Dru Halverson, RDH, BS Chief of Advisor Development & Advisor, The Jameson Group
The hygienist plays such an integral role in the overall success of our relationship with our patients. From the work we provide directly with the patient, to the role we as hygienists play in passing the baton of goodwill to our doctors or business team members, how we execute each step of our hygiene appointments can build up or break down the relationship with that patient.
Let’s review two major moments in a patient’s hygiene appointment where the team approach makes all the difference in the successful execution of a patient’s experience: The doctor-hygiene evaluation and the patient checkout.
THE DOCTOR-HYGIENE EVALUATION
Does your practice take the doctor – hygiene evaluation to the highest, most effective level to ensure that the patient says YES to restorative and periodontal treatment needs?
Take your evaluation to a new level for your practice by following these steps below.
It is our responsibility as hygienists to investigate where the patient stands prior to the doctor arriving for the patient evaluation. There are many items to investigate. However, let’s focus on the items that will be ultimately important to have for the evaluation.
• The patient’s goals for their mouth, teeth, smile.
• The photos of the patient’s concerns and yours.
• The necessary, diagnostic radiographs.
• The periodontal comprehensive charting.
Understand that the typical adult hygiene appointment should be approximately 60 minutes. This appointment can be divided up into three 20-minute increments. The doctor-hygiene evaluation should happen in the middle 20 minutes of time.
If the doctor comes in too early, all of the screening information cannot be gathered and reviewed. It is important for the hygienist to have some time to take and review the photos and radiographs with the patient so that they can begin to warm the patient up to possible active periodontal and restorative treatment. Many will term this as “pre-heating” the patient. If this has been completed before the doctor comes into the treatment room – the doctor can explain to the patient that there is no need for the option or the doctor may choose to move forward with diagnosing treatment. With the hygienist adding value and a higher level of trust with the patient talking through potential options –and a confirmation from the doctor, this approach builds a higher level of treatment acceptance.
If the doctor comes in too late in the appointment, the patient is ready to get back to their day. They are not focused on or tuned into the evaluation and there will be a lower acceptance of treatment than you would experience if the doctor – hygiene evaluation happened in the second 20 minutes of the appointment.
The TREATMENT ACCEPTANCE percentage should be at 85% at the FOUR MONTH mark.
Each developed treatment plan should be completed or started and moving through all phases at the four-month time frame. The Treatment Coordinator should keep the team abreast of the treatment acceptance; reviewing the statistics at the Team Meetings at least on a monthly basis. Be certain to celebrate the successes as you see your treatment acceptance improve.
How do you Pre-Plan to get in for the Middle 20 Minutes?
You must have an excellent Daily Huddle with your team and review with everyone. This is your organizational meeting to get prepared for the upcoming day. There are many items that need to be covered in this meeting and one of those items is to determine what hygiene appointments will require an evaluation and how you will come into those appointments between 20-40 minutes after the start of the appointment.
Performing the Doctor – Hygiene Evaluation to Benefit the Patient
The doctor – hygiene exchange must happen at the appropriate hygiene appointment for the Adult or Child Prophylaxis and the Periodontal Maintenance appointments. When the doctor enters the treatment room, the hygienist must bring the doctor into the conversation. All of this allows the patient to build a strong relationship with both of you so that the patient will accept treatment all at once and more quickly – in turn, getting the patient healthy.
Flow of the Hygiene Handoff to the Doctor
- Start this as the Doctor enters the room and sits to get into the communication triangle with the patient. The communication triangle has the patient sitting up at the apex of the triangle with the doctor and hygienist sitting at eye level with the patient and an appropriate distance away from the patient.
- Introduction of doctor if needed and transfer personal information.
- Dentist: Either allow the hygienist to start the review or the dentist could ask, Jennifer, is there anything you would like to bring to my attention before we begin [Patient Name’s] evaluation?
- Review the Health History update – meds or issues and status or conditions.
- Mention the patient’s chief concern (or if no concern a review of the patient’s goals) and that you will get back to it during the evaluation.
- Mention last treatment completed and comment/compliment.
- Any appliance used or not.
- Follow up on any referrals from last time.
- Photos taken and comments. Pull up photos.
- Radiographs taken or not and comments. Pull up radiographs.
- Doctor to really review the photos and radiographs. Move to look closely at these diagnostic images.
- Oral Cancer Screening: first, tongue and throat.
- Hard tissue: in order of quadrants, mention issues in the area as they come up, occlusion issues to be mentioned now.
- Perio findings: good and bad.
- Sit patient up and get back into the communication triangle and explain the diagnosis and treatment. The doctor will ask for the commitment to the next appointment.
- Once the doctor leaves the treatment room the hygienist will review and wrap up any other questions or concerns that the patient has concerning today’s appointment or their next appointment.
We know that you want all of your patients to be as healthy as possible. We must find ways to build stronger relationships with our patients. The more tightly they are tied to the dentist and the team emotionally, the more business they will do with you and your practice.
THE PATIENT CHECKOUT
It is important for each patient to be released in an effective manner. It is important for the hygienist to pass on the information. Great first impressions and parting impressions make certain that your commitment to their dental care stays on their mind.
We know that a patient must hear the message a minimum of three to five times to understand and to own it. Our goal is to gather and record information to create “linkage communication”. At
Jameson, we define linkage communication as communication that gets appropriate information from one provider or team member to another. We pass this on with our communication from the beginning of the appointment all the way through the check out process.
Wrap Up the Clinical Portion of the Appointment
Before you leave the clinical area make certain that you give a thorough review of the findings from the doctor – hygiene evaluation.
There are three very effective statements to remember to use through every step of the process. Use these to elevate your doctor – hygiene evaluation and the checkout process:
This is what we did…
This is what we saw…
This is what we need from you…
Linkage communication of the clinical information to the business team member should flow in this fashion:
- Work with the patient and your business team member to effectively communicate and support the patient’s ongoing decisions for healthy oral care through effective verbal skills, body language and partnership with the patient.
- Review with the business team member and the patient what was accomplished in today’s appointment, what needs to be accomplished at the next appointment, and any questions that need to be addressed by that business team member.
- Check in with the patient to make certain you covered everything, thank them for coming in and tell them that you look forward to seeing them at their next appointments.
You can strengthen your ties to your patients through follow-up and thorough treatment in the hygiene appointments. Be the key to elevating the doctor – hygiene evaluation, supporting and clarifying the patient’s ongoing care and clearly and effortlessly linking them with the business team member for an effective patient checkout. Your role is pivotal in the ongoing engagement of your patients with your practice. Make sure you are taking the time and using the verbal skills and visual aids necessary to build the trust, value and relationship with your patients at every single appointment.