A Healthcare Provider’s Greatest Gift
July 25, 2011
Don’t you hate to wait? I took my to get the oil changed a couple of weeks ago and there were three cars ahead of me. A man graciously opened my car door and escorted me to the “waiting room” like it was a 5-star resort, which it definitely was not. I sat there and waited and waited, constantly looking through the glass at the garage bays to monitor the progress. As I sat there I was thinking, “can’t they move any faster; there seems to be a lot of standing around doing nothing going on.” Then of course I realized that there was more to the story as there was someone under the car and “behind the scenes” doing something they were waiting for. I waited patiently from then on realizing I had no real control on how long it takes to change oil in a car.
One of my pet peeves in dental practice is running behind. I hate to make people wait. However, the reality of it is that things don’t always go the way you planned. Most patients are very understanding. Occasionally I’ll hear over my shoulder, “Doctor, your next patient would like to know how much longer it will be?” I’ll usually jokingly respond, with my current patient on their back in front of me, “Mrs. Smith, I’m sorry, I have to rush through the rest of your difficult filling because I have another patient to see.”
I believe the philosophy of practice revolves around treating the person as a whole and not just a tooth. It means patients, their overall health & well-being, must be foremost in the practitioner’s mind. Yes, it also means cleanings, fillings and crowns. These are often inescapable outcomes to dental disease – but, under what context are these services being provided?
Too often the dentist views a patient as just a mouth. The goal is to fix as many problems in as many mouths in as short a time as possible. The patient becomes the object of the “fix” instead of a participant in the treatment. How degrading is it for a patient to experience that type of environment? Where is the quality, attention and care when the dentist is busy running room to room? Although for some, this is the type of care they desire because the fees are often lower in this type of setting.
The dentist also suffers. How satisfying can it be for a dentist who sees 40 patients a day? What kinds of relationships can that dentist build with his or her patients? How can that dentist spend the necessary time with the patient to really know the patient’s needs and desires?
In a truly health-centered practice, each patient should be treated as a unique, whole person. Each patient should be treated with dignity and respect. The dentist gives each patient his/her most important gift: TIME.
Taking the time to listen; taking the time to do a complete examination; taking the time to teach the causes of existing and potential dental problems and taking the time to explain alternative treatments and modes of prevention. It means that each patient be given the opportunity to choose the highest level of health consistent with their values and life circumstances.
March Madness
March 22, 2011
March is a busy month for me. Last week I was in Atlanta at a national study club I was invited to be a part of. Today I leave for my son’s hockey tournament in Lake Placid and next week I’m off to Haiti for 7 days. I have to find some time to work!!
The study club meeting last week was great. I presented some material but got the most out of just talking with other dentists from around the country. A major discussion was the economy and how it has affected our dental practices. The common thread amongst most dental offices was patients putting off treatment due to finances or needing to spread treatment out over time if they needed more extensive dental work. We discussed some great techniques on sequencing treatment over multiple years. This allows the patient to spread the treatment out, maximize their dental insurance (if they have it) and get the treatment they need.
Another common theme was holding ground on our philosophy of care. As I have said in the past, there are many different ways to do things and for that matter practice dentistry. This particular group of dentists were all very similar in their philosophy of care. They all hold very high standards, are exceptional clinicians and have a patient base that come to them because they realize the level of care is above average.
They believe the philosophy of practice revolves around treating the person as a whole and not just a tooth. It means patients, their overall health & well-being, must be foremost in the practitioner’s mind. Yes, it also means cleanings, fillings and crowns. These are often inescapable outcomes to dental disease. However, in this type of economy, it just means that sometimes the dentist has to be a little more creative without sacrificing standards and quality.
Too often the dentist views a patient as just a mouth. The goal is to fix as many problems in as many mouths in as short a time as possible. The patient becomes the object of the “fix” instead of a participant in the treatment. How degrading is it for a patient to experience that type of environment? Where is the quality, attention and care when the dentist is busy running room to room? Although for some, this is the type of care they desire because the fees are often lower in this type of setting.
The dentist also suffers. How satisfying can it be for a dentist who sees 40 patients a day? What kinds of relationships can that dentist build with his or her patients? How can that dentist spend the necessary time with the patient to really know the patient’s needs and desires?
In a truly health-centered practice, each patient should be treated as a unique, whole person. Each patient should be treated with dignity and respect. The dentist gives each patient his/her most important gift: TIME.
Taking the time to listen; taking the time to do a complete examination; taking the time to teach the causes of existing and potential dental problems and taking the time to explain alternative treatments and modes of prevention. It means that each patient be given the opportunity to choose the highest level of health consistent with their values and life circumstances.
In difficult economic times you may need to postpone certain things that you would like or need. Your health is not one of those. Despite what I hear sometimes – it is not “just a cleaning”. Your mouth is the gateway to your overall health.
The Dental Scam – Unveiled
March 11, 2011
Last week I told you about a Reader’s Digest headliner from 1997 called, “Exclusive Investigation: How Dentists Rip Us Off.” The author had traveled around the country with his dental x-rays to different dental offices requesting treatment plans. The recommended treatment ranged from nothing to $30,000. How could this be? Was he really getting “ripped-off”?
I bring this up from so long ago because this magazine was sitting in my reception area of my “new” practice back in 1997 and I still see the image every once in a while. I am sure that most dentists do not want people to think that they are trying to rip them off.
Every dentist has been on both sides of the fence; patients presenting to us with treatment needed, in our opinion, which is more or less than previously recommended. A substantial proportion of the variation in treatment plans stems from the differences in dentist’s beliefs about dental diseases and the fact that there is never just one right or wrong way to treat any particular patient.
A dentist’s philosophy of care is built over his/her entire career dependent on education and personal experience. With that philosophy, the dentist uses diagnostic criteria, knowledge of risk factors, rates of incidence, and prevalence and progression of disease to formulate treatment recommendations.
While dentistry is definitely science-based, no one dentist has all the answers. To my knowledge, no dentist can predict the exact longevity of any particular dental treatment. Dentists, as individuals, use their own knowledge and expertise to recommend treatment which they feel, I would hope, is in the best interest of the patient. Don’t anticipate definitive information about risk, progression of disease and outcomes of treatment in the near future. Dental research still channels most of its resources into the development of new and better dental materials. Until a significant portion of these resources is diverted to investigate outcomes of dental treatment, dentistry will remain vulnerable to public scrutiny.
As in any profession, there is a wide range of talent in dentistry. There is never any one right way to treat any particular issue. There are so many different factors that go into what is the appropriate treatment for any individual patient. What may be right for one patient may not be right for another. In fact, the treatment a patient agrees to should always be treatment the patient wants and not what the dentist says the patient needs. For the patient to make an educated decision, often times treatment plans ranging widely in cost must be discussed.
It is the responsibility of the dentist to diagnose and properly communicate to the patient, in terms they understand, so that they may make the decision that is right for them. It is the patient’s responsibility to make sure they understand their condition and to understand the consequences in doing or not doing any kind of recommended treatment.
The most important thing for a patient to have is a solid relationship with their dentist. If a patient thinks they are being “ripped-off” they do not trust their dentist and should move-on to someone else……unless they have a preconceived notion that dentistry in general is a “rip-off”. That would be a subject for another column. I Would love to hear some feedback on Facebook.
Is your dentist retiring?
November 8, 2010
It has happened. The worst possible thing in the world you could ever imagine has happened to you. The dentist you have been seeing for the last 20 years has retired. What are you going to do?
Many people, including myself, get attached to their healthcare providers. When you build a relationship with your healthcare provider and the office staff, there is a level of comfort in knowing that when needed, there is a person/office that is there to take care of you and you trust. When that provider retires there is a sense of abandonment, obviously not intentional, and that feeling of – What do I do now?
In many cases, the staff members remain, which is not only important for the patients, but also for the new provider. Dental patients go to a particular office for many different reasons. Those reasons range from convenience, insurance coverage (which is not necessarily a good reason and a topic for a whole other column), they love their hygienist, they believe they are getting the best of care, or they have just developed a sense of comfort with the office. I can tell you a fact that I have seen over and over again – no matter how good the dentist is, if patients have issues with the staff, they don’t stay. Staff members play as much of a role in patient retention as the dentist does, if not more. If the staff members leave with the retiring dentist, it can be that much more devastating for patients.
The fact that your dentist retired does obviously mean that you must have a new dentist, whether it be that you stay with the office or you decide to go to a new office. Because of this, and especially if familiar faces remain, it is usually a good idea to give the incoming dentist a try. One thing is certain, regardless of whether you remain in the office or jump ship, things will be different.
Every dentist has their own unique personality, style of practice and philosophy of care. It is unrealistic to think that any one dentist will be that same as another. It is impossible for you as a patient to have any idea whatsoever of the clinical skills of any dentist. For patients, the first thing you will be looking for in your new dentist is whether or not your personality meshes with the new person.
Expect to hear new things. As I said, every dentist is different and has their own unique style of practice. It is up to the dentist to be able to communicate their philosophy of care with you. If they fail to do this it is their problem because you will not be staying.
In general, a retiring dentist has been in practice much longer than the new person coming in. Patients get used to the style of practice they have been in. You need to keep an open mind. I know we have been inundated recently with the notion that change is good. My philosophy is that change can be good.
It will be up to you to decide if this particular change is good for you or not. If you approach this change with an open mind, and your new provider communicates his/her philosophy well, it will give you the best opportunity to decide if it is right for you.
Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@dentalhealthforlife.com. You can view all previously written columns at www.dentalhealthforlife.com.
