To prepare myself mentally for starting my clinical supervising role in a few months I have been trying to think back to the the challenges I faced in dental school and how I might be able to help current students with those problems.
I remember early on in our clinical stages there were definitely times when I and my compatriots may have been about to get a patient in but with no real idea of what we were going to be doing. We would be so completely reliant on a supervisor telling us exactly what to do next.
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I have touched on the idea of a template document for explaining options to pts before but felt it was time I actually discussed this in more detail. I call this my "Complex treatment considerations" document.
When I started doing more complex cases a couple of years ago I found it difficult to explain all potential options to some patients verbally in a short time so decided to try to create a written summary of the pts problems and their broad options. This process was very time consuming at first taking up a lot of my lunchbreaks etc. So after doing it a few times I decided to see if I could speed the process up by creating a template. Over time the template has been added to and edited but I now use it very regularly and find it very useful. Do you often find yourself having the same discussions with patients who only want the cheapest option available or whose first question is always "how much will it cost?"
Aversion to unwanted expenditure is part of human nature, but there may be some simple things you can do to help stop your patients from fixating on price and automatically choosing the cheapest solution available. First and foremost is focussing on providing high quality dentistry. But how do your patients know that you are focussed on quality? If they stick with you for many years they will over time realise that their teeth are working well hence proving your capable, but you obviously want them to understand your focus now. Let me ask you a few questions: Do you tell your patients about your passion for high quality dentistry? Does your stationary make this focus clear? Does your website say it? Do your staff say it? You have to be careful to not sound arrogant but there is no reason why this message shouldn't be made clear via these routes. For me it means that all new patients get a new pt pack explaining important points about the practice such as emergency contact details etc, but it also talks about my passion for dentistry. This information can be found on the "Info For Patients" page of my website. My stationary also has a header with my logo and a tagline again highlighting my focus on quality to provide long term outcomes. There are also a few simple tools you can implement when presenting prices to your patients to help them understand the value in the treatment you are recommending. Indirect restorations like crowns and onlays are expensive and justifiably so. They take a lot of time and highly skilled focussed work to prepare well for and a comparably highly skilled technician will want a decent fee for constructing the restoration. In most cases patients don't really care about this though. They are choosing the crown because you say it should be the best way of restoring the tooth to good shape, strength, reliability and aesthetics. Most pts will only want to spend a decent amount of money if they feel it will give good long term value for money. So have you considered explaining the cost to the patient in terms of longevity? You need to choose a timeframe you are happy to quote and then work out the cost per year or month or week. So for instance if you consider the national average cost for a crown is quoted as £500, if you are confident it should last 20 years with good OH then that works out to be less than 50p a week to restore this tooth. Obviously this method only works if you are confident you are actually providing quality work that will last but pts may prefer the idea of explaining it as "50p a week" to rebuild the tooth. Another option you can consider is splitting up your overall cost to explain its different component parts. For instance you can split your crown cost into "lab cost" and "time and materials cost". I used to do this and included is a photo of how I presented this to pts. I have moved away from it because I personally found it sometimes made things more complex than needed but now that I have more time for my consultations I might go back to using a system like this occasionally. PS my prices have also increased since I made that table. If you want to explore this topic more there is a good 30 minute audiobook available for free from the harvard business school via audible here: https://mobile.audible.co.uk/pd/Film-Radio-TV/How-to-Stop-Customers-from-Fixating-on-Price-Audiobook/B00SJWV04G/?ref=msw_search_c1_0_2_AN For my first ramble of this year I actually don't want to do that much of the talking. Instead I want to bring your attention to some previous posts by Lincoln Harris. You have probably already heard of him. He is the original creator of the R.I.P.E (Restorative Implant Practice Excellence) forum: https://www.facebook.com/groups/381541188712740/
If you haven't already found that forum I would strongly suggest you check it out. He also has his own site where he documents his work and often posts very thought provoking writing on various aspects of dentistry. I am not ashamed to say that I was inspired by these posts when I started thinking about creating my first Rambles. The ones I want to highlight today relate to treatment planning which Dr Harris compares to the 3 legs of a tripod. The first leg is "What does the patient want?". He discusses that here: https://www.facebook.com/RestoringExcellenceAcademy/posts/961267583933326 The second leg is "What does the patient have?": https://www.facebook.com/RestoringExcellenceAcademy/posts/962892833770801 The third leg is "What can the patient afford?": https://www.facebook.com/RestoringExcellenceAcademy/posts/990588244334593 Last year I had the opportunity to attend one of Dr Harris' courses about rapid efficient treatment planning but chose not to and instead invested the money on more photographic equipment. I am happy that I have a better camera but in hindsight I wish I had gone on his course. I will admit that I often struggle with the concept of treatment planning. Particularly regarding the points of what the pt wants and what they can afford. I make assumptions which may not ring true. Over time I feel I have got better at letting the pt talk and not putting words in their mouth but I still sometimes find this tricky. So one thing I will be trialling this year is a simple document that I call "The Objectives Compass". I am hoping that when I feel I am struggling to nail down what a pt really wants I might be able to use that to help guide the conversation. As you can see from the photo, it is just a very simple compass with common dental objectives for the different directions. The pt can then indicate which path they feel is right for them and that can then be the basis for further discussions about treatment options and costs. It wont work in every case, but for example it broadly works that if a pt states their main objective is to have the best looking smile, that is going to be pulling them away from minimally invasive work and will also cost more than other options and they should be made aware that some alternatives may last longer. And it works the same for each direction on the compass. It can be handled in the same way as the consent forms via the adobe fill and sign app which allows you to add extra text as shown in the example. It also allows you to document the pts selection via underlining, or circling certain words, or just putting a point anywhere on the compass if the pt is equally drawn by 2 objectives. So the main point of this post is to draw your attention to the posts by Dr Harris but also add my little addition. I am happy to take any feedback on this idea. So below is the original objectives compass I posted and an alternative version that may be useful based on discussions with other dentists. |
AuthorDr Chris Harper Archives
August 2020
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