs. Patient, it’s so nice to see you again.” And then address his next remarks to the hygienist, “Jenni, what have the two of you been talking about?”

Jenni can give her report - “Mrs. Patient and I have been going over her home care routine, and she is doing well with the new electric toothbrush she purchased after our last appointment. I also think that she may be doing a little better with flossing.  However, I found a tooth on the lower left that I think may have a crack in it, and I took a photo for you to look at.  Although Mrs. Patient has not noticed any discomfort with this tooth yet, she has a very large amalgam filling and two distinct cracks that appear to be undermining an entire cusp of that tooth. I explained to her about the possible need for a crown for that tooth and wondered what, if anything, you might recommend.”

Dr. G. can get right to business. He can examine Mrs. Patient’s mouth, give his opinion on the tooth that Jenni has identified, affirm (or not) Jenni’s suspicion that the tooth in question needs a crown, and then go on to complete his exam. Once the dental portion of the exam is complete, he can go on to the niceties that patient’s value in a caring dentist. He can ask about her family or her job, talk about the soccer team, her son and then politely (and quickly) exit the room. Jenni can enter a treatment plan for identified treatment and send the plan to the printer up front, to be ready for the treatment coordinator to go over with Mrs. Patient when Jenni brings her to the front desk area. She then goes on to finish the prophy.

Using this recall format, the hygiene schedule stays on track, necessary treatment is identified, the dentist is more in control of his time, and the hygienist and the patient are not kept waiting,

While this example does not take into consideration every aspect of every hygiene recall appointment, for instance, how many times a year a complete periodontal probing is accomplished, it shows how a recall appointment format can help dentists and hygienists work together. When a dentist doesn’t feel pressured to “drop everything” when the call comes for an exam, he can arrange for a smoother transition from one patient to the next. When the “hand-off” script allows the dentist to address dentistry first, and pleasantries second, less time is spent in non-dental conversation, allowing for him to get back to the other patient in his treatment room in a more timely manner. And, when the hygienist knows that the dentist will be arriving during the prophy time in good humor and on schedule, her day also goes more smoothly.

Working with patients in a dental office can be stressful. The constant pressure to stay on time can take its toll on the entire team. However, a recall format and “hand-off” script can provide a method for reducing these problems, making the work-day more pleasant for everyone.

Carol Tekavec RDH is the director of Hygiene for McKenzie Management.  Carol can improve your hygiene department in just one day of training “in your office”.  Interested in knowing more about how to improve your hygiene department?  Email hygiene@mckenziemgmt.com.

Carol is also a speaker on hygiene efficiency and profitability for McKenzie Management. Interested in having Carol speak to your dental society or study club?  Click here

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