Jan. 1, 2006
After what seemed to be a very smooth, positive hygiene appointment, your patient goes to the front desk to pay his associated fees for the day, reserve his next hygiene visit and bid a fond adieu to the appointment coordinator.

After what seemed to be a very smooth, positive hygiene appointment, your patient goes to the front desk to pay his associated fees for the day, reserve his next hygiene visit and bid a fond adieu to the appointment coordinator. She hands him a copy of his itemized statement, and Dr. Jekyll immediately becomes Mr. Hyde bellowing, “What is this $13 infection control surcharge? You mean to tell me I’m paying $13 for that little bit of swish she gave me before my appointment?” After the fire-breathing dragon has singed her eyebrows, the appointment coordinator rolls back in her chair and waits for the smoke to clear.

How would you respond to this question? Would you be prepared to give a skillful response on the spot? Maybe, maybe not? No matter how knowledgeable you may be on this subject, when someone takes you by surprise your initial reaction is usually a defensive attitude. Your mouth may go dry and your brain may go blank, but your tone will most likely be defensive. I wish I could say I would not react defensively, but the truth is, that is exactly how I would feel and react.

Rather than just being reactive, maybe a better way to handle this type of situation is to be proactive. If you are prepared for this circumstance, when it does occur you can better handle it with grace and an informational tone. You know, a caring attitude, because after all we do care. Actively marketing your infection control program may be the easiest way to be proactive and handle this scenario.

Actively market your infection control program

So, how can you do this? There are many ways to promote your infection control program. I would like to get you started with some ideas that have worked for me in a few practices. You can do one thing or several, but the idea is to get started talking to your patients about your infection control practices.

Those of you who know me know that I am very big on team meetings. Team meetings are a wonderful opportunity to get everyone on the same page quickly. You can learn to use the same or similar language and discuss ahead of time how to handle this situation before it arises. It can also help to have a designated infection control coordinator in the practice who will knowledgably address the patient’s concerns. I believe that the hygienist is the perfect person for this job. The hygienist is used to presenting information to patients on a daily basis regarding their dental and general health. The RDH can be the one who brings the infection control information to the forefront of the conversation during a routine hygiene maintenance appointment.

What other ways can you actively market your infection control program? An easy way to start is with a poster in the reception room, which explains your program and how you are protecting yourself and your patients. You may have a sign that reads, “Ask our infection control coordinator about our program to protect you,” or, “Your health and safety are as important to us as the quality of dentistry we provide.” One office I know has each employee wear a button that reads, “Ask me about our infection control program.” Another button could read, “Ask me for a tour of our sterilizing area,” or “We sterilize because we care about your health.” I am quite sure you and your team can come up with many more creative ideas.

If your practice is one that advertises in a magazine or on television, you could have a line in the ad that may read, “Our infection control practices exceed the current OSHA standards and meets all the new CDC infection control guidelines. Come in and let us show you how.”

Some practices will send out new patient information mailings, which explain the practice policies. Marketing the infection control program to these new patients could easily be one of your office policies explained in the introductory letter, along with offering a tour of your facility.

The infection control program tour

A room-by-room tour may work for you. This would allow your patient to understand how important the flow of the work area is to proper infection control. (I choose to look at it as well honed choreography amongst the team members.) You can start with a treatment room which is set up and ready to go, but does not yet have a patient seated. This gives you a chance to explain why plastic is covering so many surfaces. Your script might say, “Some surfaces are difficult to disinfect between patients, and therefore require a new cover for each appointment.” You may mention that it includes the chair cover, hose covers, X-ray heads, air/water syringes, power scalers, etc. Also the fact that the instruments used intraorally must be sterilized or disposable.

I want the patient to know that it is not just the products we use for infection control that are costly, but also the additional time taken away from productive “chair time” that needs to be factored into the overhead cost. In order to make that point I would say, “Each room is shut down for 15 to 20 minutes between patients in order for us to remove all of the contaminated instruments and products, disinfect the room and prepare the room for the next patient. It is important for the chemicals to be in contact with the surface long enough to kill the bacteria present. If the chemicals are wiped away too soon, they may not destroy all the organisms and may then be passed on to the next patient.”

Different terminology may be better suited for your practice. The point to remember is that the days of everything you may possibly need for any procedure sitting on a crowded countertop are over. I think it helps for the patient to understand this difference.

Next, I explain about the preprocedural rinse and how they will be swishing with this rinse every time they have an appointment in our office. I say, “This is a 15-second chemical swish that removes approximately 95 percent of the bacteria in your mouth.

This will reduce the amount of bacteria we introduce into your bloodstream when we are probing under your gum tissues. It also reduces the amount of bacteria that flies in the air when we use drills and power scalers and may help reduce cross-contaminating patients.”

Sterilization area and lab

The next area I would present to the patient is the sterilization area. This will give us an opportunity to show our patients what lengths we go to for their safety. We have a dirty side and a clean side. I show them the utility gloves and how the instruments are processed going from contaminated, through the ultrasonic or dishwasher, bagging (or cassette system plus bagging) and then through the sterilizers. I then show them where they are stored and explain that they remain intact after sterilization prior to opening them for use on another patient.

If you have a lab, you may next want to take them on a tour through that area and show them how impressions are handled prior to being sent to the lab. I also show the patient the ultrasonic cleaner we use for cleaning partials and dentures. Then I explain the double baggie process, which prevents contamination of the ultrasonic fluid into the second baggie with the denture cleaner in it.

Treatment room in use

The patient may then walk by a room where treatment is in progress. Of course, you will have to be careful when you pass by this room not to linger and break any HIPAA rules. However, as you move past that room, you can then educate your patient regarding the use of the masks, glasses, gloves, gowns and how even the patient safety glasses are disinfected between patients.

If you use disposable gowns, when you are taking them by the room in use, it is an opportune moment to segue into the subject of protective clothing. If you use washable protective clothing, I would next give the patient a glimpse of the washer and dryer area (or the pick-up and delivery area), where the contaminated and cleaned protective clothing are handled and stored.

I will talk about our weekly team meetings to make sure we are all on the same page. We dedicate at least one meeting a month to the ever-changing infection control guidelines and our responsibilities for protecting ourselves and our patients. I explain the once a year mandatory training as well as when a new employee joins our team.

For the patient as well as the professional, knowledge is power and when patients understand the why’s and how’s of infection control, they will notice the difference if they ever have an occasion to go for treatment in another office. Patients are very savvy consumers nowadays, and they will not want to be seen by professionals who don’t appear to have the same care and concern. This other office may have the same level of care and concern, but until we actually tell the patient what we do for their protection, it may be the best-kept secret in town.

To cover the additional expenses for infection control, some practices choose to incorporate the infection control charges into a fee increase for the procedures. After patients have seen and heard what they are receiving regarding the infection control program, they are less likely to object to a fee increase. Other practices charge an infection control surcharge for each appointment. This can open the door for questions and begin a dialog with the patient about your infection control program in the office. Either way, you can turn a potential negative into a positive marketing opportunity.

Back to Mr. Hyde

So, meanwhile, back to Mr. Hyde. When you are prepared, a good response might now be, “I’m so glad you asked me that question. It gives me an opportunity to let you know exactly what you are paying for and how we are working very hard to protect not only our health, but yours as well. If you have the time, may I get the infection control coordinator to give you a tour of the facility?”

Then he gets the grand tour. Hopefully, by the time Mr. Hyde leaves your office he has once again returned to be Dr. Jekyll. And, he just may become one of the best marketers for your practice!