A step-by-step strategy for becoming a therapy-led practice

Cat Edney explains how dental therapists can build a portfolio

Introducing a therapy-led model requires a strategic plan – this month, Cat Edney shares how to make it as smooth as possible.

Dental therapy has attracted significant attention in recent years as a potential solution to the increasing demands and operational costs associated with practice ownership. Despite its benefits, the widespread adoption of shared care dental therapy, particularly in the southern regions of Great Britain, remains disappointingly limited.

As dental therapists, we possess a unique skill set that can significantly enhance patient care and practice efficiency. However, advocating for a therapy-led approach requires strategic planning and collaboration. Introducing such a model in an established surgery presents several challenges, including role ambiguity and varying interpretations of the therapist’s responsibilities among clinicians.

Following a strategic plan in order to ‘flip’ a dental practice to a therapy-led model is crucial, as is making sure every member of the team is on board and part of the plan.

Get the team on board

Understanding the challenges dental therapy has faced is a really helpful starting point for dental teams. Being able to recognise that dental therapy is a profession in its infancy with significant changes and development still happening now could help encourage better communication and collaboration in the later stages of adoption.

Dental practice owners may wish to encourage some team training on the legal and regulatory changes that have affected dental therapy to date. Discussions on how direct access impacts dental care delivery, and on the recent changes to prescribing rights, would help to explain why dental therapists have previously been more limited in their delivery of care.

With better education, dental teams may avoid common obstacles, such as limited professional recognition and the bias that could come from previous negative experiences.

Considering the financial implications

Take time to model the financial implications for the practice. Expanded access and efficient patient management help to improve the turnover of all clinicians within the practice and makes the most of individual surgery time. 

Having a clear understanding of the financial benefit as well as the areas in which your dental surgery is currently experiencing inefficiency can help to guide further training to support integrated care. By deciding how the financial model will work in your practice, you have a clear goal for the team to work towards and motivation to make it happen.

Take time to collaborate

When patients are going to be seeing multiple clinicians and team members it is helpful to take the time to standardise the care offering. Refining referral protocols can help to align clinicians’ expectations and requirements. 

One huge benefit of a shared care model is that dental practitioners are able to accept referrals from dental therapists without having to repeat the full dental examination. However, without creating a synergy between the dentist and the dental therapist, there could be a number of stumbling blocks. Take the time to sit with your colleagues and discuss what would constitute an appropriate referral.

For example, how much information should be included in a referral for an indirect restoration. Is a radiograph enough? Or would the dentist require digital scans, photographs, pain history, vitality testing and periodontal examination prior to proceeding? 

In addition to this, what would the dentist consider to be a simple case and what would they consider to be a complex case. Does this affect the time and fee required for the treatment? Is there a point at which the dentist would like to see the patient for a consultation prior to commencing treatment?

Integrate digital tools

Digital dentistry encompasses many areas of our professional life. However, some practices still see many digital tools as the domain of complex restorative work. Building digital dentistry such a digital scanning, photography, AI radiograph education and communication portals into every clinician’s day allows for better communication – both between patient and clinician, but also amongst clinicians.

Being able to see a 3D digital image of your patient and their presenting complaint prior to meeting and treating them can hugely impact the amount of consultation time required. If all members of the team are able to ensure a complete set of digital information is taken about every patient, there is far more flexibility in terms of referral – saving time in the dentist’s diary, reducing appointment wait times and patient inconvenience.

Adapt the patient journey

Practices adopting a therapy-led model need to consider the full patient journey. From the moment a patient first contacts a practice, there needs to be some indication of what the patient journey may look like.

This is as simple as having information about each clinicians’ roles and responsibilities – a written piece on the website about shared care and how the practice operates. 

In addition, it could be helpful to look at the reception processes – how do they triage patients and decide who is booked with the dental therapist and who is booked with the dentist? Practices may wish to adapt the communication that patients receive about their appointments – including what will happen if they need to be referred to another clinician. 

Standardisation

There is a lot to be said for ensuring that the new patient examination is standardised so that all clinicians perform this in the same way, taking the same information and documenting it in the same way as each other. This ensures a cohesive patient experience and also helps with inter-professional communication.

Consider including the use of a treatment coordinator role, or maximising the use of your dental nurse with additional skills such as photography, scanning and radiography – document these steps in the patient journey so that the practice has a protocol to follow and every patient receives the same, exceptional and dedicated service.

Once the treatment plan is created, decide how the patient journey ends, how they receive it, what information the patient walks away with – is this a written plan only or will they also receive copies of their radiographs and images to maximise their understanding of their plan?

How will the practice follow up with patients who need to book treatment, who is responsible for this role and how will they know which part of the treatment plan is to be booked with a therapist and which with a dentist? Ironing out these small nuances that vary from practice to practice ensures a smooth transition into shared care and can really tip the balance between success and failure of implementation.

Establish a supportive mentorship and feedback relationship

There is a misunderstanding that a clinician should be only seeking mentorship and feedback from those who are more experienced and confident than themselves. However, in a shared care arrangement there is cause to consider a dual way mentorship relationship.

Clinicians need to be able to feedback to each other about how the relationship is working, what needs to be improved and also find solutions to situations that may not have been covered in the past. Creating a feedback loop and modifying protocols as the model evolves can support every practice in creating a unique model that suits that practice. Additionally, fostering open communication around success or failure of treatments allows multiple clinicians to review returning patients, manage minor complications or modify the treatment approach in future.

Deciding to integrate a dental therapy-led approach is not something that can be achieved just by recruiting a dental therapist, it needs some level of adaptation and collaboration within the entire team. Using training and open communication encourages the team to view challenges as opportunities for improvement, facilitating the integration of a new team member and methodology that can promote huge growth within the business. 

Practices that involve their entire team in the decision making and adaption process will see better success, staff that problem solve, and ultimately a shared care approach that is not only rewarding but also patient focused.

Catch up with Cat’s previous columns:

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