July 2009

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Creating Value for Hygiene Therapy in the First Visit

In our last issue of Practice Prosperity we introduced the idea that a slight shift in the role of a dental hygienist could lead to a significant increase in effectiveness, productivity and job satisfaction. This issue will explore what that shift could look like with a new patient. When this patient, whom we will call Mr. Smith, called a couple of weeks ago, he wanted to schedule an appointment for a ‘check-up and cleaning’.

In an attempt to create a convenient first visit for Mr. Smith, many offices would schedule his first appointment for 1 to 1½ hours in the hygiene operatory. This visit would be for an exam, X-rays and hygiene treatment. While the protocol for new patient exams is determined by each team, we encourage you to consider some options.

A common challenge for dental practices is to build value for hygiene treatment. Hearing ‘just a cleaning’ makes most hygienists cringe. If the team is hoping to increase the success of the hygiene department, their patients need to view hygiene therapy as a distinct and important event. In many offices hygiene therapy is a component of the new patient exam, with both being performed in the hygiene operatory. This can cause hygiene treatment to be viewed as a quick cleanup rather than focused, site specific therapy.

Some offices schedule the exam and hygiene appointments one after the other on the same day, but in different operatories. The act of moving from the dentist's chair to the hygienists chair is enough of a shift in the patient’s perspective to increase the value of each individual appointment. Alternatively, the new patient exam and hygiene appointment can be scheduled on different days if this is the protocol chosen by the team.

The Periodontal Evaluation

Some dentists are comfortable doing a complete periodontal assessment, including it as a part of the new patient exam. Others prefer to utilize X-rays, visual inspection and possibly spot probing to gain a general overview of the periodontal health of the patient.

Communicating the Value

Regardless of whether or not the dentist picks up a probe, the vital component in creating value for hygiene therapy is the information he shares regarding the importance of hygiene treatment. Based on the oral health of the patient, this communication could include the following:

• “I see signs of periodontal disease.”
  
  
• “Periodontal disease affects the gum tissues, ligaments
  and bones that support your teeth. It has the potential to affect your overall health as well.”
  
  
• “Carol, our hygienist, will partner with you to get this disease under control.”
  
  
• “She will determine the best course of therapy to improve your health and increase the longevity of your fillings and crowns.”
  
  
• “It will be really important for you to schedule – and commit to keeping the appointments she recommends.”
  
  
• “Carol will also help you with your oral hygiene home care routine so that together, we can achieve and maintain a healthier state for you.”

These are the basic aspects of the conversation that should be included; however each dentist will convey the message in a way they are comfortable with.  When the Dentist takes an active role in communicating this message, credibility is provided for the value he places on hygiene therapy. This will result in fewer cancelled hygiene appointments, which ultimately will lead to healthier patients.

Transitioning into the Hygiene Operatory

An effective transition between each member of the team as the patient moves throughout the practice is very important. People are more confident about the care they receive when they feel heard and respected by each team member. A simple way to instil this confidence is to not ask the client to repeat their story to each person. When moving the patient from one operatory to the next, make the transition as smooth as possible, by communicating – in front of them – your findings thus far.

For example: “Dr. is concerned about Mr. Smith’s periodontal health as there are signs of disease. We told Mr. Smith you’ll talk with more him about what the disease entails and how you can work together to help him achieve health.”

Conversations like this typically happen in whispered tones in the hall or in the dentist’s private office. Stay tuned to a future issue to learn how to include rather than exclude your patients in these important conversations.

Where do we go from here?

As dental professionals, we are well educated — eager to tell people everything we know. Unfortunately, that often happens before our patients are ready to hear it; even before we have determined its relevance to their individual problem or concern.

Our tendency is to lay the patient’s chair back and start working. What if we rather start with a conversation that immediately begins to create value for our work? Such as:

• “It’s great to meet you Mr. Smith!”  
  
  
• “How was your exam?”
  
  
• “What questions have come up for you since talking
  with Dr.?”
  
  
• “I know that Dr. shared with you his concerns about seeing the signs of periodontal disease in your mouth.”
  
  
• “At this point what is most important for me is your comfort.”
  
  
• “If at any time you are feeling discomfort please let me know.”
  
  
• “If you’re ready, I’ll lay you back and we can get started.”

 
Throughout this dialogue the patient’s responses will determine the direction of the conversation. They will now be ready to hear your opinion on their periodontal condition.

Protocol for Determining Hygiene Therapy

Utilize your diagnostic skills to label the disease and determine the best course of hygiene therapy. This information includes:

• The required number of appointments.
  
  
• The length of each appointment.
  
  
• What will occur during each appointment.
  
  
• Plaque control aids.
  
  
• The necessity of medicaments.
  
  
• Appropriate follow up.

Ideally there should be a set protocol for using the information you have gathered to create a periodontal treatment plan. The more systematized your approach, the less guesswork there will be in creating consistent and effective treatment plans.

Communicating Findings with Our Patients

We introduced the idea of how a slight shift in the hygiene department could make a significant change in the effectiveness, productivity and job satisfaction of the entire team.

Recognizing and honouring the patient’s perspective is a vital part of this shift. When Mr. Smith made his first call to the office, he expected to be scheduled for a ‘checkup and cleaning’. Our goal in scheduling the hygiene appointment separate from the new patient exam is to have Mr. Smith perceive higher value for hygiene therapy than he may have otherwise felt.

Remember, the goal is to create a profound experience so your patients are excited to come back! Having the dentist communicate the value of hygiene therapy during the patient’s first visit to your office will help you make giant strides forward in increasing patient commitment.

Points to Ponder

• Is your new patient exam and hygiene therapy performed in the same operatory?
  
  
• Does the dentist communicate the value of hygiene treatment with the patient?
  
  
• Do your team members effectively transition your patients from one team member to the next?
  
  
• Do you have a set protocol to create a periodontal treatment plan?
  
  
• How effective is your team at helping your patients understand the value of the hygiene therapy you recommend for them?

The August issue of Practice Prosperity will focus on how to help Patient B move from her current state of disease to a desired level of health.

PerioLogix is a comprehensive periodontal program…
Call our office today to learn about the exciting
opportunities that await your team!

Co-authored by CoraMarie Clark and Mitch Peters

About the Author

CoraMarie Clark, BSDH MBA is recognized as a highly effective dental practice strategist. She works with dentists that want to optimize their potential both personally and professionally. Her collaborative approach has helped teams develop dynamic competitive strategies and achieve high impact sustainable results.

If you would like to explore the possibility of having CoraMarie work with your Dental Practice or speak for your Association or Group, contact us today.

CoraMarie Clark
phone 403.686.6136
email coramarie@strategix-ltd.com
web strategix-ltd.com

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