What Is The Diagnosis and Treatment Plan for Your Practice? -By Monetta Reyes As dentist you understand and have great value for the process of providing care for your patient. There is a system for treating the patient that ends with great results. In order to meet or exceed the patient’s expectations you must have an understanding of what they are seeking for their long term dental care and why they want it. As a dentist and business owner, the same principles of diagnosis and treatment plan apply to you and the success of your practice. I am currently seeing a large number of doctors who are interested in transitioning their practices. Most all of them do not have a plan. I have not met one dentist that had a diagnosis and treatment plan written for their practice. It reminds me of the shoemaker’s son…..never having shoes. As technicians, most dentists enjoy the art of dentistry and caring for their patients. As a rule, most dread team management and wish they all had more time to focus on the practice rather than in the practice. A fine established line of balance, and many boundaries are required to achieve the dream and maintaining a sense of priorities.
This past week I had conversations with two dentists, both struggling to find great team members. Each dentist, their desk was piled high with paper’s to review, documents to process and signatures to be made. Both are very successful clinicians and production goals are being met. We revisit every month to see if we are on target with the vision. I watch as some dentists struggle to stay afloat because of the inability to say “No” and mean it with their feet. Boundaries with team members can be very challenging! Most all of the senior doctors, I would say 60% do not have technology in the practice. There is still a film processor and paper charts. The younger dentists do not have an understanding of a practice that operates without technology. What I have found in many of the successful transitions, there are certain technologies that the senior dentist has purchased, with a plan to move forward when a new associate transitions into the practice. That way the learning curve, and the new challenges that come from technology, will be minimized for the senior dentist.
If you are thinking about your own practice, the way you think of a patients’ mouth, what does the current situation look like and what do x-rays reveal? You probably are like the typical patient in the fact that you think you know but until someone shows you ….you really don’t know. I believe the best place to begin is with the exam is in the clinical area of your practice. The clinical area is exactly like the occlusal shot from an x-ray perspective. In certain cases the occulsal view is very important to have. So are photographs, serial / model numbers and inventory of equipment in established dental practices. There is a system in processing a patient through the office. If a “cusp” is fractured, and patient is pain is without pain it still will become a priority over whitening for the dentist…..maybe not the patient. Put this same type of situation into your hands doctor with a 25 year old compressor. When parts are no longer available and it is working fine but the potential….crack is there. Having it not start on the morning of a $25K case that is seated in your reception area, is not something you want to discover at that time. This past weekend, I received a call on Saturday morning, the compressor would not turn on. The total production that had to be rescheduled was $15k. We cannot afford to have a ‘cracked cusp’ on our compressor. Thankfully, I had an exam, study models, photographs and treatment plan for the office. I had several months before advised the dentist of the potential challenge that he was faced with. As fate would have it, I used a scenario of being open on a Saturday and having to reschedule patients because we do not have access to qualified technical support.
So what should a dentist do to receive a diagnostic exam and treatment plan for their practice? As with everything in this life…. it begins with a relationship. Hopefully, if you are an established practitioner, you have had a relationship for years with your merchandise and equipment supplier. This person should have an in depth understanding of you and your practice. The long term vision for your practice is the key to everything that your supplier does with regards to serving you. They should know you like a book. To be able to anticipate your needs is the one of their greatest assets. You as a dentist truly understand the power of your team members being able to anticipate. If you are interested in a list of questions used to interview this “relationship” for diagnosing “The Dental Practice”, please contact me. There is one thing I can tell you for sure that this person is not, and that is a salesman. This person should be a mirror reflection of you. They will be with you, as you are with your patients. The treatment plan that you recommend is hopefully always in the best interest of the person being served. You will be searching for that provider of service that is looking at you as a patient for life.
The beginning of a great clinical exam for your practice begins with x-rays (photos). Over the years, after viewing the photos of the dental practice, the comments from the doctors are amazing. Very similar to the same response patient have with intra oral cameras. “Oh wow….I didn’t realize how that looked!” “”I wonder how long that tile in the ceiling has been spotted?” The areas in the reception area that are out dated or worn. Comments like these are what I hear the most. The doctor gets to see the practice from the eyes of his/her patients. It is a most informative experience. The cabinet clutter, the cords that hang everywhere. We become so comfortable with the familiar in where we work that we really don’t see things the way our patients do. I am a constantly looking, listening, smelling, sensing….how does this practice appear to the patient. If my success is totally dependent upon the success of the dentist, which it is, then I should be very concerned about the patient experience. The dentist can buy cotton rolls, dental chairs and units from me but if he/she cannot pay for the purchase….. we both loose. Each dentist must be successful in their own vision. So after the photos of all equipment and work surfaces have been taken as well as documentation of treatment rooms (1,2,3 etc.), we will need an inventory. An inventory of all equipment, serial numbers, model numbers, age etc. as well as what kind of condition the equipment is in. Are there parts available? Does it function well but esthetically maybe it communicates to the patient that we really might not be the one for making great looking veneers? It is so sad that patients judge you, the doctor, by the décor of your practice, the team members you have hired and the diplomas on the wall. Unfortunately, in that order as well. In the book “Broken Windows, Broken Business”, there is a chapter in this book that actually uses a dental office to create an analogy. The author talks about the patient signing in at the front desk. Because the patient had to wait, he had the opportunity to look around the reception area. The new patient notices that the carpet is torn and worn in the reception area by the sign in window. The patient then starts to wonder in his mind….. if the dentist has old carpet in the reception area….I wonder how sharp his/her instruments are? In his mind the patient has started to look for reasons “not to trust” this dentist. All because of the worn carpet and the fact he was given this opportunity because he had to wait! When we are a cosmetically focused practice and teaching our patients about the value of quality, we cannot give away something that we do not have! If you try to do this, patients sense that something is not what you say it is and it makes it harder for them to trust. If your fees are premium and the patient experience is not premium, then you earn a reputation of being too expensive or all about money.
Today I would like to acknowledge one of the best clinicians and leaders within our industry, Dr. Kyle McCrea of Richmond, Texas. Dr. McCrea sat down with me four years ago and allowed me to do a complete exam, x-ray (photos), diagnosis and treatment plan for his practice. We examined his current situation by doing a complete inventory and evaluation of all equipment, serial numbers, model numbers and condition of equipment. We took photographs of all equipment. With our findings, we diagnosed and presented solutions for a treatment plan that reflected his long-term goals and vision. In doing this we now have an extraordinary tool, not only diagnosing his practice but a document for taxes and records, God forbidding a fire or disaster as many of the dentist in Houston have recently faced over the past 5 years. Dr. McCrea wanted to be able to provide the best care possible for his patients. He also wanted to maintain that small “home town” feeling. Technology was very important purchase to him however, so was the patient’s experience. Dr. McCrea really enjoys, and is very good at limited orthodontics. The remodel would have to include room for expansion and growth in order to bring in an associate to help Dr. McCrea. We continue to focus on the vision and treatment plan so that he remains able to have his dream become a reality. Dr. McCrea very carefully evaluated the equipment for his practice as well as the cost. We looked at what we could keep and what had to change in the remodel and expansion. He now has a finished product without regrets. He planned well and is trusting by doing his part the vision will now take on form. The colors that he and his wife, Beth, chose for the practice are warm, confident and inviting. My favorite is the fireplace in the reception area. It really makes this office cozy. Congratulations Dr. McCrea on a job well done! The town of Richmond Texas, all of your current patients and the ones that are to come…thank you! We appreciate you taking the time to plan and explore the best options and environment for delivering dental care to us! We trust you!