Dental Aggregate

I had a long discussion with The Boss this week about why patients leave and don’t come back, and I think he finally “got it”, but time will tell. Over the last two years I have noticed a steady increase in the number of existing patients who I have had to Archive or put into the Inactive files, and The Boss was none too happy about it.

Fortunately I keep very good records and notes any time I archive a patient or an entire family, and doing so helped reduce the angry tone in his voice when he asked me, “Why isn’t the schedule being kept as full as it used to be?!”

I had to explain to the good doctor that patients haven’t been coming in for treatments, or for their 6-month checkup’s for several reasons, and some of those reasons we have no control over. His question is a valid one and I don’t fault him for wondering or asking me about it since I’m the one responsible for keeping the schedule full of patients. I am not a magician and I cannot pull patients out of a hat and make them suddenly appear in our office to get their teeth cleaned or complete any other treatments. While the Hygienist’s schedule remains full at all times, there have been days where The Boss has zero patients scheduled for anything, and it bothers me just as much as it bothers him.

Why Patients Leave and Don’t Come Back

The number one reason patients leave and don’t come back is because they have moved away, with the majority of them moving to another state in order to have a job. Many of our previous patients worked for a large local corporation that completely dissolved, with thousands of workers being let go and desperately seeking another job wherever they could find one. Patient after patient called to ask if we knew a good dentist in their new location, or if we had recommendations on how to find a good dentist, since they hadn’t the chance to get to know very many people yet.

The number two reason for patients leaving is because we don’t offer what they want. Patients have heard all the buzz on the radio and television about Invisalign, one-day restorations with the CERAC machines, ZOOM whitening, etc. We don’t do root canals anymore, nor do we perform even a simple extraction, but patients are referred out for these treatments. Some patients have complained that we don’t offer these treatments anymore, and have elected to begin seeing a dentist that provides all of these treatments and more, all in one central location. We’re left with doing teeth cleanings, fillings, crowns, veneers, dentures and partials, and the occasional teeth whitening home-care kit using the Opalescence bleaching system.

The third reason is because patients have no idea what all we do, and what cosmetic choices they have available to them to enhance their smile. Some patients have come in for their regular checkup, and we’ve discovered they had gotten anterior veneers done at another dental office saying, “I didn’t know you do veneers”. Patients sometimes will call and talk to me about how they aren’t happy with having discolored teeth, and when I’ve suggested teeth whitening or even coming in for a consultation to discuss veneers, The Boss gets upset at me because he “doesn’t like” the patient and would prefer they go elsewhere. This week we had a patient who was getting his teeth cleaned and the Hygienist determined three old crowns needed to be redone due to recurrent decay, and The Boss got mad because he doesn’t want to do the crowns. The patient was referred to a Prosthodontist instead. Sigh…

Here I am doing everything within my power to bring patients in, fill the schedule and increase production, and he’s going to get mad at me because there’s a personality clash? Damned if I do, and damned if I don’t. What good does it do me to keep up with the latest dental technology and advancements, regularly reading dental magazines, taking hours upon hours of continuing ed courses in order to stay on top of everything going on in the dental industry, only to have The Boss shoot down everything I try to do for his office?! To say that I’ve grown disillusioned with my job is an enormous understatement.

The fourth reason patients have left is because their insurance changed and we don’t take it. Some patients have chosen an insurance plan that requires them to see a contracted In-Network dentist on their list, and if they were to see a dentist not found on the list, they are not given any benefits whatsoever or benefits are greatly reduced to the point where treatments are not financially possible for patients. This hasn’t been a problem for the majority of our patients, but it has put a real dent into our existing patient database, as I’ve had to archive those patients who left due to insurance reasons.

The fifth reason patients have left, and I believe this is the most important one, is that patients don’t think we care about them. Some of our existing patients have been with us since The Boss’ father was in practice, and chose to stay with us when he retired back in the late 80’s. The problem is, many of these patients are now elderly and their health has declined to the point where they are unable to come in on a regular basis anymore. Several of our elderly patients have passed away over the last year or two, but the great majority of existing and new patients are much younger.

One of the things that I always admired about The Boss when I first began working for him nearly twenty years ago, was how the dental practice felt like a big family. Whenever we’d be working on a male patient, there were always general discussions about sports, fishing and hunting, and that sort of conversation. The ladies would discuss their children or grandchildren, what was going on in the political arena, but things have changed where these discussions aren’t happening so much anymore. The Boss tends to focus more attention now on the clinical aspect of treatment and getting the job done, rather than spending those extra few moments to really connect with the patient on a more personal level.

I’ve begun to wonder if The Boss has lost much of his passion for his own career, which has subsequently rubbed off on me to where I now dread going to work each day. What used to be fun and challenging has morphed into monotony, and I truly believe I could do much of my job blindfolded. The Boss claims he doesn’t have interest in retiring for another ten years, but from what I’m seeing going on in our office, I’m thinking that his retirement may happen much sooner than that.

Tags: Basic Dental Care, Business Relationships, Communication, Continuing Ed, Dental Assisting, Dental Insurance, Dental Practice Management, Productivity, endodontics by D.A.
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I haven’t been able to post anything new here at Dental Aggregate for a couple of weeks due to some personal family matters, but I want you all to know that I haven’t forgotten about this dental blog, and have some new posts coming in the next few days.

In the meantime, I wanted to say Thank You to a few Entrecard blogs that have been kind enough to be regular chain-droppers and visitors by giving a bit of Linky Love to their blogs in return.

Top Five Entrecard Chain Droppers-

Life’s Context- I really enjoy keeping up with each new post written by “Periadex”. Even though he is a Endodontist, and surely could write phenomenal posts all about the technicalities of Endodontics in dentistry, I appreciate that his posts are more personal in nature. You have to appreciate the good Doctor’s sense of humor in his post about cheap dentistry, and the “get your mind out of the gutter” comments that kept me laughing.

Healthy Lifestyle- I’m a big believer in eating healthy and taking care of my body, and I understand the importance of teaching children to eat healthy foods and getting enough exercise. Healthy Lifestyle is an excellent source of information relating to healthy living, quitting smoking, and I especially enjoyed the post about dealing with bad breath since it’s a subject that gets discussed with patients quite often in our dental office.

Healthy Cooking Recipes- Since my husband and I are both healthy eaters, it’s quite fun to discover new recipes to add to our growing collection of recipes to try ourselves, and serve to our dinner guests. Our family loves barbecued chicken that is tender and delicious but also healthy, so it’s great to have another healthy chicken recipe to keep things interesting at mealtime.

Obesity Therapy- The subject of child and teenage obesity in society is a topic that needs to be taken seriously by parents, and needs to be dealt with in schools and school cafeteria’s and society in general by learning how to prevent childhood obesity. Obesity in children and teens has become an epidemic around the world, and these kids are not only experiencing health problems now, but are increasing their chances of developing Diabetes, Cardiovascular problems and Stroke, just to name a few.

Telling It Like It Is- Well, I guess it should only make sense that my other blog would be amongst those who chain drop with Entrecard at a higher rate than other users. Regular readers of Dental Aggregate know that I also author Telling It Like It Is, which is a large compilation of posts dealing with relationships, marriage, parenting, caring for elderly parents, deciding when is it the right time to change careers, and much more.

Thank You very much for your regular visits to Dental Aggregate, and I look forward to continuing the chain dropping exercises along with you.

Tags: Personal, dental blogs, endodontics, entrecard by D.A.
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Being in close proximity with female patients seeking treatment, dental office professionals have a unique and important role in identifying cases of domestic violence, as well as offering assistance or intervention for abused women.

It is important to note that almost a third of all women are or have been abused by their boyfriend or husband, possibly including the women you have working for you in your dental office. Anastasia L. Turchetta, RDH, and Teresa Duncan, MS have published “Domestic Violence” in the RDH Magazine that is well worth your time to review and print for further evaluation. If you are a Dentist, and you have more than three women working for you, the odds are that at least one of those women has been a victim of domestic violence at some point in her life.

“Domestic Violence: Proactive Role for Dentistry” provides important intervention strategies for dental practitioners; clears up myths surrounding domestic violence; and explains the signs and symptoms of domestic abuse that Dentists and Office Staff need to look out for:

Dentists can, and should, be proactive in recognizing abuse and reaching out to help the victims. The first step in helping these women is to consciously empathize with them and their needs. Women do not stay in violent relationships because they enjoy it or are able to tolerate it. Survivors talk about their horror, helplessness, and terror as they tried to endure the violence. Fear of losing their children, fear of being killed, financial instability, and rejection by their friends and family are examples of the realities that prevent victims from leaving an abusive partner. The most dangerous time for a woman is when she actually decides to leave an abusive relationship.

“Tackling Domestic Violence: the role of health professionals” is available in a 15-page PDF file at http://www.homeoffice.gov.uk/rds/pdfs04/dpr32.pdf, so Dentists and dental office staff can carefully examine the ways in which they can work together as a team and provide needed help and awareness to victims of domestic abuse.

Having been in an abusive relationship myself (at the hands of my ex-husband), I am very passionate about bringing greater awareness to women who are being abused, and there have been several occasions in our office where it has been necessary to use a variety of assertive techniques to assist these women in getting the help they needed.

Signs and symptoms of abusive relationships:

• Physical abuse or battering- involving shoving, pushing, kicking, hitting, grabbing, pulling hair and threatening bodily harm.

• Emotional or psychological abuse- including controlling a woman’s freedom to come and go as she pleases, brainwashing, spying or stalking her at work or with friends, monitoring phone calls.

• Sexual abuse or rape- physically forcing or coercing sexual favors against her will or with threat of violence if she does not comply, sexual acts following physical violence with or without harmful and painful devices without her consent.

• Damaging property- involving breaking household items, damaging walls, throwing objects at his victim or near enough to cause great fear of physical harm while in a rage.

In order to break free from their abusive partners, women need to identify and recognize the early warning signs of abusive behaviors, and take active steps to leave the relationship with their boyfriend or get a divorce from their husband.

Leaving an abusive relationship is typically a highly volatile time in a woman’s life, as angry and controlling men tend to react with increased levels of abuse, sometimes even killing their wives or girlfriends. Dentists and dental team members need to be proactive with female patients who show signs of having been abused, offering compassionate and empathetic attention, tactfully quizzing female patients regarding possible abuse, and provide helpful information and resources of how and where to seek immediate help.

More often than not, abused women do not have free access to money in order to quickly leave their abusive husbands, and they need to learn how to hide money from an abusive husband so they can begin making secret plans to escape the abuse and move on with their lives.

In your dental office, have you had occasions where you suspected or believed a female patient was being abused by her husband? What actions have you taken in order to provide her assistance and help? What suggestions can you offer women that need to know how to hide money from an abusive husband? Please leave any experiences, suggestions or ideas in the comment section below.

Tags: Basic Dental Care, Communication, Continuing Ed, Dental Assisting, Dental Practice Management, Office Manager by D.A.
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Dental Assistant Recognition Week starts tomorrow, March 3-7 2008. What will you do to acknowledge and recognize the dental assistants in your office? Do you make special note of the holiday, and express sincere appreciation for the good work she or he provides for your office and patients?

Many dental offices and staff members celebrate Boss’ Day, so it’s reasonable to think that dentists can and should acknowledge the hard-working assistants and front desk staff each year as well. Without their efforts to help in providing excellent dental care for your patients, as well as working together as a team to assist you in reaching goals set for the practice, where would you be?

How can you celebrate dental assistant recognition week?

A handwritten note or store-bought card expressing your sincere gratitude and appreciation for their hard work is always nice.

Taking them out for lunch, and verbally expressing your thanks is also an idea. My boss actually makes dinner reservations for one evening after work, where we can relax and enjoy a nice meal and talk like friends do rather than discussing anything about the practice. Making it a dinner celebration is especially nice since there isn’t the usual lunchtime rush to get back to the office in time for the afternoon patients.

What are you going to do this coming week to thank your dental assistant(s) for all they do for you and your office?

Tags: Business Relationships, Communication, Dental Assisting, Dental Practice Management by D.A.
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