How to avoid an empty waiting room

Why am I still hearing from principals suffering from empty appointments? So frustrating when it’s so unnecessary.

I want to share the steps you can take to turn this around in a short period. The challenge you’ll face with your staff is making changes. When making changes we move through four stages:

  • Shock – can’t do it, will not work in our practice
  • Uncomfortable – don’t like this, preferred the old way
  • Familiar – still don’t like it but seems to be working so best keep going
  • Routine – I never said it wouldn’t work.

If you recognise the stages it’s easier to deal with the changes necessary to make in your practice. Everyone will benefit: patients, staff, dentists and the bank manager!

Increased case acceptance

If we buy something, in most cases it’s because we want the product or service and it has been our idea to make the purchase. If we go into a business/shop and the sales person seems pushy, we walk away, your patients are no different.

Patients want to purchase dentistry when they want it and they want it to be their idea, they buy a solution.

Follow these simple steps for increased case acceptance:

  • Focus on why the patient came to you, in my experience it isn’t normally the implant the patient is buying, but the ability to be able to go to a restaurant and not have the food you have to eat because of a loose denture
  • The key is asking questions and not talking at the patient. Use the pull strategy not the forceful push strategy. ‘Tracy you’ve had this denture for 10 years, what is the reason for looking into dental implants now?’ People buy on emotion
  • Talk to patients about the benefits of the treatment and share stories of how your other patients have felt. Remember to discuss risks and what would happen if no treatment were delivered to ensure you are compliant with the Care Quality Comission (CQC)
  • Show before and after photos of similar cases/treatment. Seeing is believing, and a picture paints a thousand words
  • Make your services affordable, can the patient have a dental implant for £100 per month or do they have to pay the bulk at the first appointment? It isn’t about being cheap or free but being affordable
  • If you have a treatment coordinator make use of their skills, patients talk with team members in a more open manner than with the dentist.

All the above is assuming you have an outstanding patient journey policy, without exceptional customer service your practice will never achieve the goals you set. If you don’t look after your patients somebody else will.

Raising the bar

Many consultants talk about 10, 15 and even 30-point health checks, just a fancy name for the good old-fashioned dental exam. Just giving the service a fancy name is not enough, patients need to feel the value. This has always been mainly aimed at the private dental patient to show them the value of being a private patient. Having an examination at an NHS pilot practice is proving an issue for the private principal as the NHS examination is perceived to be of higher value, so now is the time for the private practice to raise the bar.

With clinical care pathways, this is no longer a luxury but a standard requirement, so the five minute NHS exam will need to be increased in order to be compliant. Audits will take place of your clinical records and you need to demonstrate all the areas you have screened, risk assessments and the advice given to the patients. The length of recall for the patient will be based on the outcome.

A fully trained ‘Tracy experience’ practice engages the nurse in the dental exam appointment. The nurse will call out questions, such as: ‘How much harmful plaque and tartar does Tracy have?’ This would then lead into perhaps a BPE (basic periodontal examination) score with a full explanation without the dentist counting to three.

The point is so the patient hears what is being said and hears the outcome. The response from patients all over the UK has been amazing and dentists have been very moved when a patient thanks them for carrying out an oral cancer screening, even though they always did. With this system the patient is involved and that is what the CQC is all about, and wouldn’t you want to do this anyway.

Fully trained practices give the patient a beautiful branded report postcard, this has either a score or tick box and the patient not only understands how important the dental exam appointment is, but takes something away with them. No different to a health check at the gym or an MOT for the car. The postcard works well as a marketing tool and the second side can be utilised with a marketing message.

The role of a hygienist

Practices throughout the UK are still reporting gaps in the hygiene diary and quite often when I am in a practice I hear a patient call to cancel a hygiene appointment, the receptionist says: ‘No worries, it’s only a cleaning appointment’ and I cringe every time! I’ve also heard dentists tell the patient to book a clean after an examination. How do you expect them to value your hygienist if you don’t?

Using your dental health check, explain to the patient that research and studies are showing a direct link between gum disease and other areas of the body and as a result you want to monitor patients more closely carrying out a risk assessment. Why should the patient read this in a health magazine after paying you for a health check?

If you communicate this in the right manner, patients with a poor diet, smokers, drinkers and patients with conditions such as diabetes, should keep your hygienist busy.

A trained ‘Tracy experience’ practice gets the patient to complete a medical history form before seeing the hygienist with questions like: Are you aware of your gums bleeding? Are the gaps between your teeth getting bigger? This delivers a message that the hygienist does more than just clean teeth.

The hygienist also carries out a risk assessment and the patient leaves with a report card and plan of the appointments needed to become healthy.

The patient gets a separate estimate for hygiene and has to sign if they wish to decline the treatment or accept it, you’ll be amazed the effect this has on patients accepting treatment.

The role of the treatment coordinator

The TCO (treatment coordinator) role in dentistry is growing by the day, we are being expected to carry out detailed explanations and deliver outstanding care whilst trying to earn a living. The TCO doesn’t replace the dentist communicating the care plan but supports them.

The TCO would review the medical history at a new patient consultation, but they would also explain that the dentist might ask a few more questions during the examination. The TCO would ask lots of open ended questions to establish what the patient wants and why. The TCO can show and take photos and give an idea of the fees, whilst also explaining the expectations and the level of care you provide and any other services like payment plans, etc.

The consultation is a free service, however some of my practices collect a refundable deposit to gain commitment, and it is all in the communication skills. The consultation can be offered alone or immediately before the new patient assessment with the dentist.

The TCO can also support the dentist in the treatment plan appointment; they tend to stay with the patient after the dentist has explained the options and clinical findings from the exam. Here the TCO’s role is to build rapport with the patient, offer reassurance and maybe show photos of similar cases, book the appointments and collect a deposit.

The TCO should also be responsible for tracking systems and following up any patients that haven’t booked in for the treatment on the day and within three to five days. The TCO can take a lot of pressure off the receptionists.

Although this isn’t the entire role of the TCO, hopefully it will give you an idea of whether you wish to explore it in more detail. The CQC is all about communication so now may be the time to explore a TCO role for your practice.

Tracy Stuart is a practice development specialist with a fresh approach, delivering outstanding results. Tracy is well known for her hands-on and straight talking approach, which has helped practices ring fence its business in this competitive climate, whilst they deliver the dentistry they have a real passion for.

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