Doc, I know you would LOVE to see restorative treatment being scheduled out of hygiene. Every dentist I’ve ever met feels the same way. But sometimes, it’s just not happening. For your hygienist it may be a function of not having enough time and we’ll talk about that in an upcoming video. Or it may be that there are some critical steps you’ve missed in training your hygienists and setting expectations for co-diagnosis.
There are 2 very common reasons that hygienists are timid in this area:
1-The ‘I’m not supposed to diagnosis’ syndrome
2-They don’t have a deep enough knowledge of your treatment philosophy
Here are 3 simple steps to help them overcome those obstacles and help fill YOUR book.
Step 1 – Empower your hygienist by clearly stating that you are confident in their dental knowledge and skill. Then set out your expectations regarding co-diagnosis. If you’d like them to take one photo on every patient with outstanding treatment, make that a policy for the entire team. And, unless they are way off base, try your best not to ‘undo’ what your hygienist has tee-d up for you. If your hygienist sees that you won’t move forward with the treatment they’ve helped enroll, they will stop because they’ve lost confidence in themselves and in you.
Step 2 – Give your hygienists permission to observe restorative needs and to begin educating patients on those conditions. This includes permission to participate in diagnosis, not only for perio disease but for restorative needs as well. Give permission to think in a broader sense when reviewing x-rays, intra-oral photos, etc.: to think beyond calculus and gingival health and begin to think about what might have caused that abfraction on #11; to think about what you might recommend to strengthen that broken 2nd molar.
Give them permission to take the patient as far down the diagnostic path as possible.
I want to be very clear here. The doctor makes the final diagnosis and creates the final treatment plan. That being said, it is well within the parameters of the hygienist to offer information to patients about what conditions he or she has observed in the patient’s mouth and what your recommendations may be.
Step 3 – Clearly communicate your treatment philosophy. Often, dentists assume that since their team works with them each day, they are familiar with their treatment philosophy. This may be true, but there may be some specific aspects of treatment where staff may need more information. Confusion about your treatment philosophy feeds inaction.
When your hygienist is not totally confident with your treatment philosophy, she may be reluctant to reinforce recommend care to patients. Being unsure about how you would plan a restorative case is another key challenge that must be overcome before there is consistent enrollment taking place in hygiene.
Set aside one hour each month to review cases and have your team create their own treatment plans. Then compare their plans and openly discuss how close they were to what you would have planned and the areas that you need to focus on.
Hint: Take photos of teeth while you’re working. If there’s a crusty old amalgam, take a photo of the tooth once it’s removed and what they decay looks like. Then take a photo after you’ve prepped it and there’s little tooth structure left. This goes a LONG way in getting your team behind why you recommend a crown when they think maybe a filling would do.
If you implement these steps you’ll see co-diagnosis increase, your exam time decrease and healthy, happy patients.