by Eileen Morrissey, RDH, MS
One lament I hear frequently from hygienists regards the wait for patient exams. I am fortunate, since my doctor totally prioritizes the importance of staying on schedule. When Dr. Cifelli tells me, “Two minutes for an exam,” he means it, and he walks the talk. If staying on schedule is not possible, my office uses two solutions that make complete sense, yet appear to be underutilized out there.
The first is to move the hygiene patient to a different room for the exam (provided it is available), thus freeing up the hygiene treatment room for turnover. This inconveniences both the assistant as well as the doctor, and acts as an incentive to prevent the need for it to happen. J
The second solution is for the doctor to do the exam during any of his/her windows of opportunity. That’s right, interrupt me. Readers might be amazed to hear how many doctors are uncomfortable interrupting hygienists. One doctor told me he thought I was “in flow,” and was very reluctant to interupt. (Are you serious?) We established that interruptions are, in fact, welcomed — a necessary change in his mindset helped the practice run more smoothly.
Two other dentists made comments I found baffling. The first stated that he refused to examine teeth that were not clean, as it could potentially interfere with the diagnosis. Huh? My thoughts: “Do you treatment plan a new patient at an initial visit who has not yet had a cleaning? Most likely, yes.” The bottom line is that rarely are patients so knee deep in calculus or biofilm that you cannot see their dental issues.
The second doctor stated that he did not want to provide the exam early. He did not trust that his hygienist would work to the end of the appointment time, or be as thorough with treatment if the exam had already taken place. (Enough said; sad commentary for both parties.)
Here’s the scenario that happens regularly, or so I’m told. It’s the dentist who is chitchatting. The recare clock is ticking, and the stay-on-schedule timeline is slipping away. Have you considered that the dentist may dislike this as much as we do? He or she is trying to balance keeping the social relationships going with hygiene patients, while knowing that there is a patient waiting in his or her own treatment room. The dentist is probably also very aware that you are feeling frantic. Everyone in the hygiene room is being held hostage. It’s rescue me time!
It makes sense that hygienists and doctors should openly discuss possible solutions to this problem. I worked in a practice where a no-nonsense administrator never allowed this situation to happen. She had an eye on the clock any time the doctor went into hygiene for an exam. If the exam was moving slowly, she would appear on the scene to tell him, “We need you right away down the hall.” He knew what that meant. It took the heat off him and enabled him to escape.
Another hygienist would simply hit the automatic chair-return button if talk was going on for too long. That let her dentist know it was time to wrap it up. Still another would state decisively, “I need to prep for my next patient. Would you mind taking the conversation to the front desk?” This resulted in an immediate reaction from everyone present.
Hygienists who experience this ongoing challenge need to have a discussion with their doctors to create their own unique solutions. Why are so many of us timid about this? You are asking for something that is within the best interests of the practice (staying on schedule), a win/win for all parties. Remember, sometimes everyone present wants to be rescued — that means hygienists, doctors, and even the patients. Someone simply needs to initiate!
Onward we go; it’s in our hearts’ core.