EP21: Providing Optimum Patient Care Every Day

We are in a healing profession and it is hard to talk patient care vs. finances and insurance coverage. Provide value, support and understanding when presenting optimum care that patients will be completely happy with. Listen in to Dr. John Meis and Wendy discuss how to present AND provide the best care for our patients in this third episode in our 6 part series on major concerns that most dentists have. Get more profitable by understanding and providing exactly what your patients want!

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“EP21: Providing Optimum Patient Care Every Day” Transcript:

S1 00:00:02.221 [music] Welcome to the Double Your Production podcast with the Team Training Institute. The one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it, who are in the trenches, who know exactly what you’re going through. And now your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs.

S2 00:00:26.632 So excited to be with you on this Double Your Production podcast. So I’m Dr. John Meis and I’m here with Wendy Briggs. Wendy, how are you doing?

S3 00:00:36.937 I’m well. Thanks, Dr. John. It’s always good to visit with you.

S2 00:00:39.975 Yep. Good to visit with you too. So I was at a meeting recently, a DSO conference, actually, you know, kind of the big boys and they had a speaker there from the American Dental Association. This speaker had– it was sharing the survey results that the ADA did with the dental profession, specifically with dentists. And it was talking about the dentist’s most urgent concerns and so we’re going to move to the concern of providing the best care. And first of all, I am super proud of our profession that that is one of the number one concerns. That dentists and their teams feel an obligation to provide really good care and that it’s a concern that they do that, that they continue to do that, and they continue to get better. So I think it’s a real feather in the cap of dentistry that that’s one of the top concerns. And so I thought, Wendy, you and I could have a conversation of the things that we know and have seen and ways of thinking about providing the best care. And just kind of share our collective knowledge of the things that we’ve seen, the things that we’ve learned, and the things that we see that have moved the needle and really have made a difference in the practice at a patient level. Sound good?

S3 00:02:03.262 You bet. Yeah, that sounds great, Dr. John. One of the most common concerns that we get from hygienists, especially hygienists that don’t know team members even. Not just the hygienists, but people that don’t know us. Whenever they hear the word, “We’ve hired a consultant,” they automatically get anxious. And I think the reason for that is because, as a profession, we are committed to providing the best care. And what they don’t understand yet is that’s a big part of what we teach, right? It’s how to maximize patient care and increase the level of service to the patient. Sometimes they may have had a negative experience in the past or the focus of a consultant in their experience has been not really focused on patient care. So this is something we hear a lot. We hear a lot of concerns from team members and hygienists that really want to make sure they’re providing optimum care. So it’s awesome, once we actually get into the practice and meet with them, how excited they are that everything we talk about really is about providing better patient care. So this is something we hear a lot and concerns that we address quite consistently.

S2 00:03:08.672 I can imagine how frustrating it is for teams when they feel like the office is super financially motivated. And that just doesn’t resonate with people that go into a healing profession. And the good thing about dentistry is, if we just focus on doing the right things for patients, the finances take care of themself, largely. So what we really want to do on this podcast is really focus on what are some things that we’ve seen that have really changed how teams function that has a result on better care and on better practice success.

S3 00:03:50.671 You bet. Well, one of the things we that do on the hygiene side, one of the first things that we look at is how well we’re maximizing preventative services. And on an earlier podcast, we talked about The Next Dollar phenomenon and how, many times, to be successful, you know, financially successful in dentistry today, we have to participate with insurance companies. And we talked through how we can maximize that potential and a lot of it has to do with maximizing the role of preventative therapists. And here’s another thing that we find– that I find fascinating. It’s a little bit of a conflict, right? We hear from team members that patients are very insurance-focused and they may not always choose the best care. But then when we dig into why this may be, we often find it’s because we, as team members, over time, become very insurance-focused. We may know this patient would benefit from a fluoride varnish, especially given their risk factors and some of the challenges that they’ve had, but we may not offer that to them because it’s not a covered benefit. So when we look at optimum care, I think one of the things that we have to discuss right at the beginning, Dr. John, is that we have to separate ourselves, in many circumstances, from what the insurance benefits may be for the patient when we’re evaluating what the best possible care is for them. And that can be really hard to do because a lot of times, we are the ones that get stuck in the outdated way of thinking or in letting insurance dictate the care. We always say we don’t, right, we say we refuse to allow insurance to dictate the level of care, but then when it comes down to it, when we really dig in, we often find that we do. And I’m as guilty of that as anybody. But we often find that we do allow insurance to dictate the level of care. And if you think about it, how sad would it be if our patients only expected what their insurance covered for everything? They really would not be receiving a high level of care.

S2 00:05:50.748 No. That’s for sure. And people don’t think of health care in that way with their general health care. Generally, people want to maximize the benefit that they get from their insurance, but that’s not how they’re going to make decisions. I live in Arizona, which is the cosmetic surgery capital of world, I think. There’s a cosmetic surgeon on every corner. I know insurance isn’t paying for that and people are making the decision to do it anyway. So people will go beyond if they value, if they understand what’s available, and what the value to them it is. And I think that’s one of the great things that you do in working with hygiene teams, Wendy, is you have such a great model of helping the teams understand the science behind preventative services, but also the nuts and bolts of how to get it done and how to get it done in a time-efficient manner.

S3 00:06:46.175 Exactly. And I think if we had to pinpoint the main driver of patients valuing their care and being willing to do it, and also the team, our own willingness to support and have the confidence to offer some of these services, I think if we had to put our finger on the one key driver, that is the risk assessment tool that we’ve created and we help hygienists implement. So we talk about making sure we’re providing best possible care, a lot of these decisions really do need to be dictated to or guided by the patient’s risk status. And that’s one system that many practices really don’t embrace consistently. They may have it tor patients that have rampant decay or exhibit really obvious risk factors, but this is really something that we should be striving to do for everyone. And what we found is, when we do that, then it opens the door for conversations for all sorts of optimum care services that are on the menus in many practices but we’re just not maximizing that. You’re exactly right. We often, as professionals, need to know the science for, why should we offer these services. But we often forget the patients need a very compelling “why” also. They need to understand why they should take money out of their pocket, especially, if that’s the case, and pay for some of these services. And what we found is the risk assessment tool helped them understand why they should say, “Yes,” especially for a patient who hasn’t moved forward in the past. But also helps build the value for some of these services and they understand, “This is an investment that is going to provide a powerful benefit.” So one of the things that I love about that is that it provides a very compelling “why” for both the team, the hygienist, and the rest of the team, frankly, as well as the patient, why these services are being recommended. And what we see is when patients understand that and they understand where this fits, what’s in it for them, and they accept more care, it’s really kind of funny because just as you mentioned before, when we really do the right thing for the patients, the financial side takes care of itself. But we also see a higher level of satisfaction and engagement from the hygiene team and from the entire team. All of a sudden, we’re really proud of the services we’re providing and patients are accepting a higher level of care, which means production’s going up, and interestingly enough, the patients are happy about it too. So everybody really does win.

S2 00:09:08.102 I haven’t had a chance to share this with you, a practice that you worked with not long ago, it was a multi-location practice and all of the hygienists went up except for one. And so we went back, looked at what they were doing, and she made a commitment to use the risk assessment on every single patient. And guess what happened? All the–

S3 00:09:32.880 She went up?

S2 00:09:33.436 Yeah. All of a sudden, her fluoride acceptance went up. Now she was doing them and the amazing thing for me is, when I see someone who uses the risk assessment well, is it takes almost no time at all. I mean, how many minutes would you say it takes to use this tool?

S3 00:09:50.130 Well, we tested it and on average, it takes 90 seconds for the hygienist to fill this out. Now, sometimes the conversation about what they find with the patient’s condition can continue throughout the rest of the appointment. But they’re having that conversation while they’re doing other tasks. And so it’s an investment of 90 seconds.

S2 00:10:07.889 And really, with a ongoing continuing care patient, you’re going to do this once. Once they understand the value, there won’t be resistance for next time. In fact, you’re just going to let them know, “This will be a regular part of your appointment and you can stop anytime, but we’ll just consider this a regular part of your appointment. Is that okay?” Of course, they’re going to say, “Yes.” And then if they do want to stop, then that’s the time again to take out the risk assessment and run through it again, just to make sure that they have the information they need to make the right decision for themselves.

S3 00:10:40.360 Exactly. So, for example, on a fluoride varnish, we teach the hygienist a very powerful phrase, hygienists and doctors alike, is to say, “From now on.” [crosstalk] from now on, at every appointment, we’re going to be doing this.” And like you said, once they understand the value, there’s very little pushback. And they’re grateful. If patients didn’t want our opinion about how they could improve their health, they probably wouldn’t be in the chair in the first place. So we often find that the risk assessment provides the provider with a high level of confidence, but also the patient for a high level of confidence. And it’s really is a win too. And on the restorative side, your decisions change about patient care based on risk status as well. So everybody benefits from having this information. And you can imagine, if you have a patient that’s super high-risk, that that may change some of the restorative options that you present the patient with as well. So, I think, as a tool, like I said, there’s certainly many things we could talk about but that is one key driver to patient acceptance and it really helps us as a team have a higher level of confidence that we are providing optimum care for patients.

S2 00:11:50.239 One of the exercises that we do in our Clinical Explosion event is we’ll through a slide up there that has– that’s just a quadrant of teeth, but there’s some complexity to what needs and it’s like each tooth is really kind of on a borderline of what would be a reasonable treatment plan for it. And it’s so funny that people will come up a treatment plan and then you change a couple things on their risk status and now the treatment plan is completely changed. And when we talk though that with doctors and their teams, we talk about, “Do you have this conversation with patients?” And they’re all like, “Well, no. We just kind of do it in our head. We just kind of figure it out,” and I say, “Well, how much more powerful would it be if you had that conversation so that the patient understood the value of what you are bringing and why you are recommending what you’re recommending?” So it was really kind of an interesting exercise that the normal set point is to not discuss stuff when really, it’s more powerful to allow them to see what you see like the risk assessment tool helps us do.

S3 00:12:55.857 Exactly. Another thing on the restorative side, Dr. John, you know that phrase, “Help them see what you see,” another thing that is stunning to me is how many times you go into a practice and they intraoral cameras in every single room, yet when the doctor goes in for the exam, there’s no consistency behind having images. And when we talk about providing the best possible care, a lot of times, in our experience, doctors and hygienists, they’re already recommending the best possible care. The key, or the disconnect, is having the patient accept the care. So we see millions of dollars in unscheduled treatment plan reports. It’s just a very common thing though that we see. And so one of the most powerful piece of technology that I know of to help the patient understand the “why”, just as you said, is to use the images and use the camera. And that can be a tremendous driver for patient acceptance and it’s stunning to me how often we go in and there’s no system for consistency, so it’s hit or miss. You might use it on new patients, we might use it if the patient has a broken tooth, we might use it here or there, but in some ways, a patient comes in with a broken tooth, that’s a slam dunk already. We should almost be using that piece of technology more consistently on those things that aren’t as obvious to help the patients see what we see. And just like you said, once you use that and you lay out the reasoning behind it, we’ve seen a lot more patients choosing best possible care.

S2 00:14:18.160 Yep. And everybody knows a picture’s worth a thousand words, right? And the fastest way to the brain is through the eyes. We all know about these visual things and how important visual is, but it’s quite frequent that we go into an office, we’ll see they have intraoral cameras but they’re pretty dusty. They might be in the op room but they’re pretty dusty because they haven’t been used as much as they could be. And really having a set standard on when those are used and how those are used are really important because without it, it’s really, really difficult for a team to feel like they’re doing something valuable. So one of the things that we’ve heard, Wendy, is that, “Well, I take pictures of stuff and then the doctor doesn’t even look at them.” Or, “I’m going through the mouth. There really isn’t anything to talk about. This patient’s restored and healthy. There isn’t really anything to talk about.” So knowing if your team understands, first of all, what your expectation is and second of all, understands that you are going to look at them, that you are going to support them, and when they’re identifying something and looking at it, you’re going to be right there with them and going through it. But if the team feels like they’re not supported, pretty soon, that camera starts getting pretty dusty.

S3 00:15:50.976 Exactly, so. And also, another thing, to be fair, we also need to make sure we’re being reasonable with our expectations on the amount of time we’re giving the hygiene team, right? We’re seeing an alarming trend, for me, it’s alarming, where practices feel like you have to shorten the appointments down to 30 minutes, 40 minutes, 45 minutes to increase hygiene revenue. I don’t want to go too far down this rabbit hole because this would be another great topic for a podcast is, How to Use Time Effectively, and the Anatomy of an Appointment. Those are some of the principles that we teach. But the key is, if your hygienists have 30 minutes for a recall appointment on the hygiene side, they’re probably not going to pick up the camera, right? They can only do so much. So we’ve got to be reasonable with the expectations. And then, to be fair, on the opposite side, “Hygienists, if you have a full 60 minutes, we want to make sure that we are using the camera, using the technology that we have.” And so even if you have shorter appointment times, there’s a way to get it all done in a timely manner. But just like you said, Dr. John, you got to have a system in place. So system’s the key for all of the things. We talk about a system for risk assessment, a system for using the camera, really, we could probably come up with a list of 20 best practices to increase patient service and increase patient care. And every single one of them requires a system.

S2 00:17:06.375 Yep. Yep. Very good.

S3 00:17:09.240 Well, very good. One other thing I should probably let our listeners know, Dr. John, is that if they go to theteamtraininginstitute.com/podcast, right there on that page is a couple things that are pretty interesting. Number one, they can subscribe to our podcast. They can just click and subscribe with iTunes. If you haven’t already done that, we try to make that super easy for you. But the second thing, if you scroll down a little bit more, there’s a Double Your Production Club. And you can join this membership for just a dollar. And the reason I bring that up is because part of that online members site is a component called “Hygiene Explosion” and also there’s “Clinical Explosion” tools there as well. So really, there’s training videos to help your team know how to increase patient care and to make sure that you are on point with the standards of care in our profession. So we thought that that would be good, just to highlight that for you. So that you can see what we’re really talking about when we talk about the risk assessment tool. All of that’s loaded there for you. So you can take a test drive at that member site and provide your team with the tools that they need to really succeed and make sure that you’re continuing to grow and provide a high standard of care for your patients.

S2 00:18:32.627 Yep. For sure. There’s so much stuff on there. It’s really a valuable tool. So everybody really wants to check that out.

S3 00:18:42.562 We actually had a doctor today, just today, reach out, so I have to hear this [inaudible]. Just patting us on the back a little bit, Dr. John. But I guess this is our podcast, right? It’s okay for us to do that. We actually had a doctor who’d been participating with another consulting firm for several years to the tune of hundreds of thousands of dollars. It’s probably the most expensive program out there right now. And he sent us an email and said, “Listen, I did your one dollar trial a week ago and in one week, watching just a handful of videos, I’ve gotten more from those videos than I’ve gotten out of the past several years with this other company.” So it’s good to hear that. It’s good to hear that there’s value here for our members. And again, those that are listening on the podcast today, we [inaudible] out so you could give it a test drive for just a dollar.

S2 00:19:30.761 Awesome. So shall we talk about– on the restorative side in the practice, Wendy, a little bit about providing the best care and some of the skill sets that we think are valuable for dentists to have and how they go about developing them?

S3 00:19:48.447 Of course. Yeah, that’s good stuff.

S2 00:19:51.423 So one of the things that varies dramatically from dental school to dental school and from people’s experience in practice is how much experience and confidence they have in doing extractions and surgery, really of any sort, but extractions. And the other thing is endo. And so we see dentists sometimes that come out of school with very, very little experience with this and because their confidence level is low, they never really start to implement it in their practice. But yet, these are two of the most important things that will drive patient satisfaction because we all know that almost everybody that calls a dental office to make an appointment, whether they tell you it or not, they’re really calling because they have a problem or an issue. And so with the– having the ability to do those two treatments allows you to take care of what those problems are much, much more frequently. So sometimes it’s a chipped tooth, sometimes it doesn’t need any help, sometime they just have a concern, something it’s the way it looks, but if they’re having pain, being able to deal with that pain in your office is such a valuable tool. And we know that when a patient comes into a practice and is seen about a chief complaint and then is referred to somebody else to deal with that chief complaint, that patient is not going back to that practice. Patients do not like to be referred. So when we look at providing the best care, we look at, really, kind of ground zero, all right? Starting out with understanding how to remove teeth comfortably and efficiently. And then doing endo and there’s great courses for endo and a lot of the manufacturers of endodontic systems will provide that training at a steeply discounted rate or for free. And really, there’s so many good ones out there, I don’t even have one to suggest. There are just so many good ones. And I found the best way to learn how to do surgery, and you’re going to love this one, Wendy, is to go on a mission trip. Find a mission group that’s going somewhere and treating the underserved and you’ll go with other dentists so that if you have a difficulty, you’ve got someone to show you how to manage the complication, and three or four days on a mission trip, extracting a few hundred teeth, you’ll have a tremendous amount of experience and your confidence level will soar. And when your confidence level is high, you just do a better job. So once people get–

S3 00:22:28.966 We actually have a couple– I was just going to give Dr. Nate Lester and David Prince a shout-out. We have a couple of longtime members that have a foundation where they go to Guatemala every year. And so if you can’t find a group to go with on your own, be sure to reach out to us. Shoot us an email at The Team Training Institute and we will help direct you and pair you with some people who can give you more information about service projects that they’re already doing.

S2 00:22:54.375 Not only will you gain skill and confidence, but you’ll have a different feeling about yourself. You’ll have a different feeling about your life. You’ll have a different about our great country when you go somewhere else and serve. So it’s really life-changing kind of events. And as we look at the skill sets that people learn during the course of their career, remember, we always should be learning. We always should be improving. And the next thing that I think is very, very helpful for dentists to have is, really, an understanding of reconstructive-type dentistry. Understanding occlusion and reconstructive-type dentistry. So there’s again, great courses. The Spear Education system, the Dawson Academy. Yeah, there’s a bunch of them. But those are ones that I think are fantastic and will help you understand the entire system: the musculature, the bony structure, the teeth structure and how they all interconnect and if you have a problem, how do you go about fixing it. And after that, gosh, you know, cosmetics is probably the next thing. Each of those groups has a cosmetic section that’s really valuable to be able to understand how to make people’s teeth look like teeth.

S3 00:24:10.282 And we’re seeing a huge trend towards implants too. I mean, huge profit centers on the implant side. And I know there’s a lot more general practitioners, even early on, that are diving into implants. So I think it’s exciting to see.

S2 00:24:21.233 Yeah. For sure. So implant was going to be the very next one I was going to mention. And again, great education. I went to Misch Institute. That was a fabulous education experience. I mean, second to none. It was absolutely super. But there are others as well that will allow you to understand the mechanics, the techniques, the science, the physiology behind it. And so that’s kind of an idea of a pathway and if you are early in your career, that’s one of the things that I would look. Often people will jump ahead, to say, implants, before they have an understanding of reconstructive dentistry and occlusion. And I think that might be a little bit of a mistake because occlusion certainly does have a factor– is a large factor in implant success. And if you don’t understand occlusion well, then the implant dentistry is probably not the place to go. It’s probably take a step back and understand occlusion at a higher level.

S3 00:25:25.989 Yeah. One of our longtime members too, Dr. Justin Moody, is doing some really great work. He’s got a program call the Implant Pathway and they go and do clinics where they place implants as a part of this continuum on veterans who really need the care. So we love that as well, being able to support people in our own country that really are deserving of our support. I think that’s wonderful and they do that in cities all across the country as well. So, when you’re ready, once you’ve got the occlusion stuff sorted out and you’re looking for implant training, again, there’s some really great resources. And certainly, he did the implants on my own child, so I’m a little biased [laughter].

S2 00:26:06.920 Yeah. No. He’s got a super thing. He has a program here in Phoenix where he does care for veterans and he’s just a really cool– cool thing, cool guy.

S3 00:26:19.572 Yep. Love that. Well, great. Well, he hope there’s been some good ideas for our listeners today on the podcast. We could talk about this topic, as I said, we could probably list 20 different talking points on how to improve patient care. So it’s tough to cram all that in into a 20-, 30-minute window but I think we did a good job. I think we covered a lot of ground and hopefully, everybody’s got some fresh ideas to hit the ground running with.

S2 00:26:44.842 Fantastic. All right. Thanks, everybody.

S3 00:26:49.361 Thanks so much, Dr. John. Make it a great week. [music]


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