November 19, 2019
by Jodie Cantarelli, AAS, RDH, Dip.AdEd
In the world of dental hygiene, we commonly refer to routine follow up exams with patients as ‘recall’ appointments. More appropriately, these can be considered re-care exams, as our patients aren’t recalled per se, rather compassionately re-cared for through the ongoing monitoring and maintenance of their oral health.
Re-care exams play a very important role in the retention of patients and the success of a practice at large. The repeated face-to-face interactions afforded by re-care appointments have the potential to build long term relationships between practitioners and patients. Effectively managing your re-care exams is essential in creating a smooth and positive experience for patients that will keep them coming back to your practice.
The tips below will aid you in crafting a successful and efficient re-care program that will benefit both patients and team members.
Start the day with a team huddle. A key component of a successfully run practice starts with a pre-planned daily morning huddle that must include the entire team. Effective re-care programs are a collective effort and require the active involvement of all practice team members. Ensure that the team is prepared for the day by organizing and reviewing the schedule, confirming lab cases, anticipated patients, what support is needed, equipment required, financial issues, and other factors that will help streamline the day. Synergy fosters a prepared and organized team where patient experience is always at the forefront.
Be prepared and present in the operatory. Know the patient’s name and prompt the dentist by saying the name out loud (e.g. “Dr. Jones, you remember Mrs. Smith?”). Eliminate the hallway talk and create a system with an organized flow between you, the dentist and the patient through step-by-step communication that clearly outlines the re-care exam.
Sit in front of the operatory chair rather than behind. Your body language speaks volumes. Create a 3-way conversational setting to physically involve all parties and allow for eye contact.
Outline the key points of the patient’s chief concerns and medical history, as well as oral cancer screening. This includes blood pressure reading, medical conditions and treatments, medications, allergies and other factors important to note. Invite the patient to chime in about their medical history.
Speak in laymen’s terms. Allow the patient to understand and own their oral care. If they understand, they will feel valued and more likely follow through with treatment.
Use the evidence and don’t lecture. Maximize your opportunity to connect and guide the patient through their exam by taking real life intra-oral photos of their teeth and gums, and specific areas with new or pre-diagnosed issues. Ensure that intra-oral photos are ready and posted in front of the patient where he/she can see and be engaged in their diagnosis with the dentist. A picture speaks a thousand words.
Guide and direct the dentist where your findings are. It’s important to outline all your findings in a step-by-step method rather than all at once. As the hard tissue exam is performed, follow the flow to outline your findings in a quadrant that the dentist is examining (e.g. “Dr. Jones, in that lower left area, can you please assess the first molar.”)
Recap, document and review the dentist’s diagnosis and hygiene co-diagnosis with the client. Outline the patient’s oral health, completed treatment and periodontal status according to the AAP Guidelines, your plan and recommendations for hygiene treatment, and possible referrals if needed. It’s important the dentist and dental hygienist complete the exam together to create a customized treatment plan and clarify any questions the patient may have before the dentist leaves the operatory.
Review radiographs or document prescribed radiographs for the next dental hygiene exam.
Outline and discuss current radiographs with the dentist to ensure the radiographic interpretation is documented and included in the patient’s treatment plan. In addition, maximize planning and time management by obtaining documented prescription or plan for radiographs at the next dental hygiene appointment.
Pre-schedule next dental hygiene appointment(s). For consistency and effective treatment outcomes, ensure that appointments are pre-planned, secured and organized to maximize the patient care plan.
Provide patient specific instructions and oral hygiene aids. Outline specific home care instructions. Provide written prescription or instructions outlining optimal home care followed with next visit expectations. If applicable, maximize a digital platform to support specific home care plan.
Personally escort the patient to the administration area and verbally transfer the care to the appropriate business team member. (e.g. “Karen, Mrs. Smith is all done for today. I have scheduled her next dental hygiene visit. Dr. Jones requested two appointments to treat the upper left back molar. I have outlined everything in the chart for you. Mrs. Smith, Karen will now take over and look after you from here. Please remember to contact me should you have any further questions or concerns. I will see you in three months. Have a great day.”)
The business team needs to ensure that all financial and scheduling aspects are always organized and completed while supporting the patient’s specific clinical care, regardless of their insurance or financial status. The most common mistake is enabling the insurance to dictate a patient’s specific care. As dental hygienists, it is our professional responsibility to support and allow the patient an opportunity to fully understand what the treatment is and why it is necessary, rather than solely relying on the financial perception.
About the Author
Jodie Cantarelli AAS, RDH, Dip.AdEd is a Manager of Dental Hygiene Programs at dentalcorp. In her role, she partners with dental teams across Canada to help them provide optimal patient care. Jodie earned her degree in Dental Hygiene, diploma in Adult Education at St. Francis Xavier University. Her professional experience includes private practice, a clinical evaluator for the College of Dental Hygienists of Ontario, a clinical and didactic instructor, program director, past advisory board member, published author and professional speaker.