Exceptional Exams:
A step-by-step team approach to refining your new patient and emergency exams for maximum treatment acceptance

August 22, 1997
Carlsbad, CA

November 7, 1997
Long Beach, CA

January 23, 1998
San Jose, CA

March 6, 1998
Portland, OR

Exceptional Hygiene:
Creating a profitable hygiene department without sacrificing Your Ethics

September 26, 1997
Carlsbad, CA

November 21, 1997
Long Beach, CA

February 20, 1998
Portland, OR

May 22, 1998
San Jose, CA

The Exceptional Front Desk:
Organizational systems and verbal skills for real people...That really work!

September 12, 1997
Ontario, CA

October 24, 1997
Long Beach, CA

February 6, 1998
San Jose, CA

An outstanding new patient examination process is essential to the success of any dental practice. Not mediocre, not okay, not good-enough. Outstanding.

Do you remember what it feels like to be a new patient in a physician's office? Think back to a past experience and remember the importance of the initial phone conversation, and how you felt trying to find the office, filling out forms, and waiting in the reception room. Remember the person who seated you in a treatment room and gathered data. Recall the doctor's examination, your questions and his or her answers, financial discussions, checking out at the front desk. Do you remember making a judgment about the practice or physician based on the perceived competency and attitudes of the clinical and administrative staff?

Were you impressed? Did you leave thinking, "Wow! That was much more professional, caring, and comprehensive than I ever expected!" For weeks after, did you tell anyone who would listen about this incredible experience at your new M.D.'s office? Chances are that you didn't. If you did, you probably recall it vividly to this day.

If you aren't completely confident that your new patients feel the same about their experience at your office, then you have work to do. Your goal should be to know, without a doubt, that a more thorough, comprehensive, and impressive exam could not be found in any other dental office in your community.

Frequently, when I evaluate dental practices, the doctors or staff members tell me, "We have a great doctor, a great team, and we really care about our patients. What we really need to grow our practice are simply more new patients!" It's been my experience that very often an office will spend large amounts of money on direct mail campaigns, yellow page ads, or referral programs to attract new patients. At the same time, however, very little money has been invested in the facility, written patient materials, visual aids for treatment presentations, or communications training to ensure that patients in the office, particularly new patients, have a truly remarkable experience once they get there.

After years of experience and observation, I believe your very best marketing tool is an incredible, remarkable new patient exam. It must be dynamic, well thought-out, and well rehearsed by the entire dental team. To maximize those precious marketing dollars you've spent attracting new patients, you must be prepared to give them a dental experience that far exceeds their expectations. These kinds of experiences don't just happen ­ they are created.

One very important part of creating that outstanding experience is to maximize the "peer relationship" that exists between your patients and clinical assistant.

No matter how good a communicator the dentist is, many patients use caution and show some degree of trepidation when communicating directly with a dentist. They often speak more candidly and openly with clinical assistants simply because they do not have "D.D.S." behind their names. Patients view dentists as being more intelligent and better educated than they are, and don't want to appear stupid or ask stupid questions. They view the relationship with the assistant as much less intimidating.

The undeniable proof of this special relationship comes from listening-in on typical operatory conversations. I have observed many occasions where the dentist has done a good job presenting treatment and even asked, "Do you have any other questions? Is there anything you'd like me to go over again?" No, No, No, from the patient. But as soon as the dentist leaves the room, the patient turns to the clinical assistant and asks, "Now, did he say two crowns on the right and one on the left, or was it two on the left and one on the right?" "Do you think I should get this done right now?" "What would you do?" How the assistant handles these questions can make or break treatment acceptance.

Understanding and accepting this special relationship is essential to producing a great new patient exam. In my exam process, I have tried not to ignore the existence of it but rather to maximize it and utilize it in relationship building and obtaining critical information from the patient we could not otherwise have.

There are several ways a well-trained assistant can enhance your new patient exam:

1. Make sure the initial patient greeting is above average. The assistant should walk out into the reception area to greet any patient, but particularly a new patient. Offer her hand professionally in a warm handshake and introduce herself by name and position. No more standing at the door, calling a name, and walking away leaving the patient scurrying to catch up. She should relieve patient anxiety by saying, "Mrs. Jones, please come with me so that I may get some initial information from you and find out what we can do for you today." Or simply, "Mrs. Jones, please come with me to meet the doctor." And for heaven sakes, don't forget to smile! Once, while staying in a very expensive hotel, I observed a sign above the reception desk that stated, "The Grand Hotel makes no charge for its rooms if any of our clerks fail to smile." I've often wondered how many dental offices could do the same.
2. The clinical assistant should be carefully trained to interview the new patient. This not only saves time, but gives the assistant and new patient a chance to get better acquainted. When this information is professionally "handed off" to the doctor in front of the patient, it gives the appearance of a competent and organized clinical team with great respect for one another's skills. I recommend the doctor hold a series of team meetings to refine clinical skills for the new patient exam. One topic would be how to review a health history and patient registration form properly. You might even provide additional screening questions for your assistant concerning the patient's previous dental experiences and current expectations. Role playing this interview process in the operatory can be very helpful.
3. Charting existing restorations and pre-assessing dental needs is another area where the clinical assistant can enhance your exam process. During this component the assistant can ask questions like, "How long has this tooth been missing? Has anyone talked to you about replacing it? How long have you had these silver fillings?" I don't advocate pre-diagnosing, only pre-assessing patients' dental education and attitudes. It will not only give the assistant a chance to brag on the dental work performed in the office, but also to prepare visual aids the dentist will want to use and have intraoral camera pictures already on the screen.
4. In the actual exam procedure, I recommend the "assistant-directed" exam. This requires the dentist to meet with the entire team to discuss the components and order of the "perfect" exam. Once these are outlined, they should be printed on the charting forms in that order. On a cue from the doctor, the assistant then begins the clinical exam by calling out the components from the top such as, "lips, cheeks, palate, tongue," etc. The dentist simply responds with his answer. This approach allows the assistant to control the pace so she can document each part of the exam well and make sure every patient receives the same thorough exam every time. Many doctors only verbally comment on pathology if it is remarkable and patients don't always hear the exam they've received. With this approach, patients will remark that they've never had such a thorough exam before (even if they have!)
5. Once the dentist has performed his clinical exam and given his treatment presentation, the assistant should "debrief" the patient before handing them over to the financial manager. She should briefly recap the appointment and make sure all the patient's questions have been answered. One word of warning: Make sure your clinical assistants share your diagnostic convictions and believe 100% in the quality and warranty of your work. Also, make sure that the assistant, like everyone on the team, sees your treatment plans as "good news" for patients, not "bad news," for those attitudes will surely come across to patients.

There are dozens of other ways your clinical assistant can enhance the new patient experience in your office. Devote one of your next team meetings to creating, refining, and rehearsing your new patient experience so that it becomes your very best marketing tool.