New Patient Exams – Let’s get clinical for a moment. I think your auxiliaries should be doing the new patient exams. Now, before you go and get all hot and bothered by that statement, let me explain what I mean. This is not a new concept. Even Gordon Christensen had a video out several years ago about the auxiliary centered new patient exam. I own that video. Certainly don’t let your assistants do anything that is not legal in your state or even unethical in your own eyes, but let them do what they are hired to do, help you. There is no reason you should be spending upwards of an hour in there with any new patient for the first time. For a while in dentistry, it was all the rage to schedule blocks of time (usually 1 hours each) for the initial new patient exam with the doctor doing the bulk of the appointment themselves.
To make this idea even worse, it was many times suggested that the doctor have the patient come back for a one on one sit down meeting with the patient in their private office to go over their findings. Then, the doctor would report in miniscule detail all the stuff they found wrong with the patient and try to shove a HUGE treatment plan down their throats. I sat through many lectures and seminars where this was the way treatment planning was approached. It was even insinuated that if you didn’t do things that way, you weren’t much of a dentist.
I believe the term those presenters liked to throw around for anyone straying from their ideal was “mouth mechanics.” Hey, if you’ve got plenty of money, know how to do big case dentistry, and just like doing exam data capture and big presentations to patients as a hobby, then, by all means go for it. Present away. Heck, take a course on video and power point and really spruce up that case presentation. But, for those of us living on planet Earth with a need to keep the new patient in the walls of our practice without running them off, and who need a case presentation acceptance percentage higher than the Mendoza Line (that’s 20% for those non-baseball geeks out there), I think there is a better way.
That way very much includes the doctor, but the doctor is used sparingly and in the role that only he or she is truly needed. In Mississippi, I have to do the initial exam before I can delegate the x-rays. That’s a bummer. I don’t really see why I need to diagnose x-rays in this day and time of digital radiographs, but that’s the way it is. It may be that way in your state, too. I don’t know and I’m not a lawyer. You’d better check on that yourself, but here’s how I handle the exam.
First, the new patient comes into the waiting room. They are greeted by our new patient liaison staff member. They are given a physical gift and their paper work to fill out. Then, after the paper work is done, they are given a tour of the office patient areas by that same new patient liaison. They are shown a couple of offices, a couple of operatories, our sterilization area, and our Studio room.
This one operatory is set up nicer than the others. It has a different color, the nicest dental chair in the office, more elaborate trim and molding than the other rooms, and better fixtures and pictures on the walls. It is also set up for filming. The patient is told that this is where Dr. Griffin does his smile makeovers and films for his seminars where he teaches dentists from all over the country. What we are trying to do here is make it very obvious that we are not just another dental office. This can be done by virtually anyone, anywhere. Just be smart about it and don’t overwhelm the patient to the point that they think they are in the wrong place. Then the new patient is led to an operatory to be seated. I have to pop in and do a cursory exam due to state law, so that’s what I do. I find it a waste of a perfectly good set of gloves, but I make the most of it. When I first come in the door of the room, the assistant does a proper introduction. Next, I do the exam-light and the whole time I am making small talk, trying to make a connection to the patient. It is rare that I can’t find something in common with them, heck; down here I am related to many of the patients distantly even if neither of us knew it before that day. Then I order the x-rays and leave the room. Wherever I am in the office after the x-rays are finished, the assistant comes and pulls them up for me so I can get an idea of what we are looking at. We have digital x-rays or this strategy wouldn’t work nearly as well.
If it looks at all like perio, I’ll probably order a probing by a hygienist. Otherwise, it just goes up on the Route Board in sequence for me to come in for the final diagnosis. When I can get back in there, I make a little more small talk as I am getting gloved up, then I do a complete exam from tooth #1 to tooth #32, just like in dental school. I talk over the patient using common terms, but also adding in specific terms so the assistant knows what to write down for the treatment plan. Once I am through with tooth #32, I make a little more small talk and maybe talk a little about a specific dental problem the patient is having. By the time the assistant has entered all the procedures needed into our software, I have a pretty good idea of what the patient wants and expects and I also know what I am going to recommend.
Then I go over to the monitor next to the assistant to review the x-rays one more time against my findings. Next, I like to look at the patient chart view of the software and I begin to group the procedures into appointments, placing the patient’s chief complaint first if possible. Next, I discuss what I think should be the first appointment with the patient while the dental assistant takes the Treatment Organizer card to the Financial Coordinator. Once I have answered all the questions the patient has for me directly, I cordially exit the room telling the patient that the assistant will be back in shortly to go over the treatment in more detail. Of course, I am not going over this whole thing in microscopic detail, but this is a pretty good overview of what happens on a regular basis. Once I have left the room, I go back to the Route Board and get back into the mix of the day’s procedures. I may never see that patient again if financial arrangements couldn’t be made or I may see them later that day. It is all up to my staff. The cool thing is that all the concerns of the new patient appointment leave my mind the instant I leave the room. I have completely delegated the worry to my staff. That’s another good thing.
So, there you have it. You’ve just learned one of the biggest secrets that high production offices all share. You must give up and delegate to your staff if you want to really get out of the way of your practice and grow it. As an added bonus, you might just be able to keep your sanity, too. One of the greatest findings of Dr. Griffin during his consultation with dental practices has been that once all staff members are aware of their specific duties, they can resolve longstanding issues and enjoy, fun, profitable growth to superstar levels. You can get your free CD explaining the 5 most common Staff Secrets at http://www.dentalstaffsecrets.com.