Partnering in Health Part 5: Do you have TIME for new patients? 

June 17, 2024 Mary Osborne RDH

By Mary Osborne, RDH 

How much time do you schedule for a new patient, non-emergency visit? Is your priority efficiency or effectiveness? Is your goal to gather as much clinical data as possible, or is it to begin to build a relationship of mutual trust? Both are possible if you see the new patient visit as more of a process than an event.   

Too often new patients are rushed through an assembly line: brief conversation, clinical exam, diagnostic records, and treatment presentation! Is that really the best way to help people make choices about their health?  

There is no one right way to schedule a new patient. Different practices are successful with different models based on the values of the practice, practice growth, and the personality and skills of doctors and team members. The most important determinant of success is our ability to meet each patient where they are and join them on a journey to health. I am not suggesting we should be without practice standards of care.  We have a responsibility to decide what we need before beginning treatment. Our challenge is to guide patients to understanding why we need what we need, and why that is relevant to their unique situation.   

We may anticipate that patients will resist this type of experience, but if we make it truly about the patient and are flexible, I have found that patients are more than willing to participate in an individualized process that best meets their temperament and circumstances. 

I remember seeing a new patient that I was told was a “very busy attorney” because his secretary said so when she made the appointment and his wife said so when she confirmed the appointment. I anticipated that he would be a driver and prepared to efficiently move him through his appointment.  

As I explored his health history with him he expanded on the specific answers to questions. Soon, he was leading the conversation. When I remarked that I wanted to make sure we were making good use of his time. He said, “Mary, what’s this about time?” I replied that I knew he was very busy. He said, “Mary, this is about me. I have time for me.” 

His statement has stayed with me because I realized that if the conversation had been about me going through my check list and not listening to him, it would not have been a worthwhile experience for him. It also wouldn’t have been a worthwhile experience for me. 

I have learned that when the patient feels in control of the process they are willing to give that time to themselves. A lot of aha moments occur as they learn about themselves while speaking. When patients feel like they are on an assembly line being moved through our system, they have every right to be resistant.  

Empowering patients to lead the process is both an attitude and a learnable skill. When we can lose ourselves in the moment, really listen, really encourage, and really care about the patient’s thoughts and feelings, it is easy to make connections to the next step we recommend.  It is my experience that I can more quickly become a trusted health advisor when I intentionally share control with my patient. 

Most patients are willing to invest more time in the process when they see the connection between their needs and what we recommend.  These are typically patients who have or have had complex health issues and are seeking to improve and retain health. They perceive the value of the extended process and how much value you place on spending in-depth time with them.  

The entire team’s communication can deliver the message that everyone in the practice is keenly interested in them, and their appointment is uniquely planned to meet their needs.  

What has been your experience? Are you open to scheduling more time for conversations that typically garner trust and appreciation earlier in the relationship? 

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.

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12 Things DSOs Strive to Do that Private Practices Can Do to Flourish

July 29, 2022 Deborah Bush, MA

For support organizations and dental service organizations (DSOs) to scale, they focus on developing a branding patient experience and a predictably profitable business model. They seek to maximize:

  • efficiency while serving the needs of consumers,
  • provide a wonderful patient experience, and
  • increase both their top and bottom financial lines.

Dentists who have chosen the private practice way of life may want to reflect on the following 12 things DSOs strive to do in 2022, and then apply these tactics to their own business model. These tactics have been among the top topics of conversation at DSO meetings in 2021 and 2022 and will sound familiar to those who follow The Pankey Institute. Why familiar? Because they are top topics also discussed among private practitioners and many are addressed within the Pankey Institute curriculum.

1.Monitor more aspects of your clinical and business operations to determine what is working well and what problems need solving. Then solve the problems as rapidly as you can. As the practice leader, open your eyes and ears, and lead.

2. Track key performance indicators and seek growth in those KPIs.

3. Cultivate a positive practice culture and work environment in which employees want to work and patients want to visit. Team members should constantly check in with each other to communicate what is happening “now” and intentionally tune their senses to know how they can help one another. The goal is both a wonderful patient experience and a wonderful team experience.

4. Design systems and protocols with intention, follow them, and assess them for improvement. Make sure team members understand the Whys.

5. Invest in training your clinical and business teams. Especially important in the last two years are to:

    • Realize the potential of each team member and affirm they are valuable to the practice.
    • Educate clinical and front office teams in how to best engage and support patients with special attention to facilitating the treatments patients need. DSOs have targeted implant treatment and doctor-supervised, clear aligner orthodontics as two niches to focus their education efforts on with staff and patients.
    • Educate front office team members in how to appropriately maximize lead conversion, so the cost of expensive digital marketing can be contained. With increased new patient acquisition, reserve more time on the schedule for new patient appointments. In 2022, if new patients must wait, they tend to go elsewhere.

6. Maximize clinical technology to improve the patient experience and increase the efficiency and accuracy of clinical records, diagnosis, treatment planning, dental lab communication, and manufacturing.

7. Maximize practice management technology to improve the patient experience and increase the efficiency and accuracy of business operations, for example, AI enhanced software that automates billing and online collections or reviews insurance claims for accuracy prior to submission.

8. Migrate to a Cloud-based PMS system to ensure the security of your data.

9. Block schedule to do more procedures in a single visit. Patients and clinicians benefit from this efficiency. Maximize spaces in the visit—as you transition from one procedure to another, to enhance relationships with conversation.

10. Deploy a dental assistant to assist in hygiene, for example, to help clean and turnaround hygiene operatories between hygiene patients. This way, the hygienist’s relationship time with patients is not shortened or eliminated in the race to meet clinical demand.

11. Ensure adequate front desk coverage, so there is always time for those personable conversations that ideally occur when each patient arrives and leaves their appointment. Manage your human resources so almost all phone calls are answered live during business hours by a receptionist well versed in optimal conversation with dental patients.

12. Frequently ask, “What is our branding patient experience? What can we do better to meet the desires and needs of our existing patients and the prospective patients we target?”

Looking at this list, I can’t help but think that Dr. L.D. Pankey would smile. Just because you don’t have a corporate support organization helping you run your business doesn’t mean you can’t do these things on a smaller scale and possibly do them better.

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Deborah Bush, MA

Deb Bush is a freelance writer specializing in dentistry and a subject matter expert on the behavioral and technological changes occurring in dentistry. Before becoming a dental-focused freelance writer and analyst, she served as the Communications Manager for The Pankey Institute, the Communications Director and a grant writer for the national Preeclampsia Foundation, and the Content Manager for Patient Prism. She has co-authored and ghost-written books for dental authorities, and she currently writes for multiple dental brands which keeps her thumb on the pulse of trends in the industry.

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ABCs of Dental Office Organization: Part 1

December 3, 2018 Bill Gregg DDS

Efficient office organization leads to effective office functioning. It frees team members up to take care of people. It can greatly increase effectiveness – defined as helping people make choices appropriate to their health and improving efficiency of care delivery.

Dental office organization starts with understanding tasks and roles:

ABCs in the Dental Practice

A = Administrative Tasks

These are tasks that can be done when patients are not present. For example, planning next week’s schedule for effectiveness or following up on and processing insurance claims.

More examples:

  • Filling the hygiene schedule.
  • Working the re-care system.
  • Supply ordering.
  • Treatment planning.
  • Specific treatment pre-planning.
  • Review of x-rays, charting, and chart notes. 

B = Behavioral Tasks

These are usually communication efforts with patients. Focused, uninterrupted time is available.

Examples:

  • Talking to new patients on the phone.
  • Care instructions following treatment.
  • Treatment conversations.
  • Financial arrangements.

C = Clinical Treatment

Here the patient is present. Ideally, treatment has been organized and so thoroughly thought-out beforehand that care proceeds rapidly and efficiently.

I have heard it said that treatment can be fast and good, fast and bad, or slow and bad. Slow and good is virtually never possible.

Speed and efficiency respects the patient’s time and emotions. This is why effective clinical organization must include pre-planning. 

Understanding Office Roles

If you understand these roles for yourself and each team member, your week can proceed much more effectively. Many dentists do not feel “productive” unless they are chairside spinning the high speed, but this is not always the case.

If you consider your role in the practice as similar to a CEO (vision and implementation) and/or COO (efficient operations) you must consider “A” time important.

If you consider yourself an advocate for your patients, your “B” time – especially quiet time to ponder treatment options as well as learn and grow in communication – is essential.

To increase your dollar per hour productivity, you must practice continual chairside improvement and time management in treatment procedures. This is the only way to accomplish more work in a single day.

To be continued …

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Bill Gregg DDS

I attended South Hills High School in Covina, Denison University in Granville, Ohio and the University of Redlands in Redlands, California prior to dental school at UCLA. My post-graduate education has included an intensive residency at UCLA Hospital, completion of a graduate program at The L.D. Pankey Institute for Advanced Dental Education ; acceptance for Fellowship in the Academy of General Dentistry (FAGD); and in 2006 I earned the prestegious Pankey Scholar. Continuing education has always been essential in the preparation to be the best professional I am capable of becoming and to my ongoing commitment to excellence in dental care and personal leadership. I am a member of several dental associations and study groups and am involved in over 100 hours of continuing education each year. The journey to become one of the best dentists in the world often starts at the Pankey Institute. I am thrilled that I am at a point in my professional life that I can give back. I am honored that I can be a mentor to others beginning on their path. As such, I have discovered a new passion; teaching. I am currently on faculty at The L.D. Pankey Institute for Advanced Dental Education devoting 2-3 weeks each year to teaching post-graduate dental programs. In other presentations my focus is on Leadership and includes lifestyle, balance and motivation as much as dentistry.

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Boost Your Hygiene Appointments

November 5, 2018 Pankey Gram

There are many reasons to continually think about how you can add more value to patient appointments. First and foremost, though returning patients want to feel comfortable, they will also appreciate small beneficial changes when they visit.

Value is the number one motivator that will keep patients coming in regularly on time without missing appointments. If being at your practice is particularly enjoyable, they’ll be excited to keep their commitment to regular recall appointments. Additionally, if you provide expanded health services, you’ll be elevating your hygiene appointments to another level.

Here’s a value add that’s easy to implement and good for patients:

Hygiene Boost: Taking Blood Pressure

Many patients may see their hygienist more often than their regular physician. That’s why taking their blood pressure at the start of an appointment is so beneficial. Blood pressure can tell you a lot about the state of their general health.

Patients may be surprised at the result gathered from the blood pressure cuff. If it reveals seriously high blood pressure, a recommendation to a physician may be necessary. The hygienist should explain that your practice takes this additional measure so that you can truly provide comprehensive care. It’s part of your thorough screening process, including periodontal assessments and oral cancer screenings.

Your hygienists will also appreciate being able to provide this extra touch of healthcare. They could really be making a difference for someone who had no idea they were experiencing an issue. Most importantly, it’s another relatively inexpensive way to show patients they are cared for. The entire process should take less than two minutes.

For more Pankey fun, check out this blog on our favorite places to eat Cuban food here. The next time you’re in Key Biscayne, you won’t be able to resist.

What add-on services do you provide during hygiene appointments? We’d love to hear your good ideas!

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Starting a Dental Practice From Scratch: Part 2

March 9, 2018 Jason Hui DDS

After building my dental practice from scratch, my work life began to get more and more intense. I knew I had to slow down, but I didn’t know how until I decided to take a leap of faith and visit the Pankey Institute.

Creating a Work Life Vision at Pankey

At Essentials One, I was blown away by the faculty to student ratio. It was almost 1:1! The quality of the education was outstanding, but what I found most impressive was the encouragement, mentorship, and passion from all the faculty and staff.

Pankey taught me how to help my patients value dentistry, develop communication skills, and learn co-diagnosis. Most importantly, Pankey helped me create a vision of what I always knew I wanted — a low volume fee for service practice that allowed me to have a good family-work life balance.  

Returning to My Dental Practice Recharged

When I came back home from Essentials 1, I immediately stopped working six days a week. I started some training exercises with my team to show them what my vision was.

One month later, I went out of network with my first insurance plan. This plan was one of my biggest — it made up 25% of my patient base, but I was determined. Six months later, I evaluated our progress. We did not lose a single patient and our revenues had actually doubled. When I saw this, I went out of network with six more plans immediately. We were on a mission.

Today, two years after Essentials 1, I am only in network with one remaining plan. Our practice has continued to grow. We have worked less hours, seen almost half as many patients per day, and our practice revenues have increased.

Additionally, I have also taken more time off every year and taken more continuing education than I have in the past. My team continues to be excited in our journey together to achieving our professional and personal goals.  

My story is nothing special. I truly believe anybody can develop the clinical, leadership, and communication skills to create a successful relationship-based practice. For me, the Pankey Institute provided all the resources I needed. Pankey has changed my life. I hope to give back one day. 

What’s your dental practice story? Join the conversation in the comments! 

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Jason Hui DDS

Dr. Jason Hui earned his bachelor’s degrees in biology and business administration from the University of Texas at Dallas. Before graduating from Baylor College of Dentistry with his Doctorate of Dental Surgery, Dr. Jason received the “General Dentistry Award” and “Implant Award” for outstanding performance in both these areas. Dr. Jason has also received his Fellow in the Academy of General Dentistry (FAGD). Dr. Jason is also Board Certified with the American Board of Craniofacial Dental Sleep Medicine (DABCDSM). Dr. Jason Hui is currently an Adjunct Assistant Clinical Professor at Baylor College of Dentistry. Dr. Jason is active in the American Academy of Dental Sleep Medicine, American Academy of Craniofacial Pain, American Dental Association (ADA), Academy of General Dentistry (AGD), Texas Dental Association (TDA), and the Dallas County Dental Society (DCDS).

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Practicing Dentistry Your Way

December 4, 2017 Lee Ann Brady DMD

One of the gifts of dentistry is that we get to drive our vision and create the practice that engages and fulfills us. There are really very few professions with such limitless possibilities.

If you dream about working three days a week, you can create that. If you want to work from 7-3 or 3-10 you can. Do you love doing endo procedures? Then you can do them. If you dislike doing pediatric dentistry, then you can choose to refer it all out.

How to Practice Dentistry in a Way That Fulfills You

There is no one way to practice dentistry. This is an incredible gift and for me makes dentistry one of the best professions. Having this amount of choice also comes with some challenges and responsibilities.

The first challenge is accepting the gift of choice. Dentistry is full of outside pressures that can drive how we practice if we choose to let them. These pressures may come from other members of our team, other dentists we know, insurance carriers, or our own beliefs.

Along with choice comes the responsibility for choices, their execution, and their outcomes. Creating the practice you dream about may not happen overnight. It will require a thoughtful plan and the commitment to execute it, but it is within your reach.

The place to start is to allow yourself to dream and dream big. Walk on the beach, find a quiet space, and just let go of the constraints of how things are now. Imagine what it would look like to practice dentistry and LOVE it.

As you imagine this preferred future, tap into your emotions. If you find yourself excited, energized, and propelled to action, then this is the path to start to walk down. Refrain from asking yourself “How” you will create it.

Once you have a vision for how you want to practice, now it is time to ask the “how” question and remember anything is possible. The question is what will it take to create it. Begin with a timeline and ask yourself how long from now you want to have the practice you just dreamed about.

On the right hand side of the timeline is that preferred future. On the left hand side is today and how things look today. Then work backwards from the future and place milestones in time and change along the way.

Remember, for everything you want, there will be something to give up or some cost, but it is possible!

How have you designed or wanted to design your dream practice? We’d love to hear from you in the comments! 

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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