A question that often arises in Dental Office Management concerns the role of the dental hygienist in the physical act or the process of the examination of the teeth of the patients of the practice.
I feel that the way you “present” your hygienist to your customers and patients determines the way that your patients will accept and experience the services of the hygienist.
Firstly, in all of this, I guess, is how the dentist “frames” the examination in the hygiene room.
At Active Dental, I made it a rule that the dental examination was never conducted by the dentist until all the teeth were cleaned.
I did this for two reasons. Now I know there are dentists who like to enter the hygiene room and interrupt the hygienist to do the dental exam, purely because the dentist has a free moment, and it is a convenient moment for the dentist. To me this sends a signal to the patient that the dentist does not value the work of the hygienist; that he can just butt in when he wishes to interrupt her, at a time that suits only the dentist. To me this also sends the same message to the hygienist. Underlying this, it also creates a “culture” that interruptions are OK in the Dental Office.
The second reason I don’t do my dental examination before the teeth are cleaned is that I just don’t believe I can see everything if the teeth and gums have not been cleaned and debrided prior to my examination. Sometimes plaque can cover demineralization. Other times plaque can fill marginal defects in restorations. And other times, a dark mark may be a stain rather than decay. I also believe that the hygienist needs to and should collect and take any necessary radiographs required and have them ready for the Dentist prior to his arrival to do the examination.
Creating a *process* of hygienist and clean, followed by dentist and dental examination, also prepares the patient for any treatment required that the hygienist may see during her cleaning.
Now we know that in some states and countries dental hygienists are not “qualified” to diagnose some dental conditions or treatments. However, a good dental hygienist will recognise areas as she proceeds around the patient’s mouth performing her cleaning, that she feels she needs to draw attention to the dentist when he comes in to do his examination. A good hygienist will let the patient know that there are areas that she will draw to the Doctor’s attention. And the hygienist may also run through some of the treatment scenarios that the doctor might recommend.
Having the hygienist treat the patient in this manner also allows the dentist to “move quickly” through the hygiene room, if he requires. A great dental hygienist will always have done a significant amount of patient preparation prior to the dentist’s entering the hygiene room.
At Active Dental, we encouraged the hygienist to record all existing restorations as she saw them, and to make a list of any areas of concern that she noticed that she wanted the dentist to look at. In most cases she would also take intra-oral photographs of any areas of concern and have those available for the Doctor to review. Often, too the hygienist would discuss these photos with the patient prior to the Doctor entering the room.
Some patients are unaware that a Dental Hygienist is a further career step above and beyond the role of dental assistant in the Dental Office.
Sometimes I hear Dental Offices say that the hygienist does not have time to perform all these additional necessary duties in this manner. To this we said, at Active Dental, that if we needed more time then we needed to book and schedule (and bill) longer appointments or multiple appointments with the hygienist, or employ more hygienists.
There are no prizes in dentistry and delivering dental services for being brief and for skimming over necessary and thorough diagnostic procedures.
There are also no prizes in dentistry for the dentist doing things in the dental office that other personnel can perform. Nor are there any prizes for the dentist performing his skills in less than optimal conditions, for time and practicality issues.
In these instances we have discussed today, a good hygienist can be an asset to the dental office in preparing the patient and providing information prior to the Doctor arriving to do the examination.
“How to Consistently Exceed Your Customers’ Expectations” and “How to Prevent Your Dental Office Being Caught In A Race To The Bottom” are just two of the many straight forward chapters that make up The Ultimate Patient Experience, a simple easy to implement system I developed that allowed me to build an extraordinary dental office in an ordinary Sydney suburb. If you’d like to know more, ask me about my free special report. Email me at david@theupe.com
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One of the things that I am proud of “inventing” at my Western Sydney Dental Office was the use of the warm or hot towel in the treatment room for the patient at the end of each appointment.
The hot towel is one of the easiest ways for every dental office to differentiate itself from their local competition.
This is because as I say, it’s easy to do, but also easy NOT to do.
Let me explain.
In each treatment room at Active Dental we have installed a very small, inexpensive microwave oven. Something like $58.00 from your local discount retailer. Small is good.
The microwave is positioned on the dental assistant’s side of the treatment room.
We purchase, by the thousands, individually packaged and sealed cloth towels, that can be warmed in the microwave. These towels cost us something like fifty-seven cents each!!
So here is what happens.
At the completion of treatment, the dentist presses the button to raise the chair from the supine position. At the same time, the dental assistant presses the Start button on the microwave, which has been preset to warm the towel (previously placed inside it) for all of ten seconds.
When the chair hits the upright position, the dental assistant assists the patient with their cup and any rinsing that the patient needs to do.
Following this, the dental assistant reaches to the microwave oven and removes the now heated, warm towel.
The dental assistant then presents the warm towel to the patient, by opening the top of the sealed packet to assist the patients access to the towel, and says to the patient: “Here’s a nice warm towel to wipe your face, if needed…”
It is dramatically remarkable how many patients comment on this simple inexpensive option that concludes each appointment.
Comments we hear include:
“it’s just like flying first class”, or
“It’s like being in a Chinese restaurant”….
Patients now expect this simple, inexpensive point of difference as a pleasant conclusion to their appointment for dental treatment.
Remember: Easy to do. Easy, not to do….
This is just one of the many straight forward protocols and procedures that make up The Ultimate Patient Experience, a simple easy to implement system I developed that allowed me to build an extraordinary dental office in an ordinary Sydney suburb. If you’d like to know more, ask me about my free special report.
Email me: david@theupe.com
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Recent bad news concerning an Oklahoma based Oral Surgeon has raised infection control alarms in Dental Practices and Dental Offices across the United States of America, and also around the globe as well.
Although our end of week blog is reserved for the “Business of Dentistry”, I feel that it is important to discuss this issue of infection control, though clinical, because it is imperative in business to be prepared for all possibilities and contingencies, at all times. It’s a “Watch Your Own Back” type situation here.
Funnily enough, about a month ago, I had an online chat with Fred Joyal about a blog he wrote about whether or not it was pertinent or appropriate or mandatory to show all patients your infection control procedures and also your steri-bay area.
The issues raised as a result of the news from Oklahoma are these:
You will have some patients and customers who will ask and raise questions to you about your infection control protocol.
Depending on your clientele and your dental office patient demographics, you may have very few who are concerned enough to raise a question.
If your office layout has a prominent position for your steri-bay that is passed by most patients as they move through your office from treatment room to front office, etc., then there may be very few questions asked at all of you.
So here’s what I would do regardless of the news out of Oklahoma.
Always have your steri-bay available for patient inspection 24/7. Disney has always said, “There’s no back stage”. Meaning everything should be available and on display for your customers to see. Always.
Have a sterilisation manual. Your *Go-To* Bible that again, is available for patient and customer scrutinisation.
Make sure your autoclave records are up to date, and available.
Prepare an elevator speech about your sterilisation procedures. A quick one minute or thirty second announcement about your procedures and protocols, and how long you have implemented them. Ours usually mentions that Dr Moffet treats his family and friends here as patients, and so we maintain the strictest infection control guidelines.
In discussions I had with Fred Joyal, we raised the topic as to whether it was appropriate to tour each patient through the sterilisation area.
What I have always thought as more appropriate was to make sure that every patient is offered the opportunity, if they so wished, to see the steri-bay first hand. At Active Dental, this was simply another *Magical Moment* of being able to *Offer The Offer*.
*Offer The Offer* is a phrase or term we now use at The Ultimate Patient Experience.com where we offer a service or process to our valued clients, patients or customers that we are happy to offer, but the offer is rarely taken up. The benefit in looking for an *Offer The Offer* is that the client is very appreciative of the fact that they have indeed received an offer at all.
As an adjunct to the Oklahoma story, there is an opportunity for all dental offices to raise the bar when it comes to their office presentation. As an extrapolation on the “Broken Windows” principle, it is important to make sure that there are no areas of the dental office that require a brush up or a make over. Straighten all those pictures on the walls. Clean those scuff marks and dust all those blinds and skirtings. These are things that premier Dental Offices are maintaining anyway. However, it is an opportunity to revisit your office as a patient, sit where your patients sit, see what your patients see, in all places, client lounge, treatment rooms, and front office check out.
This is a core value of The Ultimate Patient Experience. Remember, it is no good being excellent in one area when you are dropping the ball in other areas, and you don’t even know you’re doing it!!
We know that this alarm in Oklahoma will pass. Just as it did many years ago with Dr David Acer in Florida where a number of patients were infected with HIV.
It is very important to be prepared for any patient enquiry or question.
A confident positive response is worth its weight in gold.
This is just one of the many straight forward protocols and procedures that make up The Ultimate Patient Experience, a simple easy to implement system I developed that allowed me to build an extraordinary dental office in an ordinary Sydney suburb. If you’d like to know more, ask me about my free special report.
Email me: david@theupe.com
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Last week I returned to sharing with you some of the ideas that I have implemented during my practice of dentistry over the last thirty years that have impacted significantly to separate me from “other” dentists in the provision of dental services in my area.
Today we’ll visit the third in the series of five simple changes that I know you can implement in your office straight away. These changes will impact immediately on how your clients and patients perceive your dental office as *THE* dental office that cares, rather than being seen as just another dentist.
These changes, which I like to call *MAGICAL MOMENTS* are simple to implement points of difference that made my dental office *THE* Dental Office of choice in Parramatta, in Western Sydney, and allowed us to command great respect from the community as being *THE* Dentist to go to.
CHANGE NUMBER THREE.
Eliminate banging around
Sometimes we send negative buying signals out to our valued clients, patients and customers and we don’t even know that we are sending these negative signals.
These negative signals can have a significant impact on the decision of the customer to do business with us or not…..if we are unaware that we are doing this then we may be left scratching our proverbial heads as to why these customers have stopped spending with us….
Here’s an example: a while ago I used to be a member of a golf club where I observed regularly one of the most bazaar business bloopers that I believe a lot of businesses perform unwittingly. What I mean is that at this club the employees actions sent messages to the club members that were indeed harmful to the business of the club. Let me explain.
At this club, the bar area, for security reasons was protected by a roller shutter that used to have a pole track between two shutter grills. When down, these grills obviously were locked to protect valuable liquor from being stolen by unscrupulous cleaners and other employees that may have had access to those premises during times that the bar was not operational.
So here’s what used to happen…on a Saturday after golf, while patrons were still present in the lounge, staff behind the bar would start assembling the track pole and rolling down one half of the shutter grill. To me this was absolute insanity. All this did was send an immediate signal to patrons that the staff wanted them out of there. The noise, and clanging and visual image of the obtrusive shutter sent a negative message to the relaxed patrons that it was time for them to go. Really, the club bar should have stayed open until the last patron was ready to leave. I would have thought that putting up the shutters was the second last thing that needed to be done at that club every night. The last thing obviously was to lock the front door….
In a business that relies heavily on sales [of liquor, in this instance] it seemed absolutely ludicrous that staff would be empowered to send out these negative buying signals to their customers.
In the dental office we also send out negative buying signals, unwittingly. Here are two examples:
Firstly, in the treatment room, the banging of drawers and cupboards opening and closing send negative signals to the supine patient. Confused?
Well, think of it in this way. You’re the patient. You know you’re booked in for a procedure. You know you’ve had that appointment for some time.
Now, while you are there, ready, they seem to be rooking around for instruments and materials that you would expect them to have gotten out well ahead of time, since, as you said, they knew you were coming and they knew what procedure you were having…
Similarly, at the end of your appointment, the last thing you want to be hearing is stuff being put away and drawers and cupboards being closed loudly around you. Ever been in a restaurant where they start putting chairs up around you, or resetting tables for tomorrow’s diners….it’s unnervingly annoying and sends out a negative signal to you the diner to hurry up and get on out of there.
Secondly, toward the end of the day, you will find that those staff members cleaning up will diligently mop floors and bang around in other parts of the dental office without any care or concern for the noise pollution or negative signals that they may be sending or exuding to patients or customers still present and being treated in other treatment rooms within the office.
As mentioned in previous blogs, patients in the chair are more attuned to auditory stimuli because their visual is limited. They *DO* hear all the banging around of brooms and mops and autoclaves, far more than we as dentists do.
Similarly, the last patient of the day should never be greeted by the “slippery when wet” signs across the hallway. These are negative buying signals that tell the last patient to get out of here, we want you gone, we’re in a hurry to go home, what are you still doing here, cant you see we want out of here….etc. etc.
It’s absolutely imperative that your last patient should feel as welcomed as your first patient, and earlier patients during the day…
On a similar note, staff or doctors that say to patients that they hate Fridays, or Mondays, or Thank God its Friday, or that they are not morning people, or that the afternoon is dragging on…these staff need to be alerted to their negative buying signals that they are sending to your customers.
Each patient deserves one hundred percent attention from doctors, team and ancillary staff, no matter what day of the week or time of the day they attend for treatment.
Start analyzing your language, and analyzing your movements, motions, and sounds in your office. There is no reason at all to insult patients unintentionally by sending them negative buying signals. All customers deserve the same level of service. In a peaceful and fully relaxed environment.
Your patients deserve the absolute best, no matter what time or day they are booked in. Nothing less than the best will do…
These are just some of the many straight forward and simple to implement *Magical Moments* that make up The Ultimate Patient Experience, a simple easy to implement system I developed that allowed me to build an extraordinary dental office in an ordinary Sydney suburb. If you’d like to know more, ask me about my free special report.
david@theupe.com
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