The American Dental Hygienists' Association's (ADHA) definition of dental hygiene is, “:The science and practice of the recognition, treatment, and prevention of oral disease. The dental hygienist is a preventive oral health professional who has graduated from an accredited dental hygiene program in an institution of higher education, licensed in dental hygiene that provided educational, clinical, research, administrative, and therapeutic services supporting total health through the promotion of optimal oral health. In practice, dental hygienists integrate the roles of clinician, educator, advocate, manager, and researcher to prevent oral disease and promote health.” Webster's New Dictionary defines hygiene as, “:The science of maintaining health.” Neither of these definitions say anything about a dental hygienist being a financial advisor, so why do so many oral health care professionals, dentists and hygienists included, continue to allow insurance limitations to influence and dictate their standard of care?
Webster's New Dictionary defines insurance as “:being insured against loss.” In dentistry, this definition is an oxymoron to the treatment that we provide. By allowing our patients to unknowingly accept services based solely on their insurance coverage instead of promoting oral health, we essentially allow the continuing loss of their teeth and supporting structures. In addition, the proven systemic links associated with oral biofilm contribute to heart disease, pancreatic cancer, rheumatoid arthritis, obesity and more. These further initiate PAMPs (pathogen-associated molecular pattern), stimulate osteoclast, leukocyte, macrophage, fibroblast, cytokine, and PMN (polymorphonuclear neutrophil) activity, and disrupt our normal body processes, yet we continue to be held hostage by insurance companies and their perception of patient needs.
How do we overcome this challenge?
The answers are simple
- Be the educated oral health-care professional that you chose to be, and allow your patients to make independent oral health-care decisions regardless of insurance limitations.
- Educate your patients on their disease and the evidence-based modalities of care necessary to regain oral health. Educate them on their true needs and not on what you think they will accept, because this will provide them with the opportunity to make informed decisions regarding their oral health. Remember, if we don't tell them what they have, they cannot take ownership of it and their disease will continue.
- Partner with multidisciplinary teams to encourage total patient health and foster professional relationships. Many insurance companies recognize the importance of oral health in relation to overall health and may provide some financial coverage for dental services rendered. (Of course this will vary between insurance plans and it is the responsibility of the patient to seek reimbursement.)
- Develop a comprehensive dental hygiene care plan.
- Partner with your patients regarding their dental hygiene care plan so that they recognize the importance of personal accountability for their oral health.
- Use patient-centered risk assessments to determine early intervention strategies and minimize out-of-pocket expenses for your patients.
- Be confident in your educational, preventive, and therapeutic skills.
- Maintain a personal commitment to enhance the art and science of dental hygiene through lifelong learning initiatives so that you stay current with your evidence-based, standard-of-care treatment recommendations.
- Hone your communication skills so that you can effectively educate your patients on their treatment needs and gain treatment plan acceptance, regardless of their out-of-pocket financial commitments.
- Hone your customer service skills. Your patients are more likely to accept treatment from someone they like, regardless of their insurance reimbursement. If you build rapport with your patients they will understand and accept their treatment needs. Most people will invest their time and money in a dental practice and dental professional they trust have their best interests at heart.
“:People don't care how much you know until they know how much you care.” — John C. Maxwell
The first eight points above are relatively easy for most dental hygienists to incorporate into their daily care regimen. But the last two pose a challenge for some people. Most dental health-care providers expect to grow professionally, so we readily accept the challenges, but the personal growth tends to be neglected due to time issues between home, family, work, CE, and more. There are several avenues for hygienists to increase their proficiency in communication and customer service skills. One of the best courses to take to learn these skills is the Dale Carnegie Emersion program (www.DaleCarnegie.com). Dale Carnegie has several detail oriented and individually focused training modules to assist any person, any aptitude, and any skill level in these areas. Aside from Dale Carnegie, your local community college may have communication courses. Skill Path, a management/consultant company (www.skillpath.com), provides an array of customer service/communication skills programs, and with the click of the mouse, an enormous number of services are just a Web site away, so availability is not an obstacle when you're searching to enhance your interpersonal skills.
Most people want oral health, which is why they visit your dental practice to begin with. It is our responsibility as their dental health-care professionals to overcome our own fears of rejection and embrace the altruistic characteristics that define our profession.
We are knowledgeable clinicians, educators, and advocates of oral health, so we need to embrace the passion that led us to our chosen career. Providing patients with the necessary care to maintain oral health without jeopardizing our clinical standards of care due to patients' insurance benefits will assure them that they will keep their teeth for a lifetime, and will limit the risk factors that may negatively influence their systemic health. By virtue of your education, you can make a difference in your patients' health, and insurance limitations should not dissuade you from providing patients with the best treatment dentistry has to offer.
Newman, Takei, Klokkevold, and Carranza. Clinical Periodontology 10th Edition. St. Louis, MO, Saunders, Elsevier Inc; 2006.
About the Author
Sandra Johnson, RDH, BA, is based in Florida and Minnesota. She practiced clinical dental hygiene for 10 years and is now a corporate hygiene administrator (Central Florida) for Coast Dental, a division of Intelident Solutions located in Tampa, Fla. She has been active with both the state and national dental hygiene associations. In addition, she held the position of dental hygiene consultant for RJM dental supply company. She can be reached for comments or questions at [email protected].