Posted on December 5, 2016

Many saw Kevin Catlin’s article which went viral last week titled “The best sales advice I ever got was from a surfer dude.”

And it is easy to understand why it went viral – it states a simple truth which we in dentistry often fail to acknowledge, “I don’t sell, I just took my father’s advice and find out what people want, what they love…then I show them things that work for what they want.”

Most of us have heard a presentation on the difference between “wants” and “needs”, where wants are things we desire more of and needs – less. In dentistry it is easy to get these two issues confused, and when we do, we conflate them as somehow being similar.

“Wants” and “needs” are not the same things on a values level, but needs can sometimes be leveraged to help reveal wants.

And that is what truly professional sales people do. In this regard, Peter Drucker told us, “The aim of marketing is to know and understand the consumer so well that the product or service fits him and sells itself.”

And of course, “marketing” is “selling” writ large.

Where this all becomes confused is when we add dental insurance or some other form of third party payment into the relationship, as it can quickly shift the focus from values, health, better functioning…attractiveness…. to money and a scarcity mindset.

Hence it moves almost every conversation – unless strategically avoided – from possibilities to probabilities, from what they want to what is “covered”.

And a conversation centered around what is covered heads nowhere but straight to the center of the insurance company’s business philosophy and away from your own.

Co-discovery was masterfully developed by Bob Barkley in collaboration with Nate Kohn, Jr., PhD an educational psychologist. And it was not designed haphazardly. It was designed with the intention of keeping the patient in a “possibilities thinking” mode. It was also developed before dental insurance significantly dominated the marketplace.

In sum, dental insurance coverage has a tendency to alter a patient’s thinking patterns toward a direction the insurance company can control so they can advance their money-centered agendas. And consequently, dental insurance has nothing to do with health, even though it functions as a middle-man in managing the distribution of health-related services.

So there is the conflation. And there the nexus of confusion. We all need to understand according to Catlin, “It is easy to forget that whether selling backpacks, advice, or fractional ownership of a jet, people buy emotionally, and then use facts and data to back up that decision to buy.”

And when we start a relationship by first discussing insurance coverage (facts and data) we are building a money-centered relationship and not a health-centered one.

Paul A Henny, DDS

Thought Experiments LLC, © 2016

Read more at www.codiscovery.com

Posted on November 19, 2016

We are quick to blame our environment when things go poorly. If our practice is struggling, it’s because the economy sucks. If a patient declines our brilliant treatment plan, they have “low dental IQ”. If our child’s team loses a game, it’s because of bad officiating. If we are late to the office, it’s because other people were blocking our way.

When we win, however, we tend to ignore the environment completely. If a new patient says “yes”, it’s because we are talented and likable. If we surpass our production goals, it’s because we are an “A Team”. If we arrive early for the morning huddle, it’s because we are organized and always prompt.

Winston Churchill famously said, “We shape our buildings, thereafter they shape us.”

So too is it true with our environment.

Our environment at home and at the office represent a series of choices, based on our acted-upon values…how we repeatedly choose to spend our time, energy, and money.

From this perspective then, we can view what happens at home and at the office as one giant ecosystem we largely designed. And since we designed it, we can change it -if we really want to.

But sometimes complaining is easier, because it blame-shifts. It conveniently moves the locus of our problems off onto someone or something else.

This car is driving me crazy! Why are they only driving the speed limit?

That patient wasted my time, they didn’t even bother to schedule after all the time I spent explaining things to them!

My hygienist never seems to care about anyone but herself!

Pogo famously said, “We have met the enemy, and he is us”.

And he was right.

If there are some aspects regarding your practice and personal life which you do not like, the answer likely greets you in the mirror each and every morning.

Paul A. Henny, DDS

Thought Experiments LLC, ©2016

Posted on November 11, 2016

After 32 years in dentistry, I’ve consulted with a lot of dentists, many of whom were nearing a point of retirement, or leaving the profession entirely.

And of that group, many expressed regret, and would tell me something like, “I wish I had possessed the courage to run my practice the way I felt it should have been run, instead of chasing the constant down-cycle of the insurance industry.”

Why is this such a common regret in a profession which offers so much opportunity for independence, deeply rewarding interpersonal helping, and creativity?

Most dentists have their personal life under control and pointed in a preferred direction. They live where they like, they send their children to optimal schools, they involve themselves in Church and sports.

They coach.

They work out.

They vacation in fine places.

They drive nice cars.

And this is all because they know they have the power to choose, and they “choose to choose”, as Avrom King used to say.

But why is practice life so different for most? Why are dentists in so many dependency relationships with insurance companies and therefore patients when they have the choice not do so?

“Money”, you say?

“It just can’t be done any other way in my town!”

Really?

Are you sure about that?

In reality, most of us exited the dental school treadmill of producing “procedures” and “If I can just get through this last semester”, into a practice situation which was almost identical to it, rendering out a similar emotional response…

“I hate this, but I have no choice right now.”

We focus down on the present so intensely that we can’t see over the hill. In fact we don’t even acknowledge that there is a hill and something preferable on the other side.

We become automatons…we check-in, we check-out. We check for emotional scars at then end of the day. We say to ourselves, “Made it through another one…When is that trip to St.Thomas?”

And here is the result:

If we never draw a line in the sand and clarify what is really important to us and what we want our professional life to become, we just keep looking down. We just keep punching the clock. And we keep looking for the next enjoyable distraction.

Big game on tonight!

Did you see that new BMW six-series?

The gray areas of life loom larger when we fail to clarify what we believe, when we fail to live life buttressed by a philosophy which influences our decisions and choices.

Without a personal practice philosophy, we are forced to adopt one from our environment. We are forced to adopt the philosophy of the insurance company or the corporation. And we are forced to accept what THEIR philosophy does to us.

We are forced to become a slave to our own lack of personal and professional leadership.

When Bob Barkley was asked for the one thing that he would like to grant all dentists…the one wish he had for them, his answer was immediate, “I wish every dentist would create a clear and written practice philosophy”.

And all of the above reasons are why he felt that way.

Paul A Henny, DDS

Thought Experiments LLC, ©2016

Read more at: www.codiscovery.com

Posted on November 1, 2016

Problems – we all face them, with
some being frivolous, and others life-changing.

Some cause us to tap into our greatest creative problem-solving potential, while others produce nothing but stress.

Regardless, we think about them. We think about what to do, and what not to do. But how often do we think about the way we think?

You see, the WAY we think is almost as important as WHAT we think. And one of the most common problems related to thinking is OVER-THINKING.

Over-thinking does not necessarily lead us toward deeper insight, because we can often use it as a tricky little way to justify that doing nothing about a problem is somehow productive.

“I need to think about that…”

And this problem arises because living is a process and not an event which we can quantify, box-up, label, and predict. The reality is that we can never, ever know what the outcome of anything will be until we experience it.

“Planning is essential, but plans are useless.”

Dwight D. Eisenhour

A common time for this issue to arise is when we meet a new patient. And this is because we have a lot of incentive to “size them up”.

That Gucci bag? A good sign!

That Mercedes in the parking lot? We are going to create a nice treatment plan today!

In other words, we project onto others – through over-thinking – what WE think THEY think, particularly with regard to how they value dentistry. And consequently, this often leads us down an Alice in Wonderland rabbit hole toward an outcome we never imagined.

That Gucci bag? A knock-off.

The Mercedes? On lease.

Their house? Two months behind on the mortgage.

Our over-thinking often leads us to believe that we are capable of creating a grand finale decision which will never change and forever be correct. But it never happens that way, and you know it.

You will always be wrong about something.

But that’s ok.

The secret to a happy life is to live it every day. And by that I mean fully experiencing its odd, paradoxical and funny ways. The minute we try to box it in, the joy is gone… wonderment lost, and disappointment enters.

Clarify your values. Define your boundaries. Align yourself with others who feel similarly, and live without thinking too much about it.

That is often a hard thing for a dentist to do, but today is a good time to start.

Paul A Henny, DDS

Thought Experiments LLC, © 2016

Posted on October 31, 2016

There is a concept in chemistry which directly applies to the functioning of a relationship-based / health-centered practice, and it is called “activation energy”.

Here is how it works:

In chemistry, activation energy is the minimum amount of energy that must be available for a chemical reaction to occur.

In behavioral dentistry, the activation energy is the energy required to convert a patient from being co-dependent into becoming a collaborating partner in their own health.

When we strike a match, we add the energy of friction and heat to cause the phosphorus and potassium chlorate to ignite a small piece of wood.

When we invest the energy of time, listening, understanding, and truly helping, we start to build trust within a virtual stranger. And trust lowers the threshold required to ignite a “yes” toward proper and complete dentistry. So, trust becomes the catalyst- an element present which lowers the level of activation energy – required to start the relationship toward collaboration.

In this interpersonal reaction equation, trust is key, but this relational catalyst requires much more than being nice, competent, or even masterful at dentistry.

As dentists, it becomes all too easy to forget the amount of courage it requires from our patients to lay their head back in our chairs and -and from their perspective- allow us to permanently disfigure their teeth.

Just think about that for a moment.

Really think about it…because it reveals why so many people can’t say “yes”, because they can’t see the value behind the disfigurement. They can’t see the disfigurement as a constructive and creative process. From their perspective…Why break the only set of 28 or so eggs they have, when they have never even had an omelet?

Dentistry has advanced itself to a mind-boggling level of sophistication since my graduation in 1984, but you know what? Patients don’t know that 99.9% of the time. And worse…much worse really…they have no capacity to see how that fact is important to them.

Bob Barkley told us that we must find a way to make dentistry significant relative to the patient’s LIFE – not just their mouth- otherwise we simply have a transaction…a transaction that any other dentist can provide, and a transaction which will be influenced inordinately and primarily by price.

To succeed in relationship-based dentistry, we must move well past a primary discussion of financial price, because how does that cost relate to the cost of the loss of their teeth later in life due to poor decision-making? And conversely, how can that initial cost relate to the value of them having a beautiful smile for the rest of their life?

Figuring out this inter-personal calculus, is where the activation energy game is played. And it’s something you can consistently succeed at if you make a commitment to understand the interpersonal dynamics more completely.

Paul A Henny, DDS

Thought Experiments LLC, @2016

Posted on August 12, 2013

Establishing wear patterns in the patient’s mouth is the best way to determine abnormal muscular involvement related to occlusal function. Do you see occlusal evidence of bruxing? When evaluating wear patterns, it is best and most accurate to have correctly mounted study casts with arc of closure registrations along with condylar guidance registration. The steepness of the condylar guidance helps determine the posterior tooth disclusion in lateral and protrusive movements. Prior orthodontic or iatrogenic grinding such as an occlusal equilibration, can influence visual evidence of wear. These factors need to be established before using wear patterns to determine muscle dysfunction.

Of course, the best articulator is the patient. There are limitations in using the patient, especially a patient in pain who will avoid areas of discomfort, which may give an inaccurate picture. This can be demonstrated in some patients who have posterior interferences that are mitigated by the use of an anterior deprogrammer. Limited lateral movements without the anterior deprogrammer are very restricted but will immediately free up with the placement of the anterior deprogrammer. Note any muscle trismus when the mandible is moved into a lateral or straight protrusive movement. This is an indicator that there may be interferences within the occlusal scheme that evoke a protective response from the muscles that function to allow this movement to take place.

If one single improper stimulus enters into this complex interdependent system, the entire mechanism is automatically restructured into an adaptive mode in an attempt to accommodate the stimulus. If this is a temporary stimulus, then the system will right itself after the stimulus is removed. The stimulus may be from the periodontal ligament receptors, a neuromuscular spindle cell in a muscle of mastication, iatrogenic tooth position, or muscles of the tongue or hyoid group. A change in the function of the mastication-hyoid complex changes the balancing requirements of the posterior cervical group of muscles.

In an attempt to balance the stomatognathic system, the labyrinthine reflexes can be affected. At times, stimulation of the proprioceptors in the periodontal ligament that fail to return to normal can have far reaching effects within this system. The chief complaint of the patient may not be the initiating factor in the observable response. This is where our powers of observation and knowledge of how the masticatory system works are invaluable in attempting to determine the cause and effect process.

Note the matching of wear patterns of the mandibular and maxillary teeth. When putting the patient in these positions, note any report of muscular pain. Remember the patient can put five to nine times more force on the teeth when bruxing as when consciously articulating the teeth together. There may be evidence of excursive interferences, especially after immediately leaving the rotational stage of condyle function. There may be evidence of hypo-occlusion on the same side or hyper-occlusion on the opposite side. Involvement of the deep masseter may be due to retrusive inclines and/or retrusive forces in lateral excursion.

 

Posted on May 18, 2013

CURRICULUM VITAE

ROBERT LEE CUNNINGHAM, D.D.S.

November 2012

 

 

DATE OF BIRTH:    Born:  August 8, 1946

                                     Whittier, California

 

EDUCATION:            La Habra High School, La Habra, California 1964 (3.97GPA)

                                    University of Southern California, Los Angeles, California

                                                Bachelor of Science 1968

University of Southern California School of Dentistry

            Doctor of Dental Surgery (DDS) 1971 (GPA 3.90)

 

 

HONORS:                 OKU National Dental Honorary (Top 10% of Graduating                            

                                    Class) 1971

                                    Fixed Prosthetics Award—USC 1971

                                    “Ethics in America Achievement Award,” presented by

                                    Chapman University, the Leatherby Center for      

                                    Entrepreneurship and Business Ethics, June 1998

                                    Paul Harris Fellow, Rotary International

 

 

LICENSURE:            California Dental License 1971-   #D21864

                                    Idaho Dental Licensure 1997-    #3298

 

 

PROFESSIONAL

ORGANIZATIONS

AND SOCIETIES:     Member, American Dental Association

                        `           Member, Idaho Dental Association

                                    Member, L.D, Pankey Institute for Dental Education, 1992-

                                    Member, University of Southern California Dental Alumni

                                    Member, Sun Valley Dental Study Club

                                    Past Member, Newport Harbor Academy of Dentistry, 1984-

                                    1998

Past Member and Founder, South Coast Academy  of            Dentistry 1980-1990

Peer Review Committee, Orange County Dental Society,

                                    Component of the ADA—1978-1997, Chairman 1995-96

 

 

 

 

 

CIVIC

ORGANIZATIONS

AND SOCIETIES:     Board Member, Boys and Girls Clubs of America

                                    Board Member, Huntington Beach Chamber of Commerce

                                                1988-1997, Chairman 1995-96

                                    Member, Rotary International—1978-present

                                    Member, Presbyterian Church of the Bigwood, Ketchum, ID

 

 

ACADEMIC

POSITIONS:              Clinical Instructor, Operative Dentistry, USC School of

                                    Dentistry 1970

                                    Pre-clinical Instructor, Fixed Prosthetics, USC School of

                                    Dentistry 1977-78

Mentor, L.D. Pankey Institute for Advanced Dental Education 2004 to present

 

 

COURSES

PRESENTED:          “A Comparison of the Stuart and Denar Systems of

                                    Articulation,” presented to the South Coast Dental

                                                 Academy

                                    “Microbiologically Modulated Periodontal Therapy,” 

                                                presented to the South Coast Dental Academy

                                    “Marketing Your Dental Practice Ethically,” presented

                                                by DMI (Dental Marketing Institute)

“Surgical and Prosthetic Implant Mentor Program,” presented for NobelBiocare in Sun Valley, ID  2006 and 2008

 

 

CONTINUING

EDUCATION:            Over 3000 hours of C.E. since 1972

                                    Have completed the entire Continuum of the L.D. Pankey

Institute of Advanced Dental Education (seven courses ranging from diagnosis and treatment planning to dental implant prosthetics and esthetics)

 

 

PUBLICATIONS AND ADDITIONAL PRESENTATIONS:  Available upon

Request

 

————————————————————————————————–

 

 

COMMUNICATING QUALITY TO OUR PATIENTS

Robert L. Cunningham, D.D.S.

 

 

Helping our patients/clients to value fine dentistry has everything to do with how we are with the patient during their initial (and continuing care) visits to our office.  A close, ongoing examination of how we structure and pace the New Patient/Co-diagnosis Experience is vital to our success in forming a trust bond with our patients.  What we do after the initial visits will wither enhance or detract from that image.

 

Patients enter our practice in basically three ways: 1. With a dental emergency or “urgency”; 2. Through a visit with the hygienist; and 3. When requesting an examination. 

It is our stated objective that the vast majority (about 80-90%) of our patients enter the practice through the Co-diagnosis process.

 

 

THE “EMERGENCY” NEW PATIENT

 

1. Use the regular health history.  Have the patient sign the consent for treatment and the toothache questionnaire.
2. Treatment Coordinator or chairside assistant conducts patient into the consultation room and reviews the health history and toothache form with the patient, taking time to listen to their fears and concerns.
3. The interviewer excuses them and gives the doctor a synopsis of their emergency and the patient’s personality style. 
4. The doctor and the assistant decide if it is necessary for the doctor to interview the patient or have the assistant go ahead with the necessary x-rays.
5. The patient is seated in a treatment room.  If the doctor has not yet met the patient, he is introduced by the assistant and takes a few minutes to establish rapport, review the history and diagnostic information. 
6. A diagnosis is made and the patient’s options are quickly and precisely explained to the patient.  The doctor or assistant discusses appropriate fees.
7. Palliative relief is provided to the patient.  The patient’s comfort is foremost.  Appropriate anesthetic and/or analgesic are administered slowly and painlessly.
8. Future needs are quickly discussed in general terms.  The assistant helps the patient make and appointment with the appropriate doctor or specialist.  The patient is strongly encouraged to appoint for a comprehensive exam.

 

 

THE HYGIENE NEW PATIENT

 

Patients are encouraged not to enter the practice in this manner.  It puts the focus on the old adage that, “I only want my teeth cleaned and checked.”  It does not allow our practice to be represented as favorably and comprehensively as we would like.  The job of the person taking the incoming call is to tactfully and assertively communicate this to the patient.  If the patient still insists, they are appointed to see the hygienist only.

The process is as follows:

 

1. Welcome package is sent.  If time does not permit the package to reach the patient prior to the appointment, they are asked to come in at least ten minutes prior to the scheduled appointment.
2. The hygienist interviews the patient in the consultation room and takes about five minutes to review the health history and establish rapport.
3. The doctor is introduced to the patient in the consultation room after being de-briefed by the hygienist.  Using the notes made on the health history and Personal Patient Profile form, he focuses mainly on the medical portion of the form and explains briefly what the IPT (Initial Periodontal Therapy) appointment entails.
4. The doctor conducts the patient into the hygiene room, where blood pressure, bacterial slide and complete periodontal charting is performed by the hygienist.  The slide is viewed by the patient and the results are discussed by the hygienist.  AAP periodontal typing is done with an emphasis on the number and depth of pockets, bleeding points, and recession.  If a prophylaxis can be completed at that appointment, the treatment is completed.  If the patient needs periodontal therapy, the doctor is brought in at that point to make the diagnosis.  (See materials on Periodontal Team Management from JP Consultants.)
5. After the doctor leaves the room, fees are discussed, financial arrangements are negotiated, and appointments are made in the computer in the hygiene room. 
6. The patient is encouraged by the hygienist and assistant to reappoint for Co-diagnosis with the doctor.
7. Care, comfort, concern and professionalism are the main concepts to be communicated.

 

 

THE NEW PATIENT EXPERIENCE/CO-DIAGNOSIS

(85% OF New Patients)

 

Appointment #1

 

1. Telephone information is taken and recorded on the “Personal Patient Profile.  A convenient appointment is contracted with the patient.  Welcome package is sent.  Get patient’s permission to send a health history.  (If they are hesitant to fill it our at home, we will interview them and fill out the form for the patient.)

 

When the patient arrives on the day of the appointment, they are acknowledged by name and told that the treatment coordinator will be right with them.  Be sure to notice where they sit and notify the T.C. Offer hospitality – coffee, tea, water and/or a magazine.

 

1. 2.    Treatment Coordinator/Assistant Role.

A.   Introduced by the front desk.  T.C. explains her role.

1. B.    Patient is asked if they would like to see the office.  TOUR OF OFFICE.  Stress our emphasis on their care and comfort, especially sterilization and infection control.
2. C.    Interview in a private, preferably non-clinical place.  After a few minutes of social chit-chat, start the interview by reviewing the health history, dental history and the questions on the Personal Patient Profile.  It is not necessary to ask all of the questions on the Profile, just enough to get an understanding of the patient’s issues and establish rapport.  Record a healthy history synopsis on the front of the “Examination Record”.  Highlight or underline any particularly important information.
3. D.    Key Questions :

• Be sure to ask the “expectations” question at the bottom of the Profile.  Record the answer word-for-word.
• Ask them, “Would it be helpful if I share with you a little about us and what we are trying to achieve in our practice?”  This is a good opportunity to share the written “Practice Philosophy” and give them a copy.
• In a spirit of self-disclosure and deep personal sharing, let them know that we are in the health business, not the tooth business,  Share your own feelings abut your experiences in health care and how our practice might be similar or different.  Write down their response.
• If the patient has any cosmetic concerns, give them a copy of our “Personal Smile Analysis” and ask them to complete it and bring it with them on their next visit.
• Review with the patient the value of full mouth x-rays, study models, and photographs by using a set of generic records.  Let them know that the patient and the doctor will determine which records are appropriate for them. 
• Review the medical and dental histories and make notes on the form for the doctor.  Excuse yourself and debrief the doctor about the patient’s history and personality style.  Emphasis is placed on the patient’s pace and priority.  The doctor is taken into the consultation room and introduced to the patient.  The T.C. stays with the doctor and patient only as long it takes for the doctor and patient to establish an initial rapport, then she excuses herself.
• Doctor’s role:

A.  Social graces – i.e. a conversation based on starting to establish a trust bond relationship between the doctor and the patient.  Focus on who referred then, who you may know in common, family, sense of humor.  Listen intently!

B.  Summarize –  Health histories and interview forms (Personal Patient Profile and Personal Smile analysis).  Use eye contact, feedback, acceptance, and anchoring.  Remember the axiom, “God gave you two eyes, two ears, and one mouth.  Learn to use them in that proportion.”     C.  Contract – Decide with the patient’s approval which diagnostic data will be used to do a complete diagnosis and establish a treatment plan.  For comprehensive restorative cases full mouth periapical x-rays, mounted study models, and photographs will be necessary before appointment #2.  It may be appropriate to make a separate “Records Appointment” to get the necessary data.  

1. D.    Screening exam – The purpose of the screening exam is to determine which diagnostic records are necessary and to get a get a general impression of the state of the patient’s mouth.  Be sure to emphasize to the patient that this is not a comprehensive exam.  Let them know that during their next visit you will have all of the diagnostic data and complete the exam and do a consultation if that is appropriate.  If possible it is beneficial for the patient to have an initial visit with the hygiene department (I.P.T.) prior to the diagnostic appointment, so that pocket charting, bleeding points and AAP periodontal typing will be available at the Co-Diagnosis 2 appointment.

 

Appointment #2

 

1. 1.    Treatment Coordinator/Assistant role.

A.  The patient is met in the reception room, greeted, and conducted into

      exam room.

1. B.    Re-establish rapport with the patient.  Ask them if any other questions or considerations came up for them since their last visit.  Answer the questions you feel confident in and defer the others to the doctor.
2. C.    If the patient has completed a “Personal Smile Analysis”, review their answers and mark areas of concern for the doctor.  The doctor is notified that the patient is ready and the doctor is privately debriefed on the attitude, issues and concerns of the patient.

 

1. 2.    Doctor’s role.

A.   Doctor takes a few minutes to “reconnect” with the patient, first socially then picking up from the last visit as the Treatment Coordinator relays a summary of her conversation with the patient.

1. B.    The doctor focuses on any questions or concerns of the patient and is careful to write down anything that needs to be addressed after the examination.  It is helpful to revisit their answers on the “Personal Patient Profile” and “Personal Smile Analysis.”
2. C.    Helpful questions and discussions that may be used at this time:

• How do you feel so far?
• Is there anything that you need to know about us or our philosophy that we haven’t discussed.
• You may share with them – this is what I would want if I were a patient:  1). Gentleness, and 2).  A dentist who will help me need him less.
• The differences between emergency, urgency, short term, medium, and long term treatment planning.  Quality and timing. 
• Do you want to keep your teeth for a lifetime?

 

1. D.    Exam sequencing.
   1. 1.    The T.C./assistant charts missing teeth and existing restorations from the models and x-rays.
   2. 2.    On the back of the Examination Record two lists have to be made: 1).  Diagnostic Issues.  This is a 1, 2, 3, etc. list of major issues to be dealt with in their treatment plan.  Examples of commonly used issues are missing teeth, malocclusion and shifting, periodontal condition, caries present, failing restorations, bruxism, oral hygiene, pathology, etc.  2).  Diagnostic Options.  These are treatment plan options in general terms with no fees attached.  These options are usually broken down to mandibular and maxillary segments.
   3. 3.    Comprehensive oral exam.  Including tooth diagnosis, occlusal analysis, oral pathology exam, periodontal exam (If not previously done by the hygienist.) and completion of the entire checklist on the front of the Examination Record.
   4. 4.    At this point the doctor conducts the patient and T.C. into the Consultation Room, where all of the diagnostic data is assembled on the counter to be discussed by the doctor and the patient.  The T.C. usually stays in the room in the background as the doctor summarizes his findings and co-creates  the treatment plan with the patient.  The conversation may be specific with a patient who thoroughly understands their options and is able to make a decision then.  This is particularly true of simple to moderately complex treatment plans.

 

• At this point a very important decision needs to be made.  Depending upon the patient’s receptivity, pace (fast or slow) and priority (relationships or things), the  doctor must sense whether to continue the process or to reappoint for a separate consultation appointment.  Sometimes hygiene appointments, particularly a series of periodontal root planings should be scheduled as a first phase of treatment before major restorative fees are discussed.  This is because results of the root planing may alter treatment plan, and having the patient in for a series of appointments with the nurturing atmosphere of our team will made them feel more comfortable with who we are.

 

Appointment #3

 

1. 1.    The Doctor’s Role.  (In a non-clinical setting.)

       Ask the following questions and record the answers:

• How have you enjoyed your experience with us?
• Have you decided how you want to see your teeth in 10 years?
• How may we help you with your plan?

                          The doctor listens, responds, gets agreement on the patient’s plan of                                              action, finalizes the treatment plan and quotes the fee, if appropriate at                                         that time.  The doctor asks the T.C. to discuss financial arrangements                     and make appropriate appointments.  Doctor exits.

 

1. 2.    Treatment Coordinator/Assistant’s Role.

       Asks patient if there is anything that needs clarification at this time.                         Answers concerns.

 

      Whatever treatment has been agreed upon, the T.C. discusses                 financial arrangements, completes and has the patient sign a                  “Treatment Estimate”, makes the next appointment and collects                          the down payment.  The T.C. is responsible that all financial                                    arrangements made by her be signed and dated by the patient.

 

When the patient leaves, before going on to another task, the T.C. puts the patient’s case in the computer for tracking.  If the treatment is to be phased, multiple cases are used.  The doctor is presented with an updated tracking report every Monday morning.  The status of pending treatment is discussed and follow-up measures are assigned.

 

It is important that all patients be kept in the periodontal recare system so that pending treatment may also be tracked and the video used in hygiene to revisit their need for restorative.

 

THE ENTIRE OFFICE IS COMMITTED MAINTAINING AN ONGOING, PERSONAL RELATIONSHIP WITH THE PATIENT.

 

 

 

 

 

 

 

 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

Posted on May 18, 2013

M A R Y H. O S B O R N E

Mary Osborne has worked in dentistry for over thirty five years as a clinical hygienist and patient facilitator. As a lifelong student of effective communication and relationship building, she brings to her work enthusiasm, intelligence, humor, and a deep belief in the potential for significant growth through authentic communication.

Mary is known internationally as a consultant, writer, guest presenter and producer of newsletters and audio cassette programs. Her writing has been published in national magazines including theJournal of Clinical Orthodontics,and she serves on the editorial board of In A Spirit of Caring. Mary is a Foundation Advisor and serves on the Visiting Faculty at the Pankey Institute for Advanced Dental Education.

…..Improving communication in dentistry for over thirty five years and specializing in:

Patient Care and Communication:

Patients come to us with fears, doubts, concerns, and opinions. Empathic listening and clear communication creates mutual respect, clear expectations and trusting relationships.

Leadership and Personal Growth:

Communicating your vision for the practice to those who must help you achieve it is essential to your success. Leadership requires self awareness and the courage to bring yourself to your work. Ethical practice, excellent dentistry, and quality care earns you the right to influence others.

Team Development:

A successful dental practice requires a high level of professionalism from everyone in the office and an environment of open and honest communication. Developing the gifts and talents of those with whom you work inspires dedication, creativity, and enthusiasm.

You can learn to be a more effective communicator.

You can go beyond verbal tactics and scripts, and learn
communication that is both authentic and powerful.

Posted on May 14, 2013

Dr. Jim Otten lives in Lawrence Kansas with his wife and partner of 30 years Vickie. He is also fortunate to have a wonderful son, daughter-in-law and granddaughter Lexi James living in San Diego who he visits regularly.

He obtained his Doctor of Dental Surgery from the University of Missouri-Kansas City School of Dentistry in 1981 and went on to residency in General Practice and Hospital Dentistry at the Veterans Administration Medical Center in Leavenworth, Kansas. Post graduately, Dr Otten completed the curriculum at the Center for Advanced Dental Studies at the Dawson Center and the Pankey Institute completing Continuum I-VI plus Advanced Studies in Implants, Esthetics, Practice Management, Leadership and TMD. He has also continues to study at the Piper Education and Research Center, St Petersburg FL, completing seminars I-III as well as Advanced Diagnosis, Management and Treatment of TM Disorders from 1994-2013.

Dr Otten has served as Associate Professor of Prosthodontics at the University of Missouri-Kansas City School of Dentistry, is currently a Fellow of the American College of Dentists, Lead Visiting Faculty at the Pankey Institute; Visiting Faculty, Newport Coast Orofacial Institute, Newport Beach CA, and Pankey Institute Provost and Board of Directors/Advisors 2005 – current.

Dr Otten is a member of the Medical Staff of Lawrence Memorial Hospital Department of Surgery and maintains a relationship based Private Practice focusing on the evaluation, diagnosis and treatment of advanced restorative care including emphasis on TMD, Occlusal Compromise, Esthetics and Implant Dentistry. He has also lectured regionally and nationally on Concepts of Occlusion, TMD management, leadership.

In addition to the ACD Fellowship, Dr Otten maintains active membership in the American Equilibration Society and American Academy of Restorative Dentistry. Outside of dentistry he is a community leader active in academic leadership at the University of Kansas and enjoys photography, hiking and biking in his spare time.