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New patients join our office for a variety of reasons, and like most offices the most common request we get is to come in for a prophy. One of the things that I do many times a day is invite patients to have a comprehensive exam and create value for that process in their minds. In the last week or so I have been looking at how I do this, asking myself the question of how I could be more effective. My process has evolved over the years and is a blend of many things I have learned in courses and through the process of implementation.
Meeting every new patient begins with a conversation, whether they are on my schedule or the hygienist. I open by asking them what brought them to our office and how we can be of service. My goals in this first few minutes is to have the patient do most of the talking, listen and learn about them, and use key questions to frame the conversation around dentistry. I ask them to share what it would be important for me to know about their general health, and their dental health. This is my adaptation of a process called “Staying in The Question”, which I learned from my good friend Mary Osborne.
For a long time it felt awkward to explain the entire process, until I incorporated the approach Frank Spear teaches in Facially Generated Treatment Planning. I explain to the patient that the exam will look at four areas, esthetics, function,structure and biology. I then share the pieces of each section that we will do together, always linking it to something I heard from them and what we will learn together.
I use what I learned to create value and diagnose why each section of the process is important for them. For instance, the radiographs we take are based on this conversation and I might say something like “It sounds like making sure your mouth is healthy is very important to you, one of the ways we can verify this is through x-rays that allow me to see both the tops of the teeth to look for cavities, but also where I can see the roots of your teeth and make sure there are no infections or issues with the bone around your teeth. This would include a series of eighteen films, is that something you would be interested in doing today? I always end by asking them permission, it reaffirms that the choices are theirs, and let’s me discover places they are not yet fully aware of the value.
In looking at this process again I realize it works, and it feels comfortable for me, my team and my patients. Some new learning I will be implementing is how I can engage patients more in what we are learning during the exam. My friend Mark Kleive who practices in NC uses a form that outlines the exam, for patients to reference and I plan to implement this, so I will keep you posted.
Well said, Lee.
We can stay flexible as to how patients come into the practice and still offer our best and finest service to all. Helping them choose a comprehensive exam based on what you are learning about them is a great way to support patients in making helathy choices.
Thanks Mary, will you be covering some of this material in your “Dynamics of Comprehensive Care Workshop’?
Yes!
The “Dynamics of Comprehensive Care” focuses on how to build value for a comprehensive exam and care. Dentists and their teams also learn how to develop systems to keep that process of Co-Discovery going throughout the practice.
Wish you could be with us again for this one.
I wish I could be there as well. i know you and Steve will hit it out of the park!
I have the same issues….I just want a cleaning….xrays give you cancer, my insurance wont pay for them….its funny…
I blogged about this the other day…
http://www.ascentdental.com/cleanings-only
Jeff, great blog posting, hope it’s okay if I steal some of the language for when I speak with my patients.
Ahh Lee, A subject very dear to my heart…the examination. The starting point for everything, without which no real meaningful dentistry can ever get done on a consistent basis. The heart and soul of a dental practice. THE most important system in a practice. The heart of all internal marketing. The point from which everything that occurs in the practice emanates.
That is why I am shocked that so few dentists do it. When the dentist commits—-everything changes. Sure there is failure and frustration in trying to implement…getting patients and staff to buy in…but it’s worth it.
If you want to improve case acceptance, patient relationships, staff relationships, leadership skills, quality in your work, internal marketing…commit to a Comprehensive exam TODAY!
Barry Polansky
Casepresenter.com
Hi Lee
I have been using Mark’s form for a while now. (I am in The Polar Bear Study Club with him and he gave us permission to use it)
I have found it helpful for the patient to reference it during and after the comprehensive exam. I make notes on it and give it to them so the patient can review it later at their leisure,
I am interested to hear more about your use of it as you incorporate it into your practice.
Jerry
Hi Jerry,
We schedule NP’s in our office in two ways. We ask them on the phone if they have any current dental needs. If they believe they are healthy, we explain that for our healthy NP’s we schedule thirty minutes with the dentist. If they believe they have issues, we schedule them for an hour. For the NP’s that have come in believing they are healthy, I use the form to illustrate what our comprehensive exam includes, after we do a pre-clinical interview, and I check the areas that i believe I heard they have a concern or I have questions about. I then let them add any areas they are interested in. It is a good way to transition the conversation from their expectation about the exam. If they have already scheduled for a comprehensive exam, I use the form to simply illustrate and document the things we have talked about and will be looking at together. It serves to really cement for them the process.