Second Opinion: Should Your Practice Be Concerned About the Measles Outbreaks?

Source: CNN

The U.S. is experiencing a sharp increase in the number of measles cases in 2019, according to the U.S. Centers for Disease Control and Prevention (CDC). Dental practitioners need to be aware of the signs and symptoms of measles to prevent its spread within the dental office and the community.

Corinne Jameson-Kuehl, RDH, Owner Custom Dental Solutions

Measles is considered an acute respiratory illness. Because it is viral in nature, the common initial signs of possible infection include malaise, slight fever, and a loss of appetite. Patients are considered contagious four days before and four days after the rash appears. The virus is transmitted by airborne droplets when an infected person coughs, sneezes, or even breathes, making it one of the most highly contagious infectious diseases. Simply being in the same room with an infected person (and even up to two hours after they leave the area) means you are at risk for infection.

As dental practitioners, we need to be aware that the first visible signs of the disease are found in the head and neck. An infected patient will have a high fever, cough, runny nose, and conjunctivitis. A rash will form starting at the forehead and spread down to the trunk and feet. Koplik's spots may occur on the inside of the cheeks. These spots will appear small and whitish with a red background. It can be very dangerous for babies and children to be infected, as the disease can lead to pneumonia, deafness, and even brain damage in some cases.

Vaccinations

If unvaccinated providers believe they have been exposed, the CDC states that they can still receive the MMR (mumps, measles, and rubella) vaccination within 72 hours of exposure, followed up with an immunoglobulin treatment six days after vaccination.

“We need to be aware that the first visible signs of the disease are found in the head and neck.”

There are no specific antivirals. However, in severe cases, vitamin A is used in medical settings to help relieve symptoms for children. It is recommended that children receive two doses of the MMR vaccination at 12 months to 15 months and again from ages 4 to 6 years. Infants traveling to another country should have one dose before leaving the U.S.

Your provider-patient medical interview and written medical histories should include the following questions:

1. Have you been vaccinated against measles?
2. Have you traveled abroad recently (specifically to Europe, Asia, Pacific Islands, or Africa)?
3. Have you or a family member been exposed to someone who has traveled abroad?
4. Are you in a community where you suspect there could be a measles outbreak?

With more and more unvaccinated children and most U.S. cases being reported as being infected by an out-of-country exposure, it is imperative to continue with these questions chairside. If you find your office in the situation in which you believe there has been a measles exposure, the CDC asks that you to immediately report the suspected measles case to your local health department.

Teledentistry: Creating the ideal referral relationship

By Jill Shue, Administrative Solutions Coach

With the hustle and bustle in a dental practice, there is a continuing struggle around the referring process. It is easy for tunnel vision to set in once a referral need is determined. The doctor states a referral is needed, and the patient is dismissed to another team member. The focus is no longer just on the patient in the chair but also on the next patient waiting to be seen, running on time, and managing operations.

In the rush, communication is lost and patients fall between the cracks. Both the referring doctor and specialist, along with their teams, have their responsibilities to each other as well as to the mutual patient.

The reality

Your patients have chosen you as their provider. Your patients trust you. However, many general dentists do not offer specialty services within their practices. This means that when you make a referral to an outside specialist, patients have to leave their comfort zone for treatment.

Look at it from your patient’s perspective: She is ushered out of the treatment room, handed a slip of paper and told to call a new, unfamiliar office — often without follow-up instructions. The patient leaves your office knowing she needs to do something to further her care. Often patients either fail to follow through with the recommendations, or they call to schedule and are confused with their specific need.

If patients overcome those obstacles and have the treatment completed by the specialist, they often experience a lack of follow-up. Patients assume the general dentist’s team will be in touch to take the next steps, but usually, in our experience, there is no communication back to the general practice.

When there is no communication, the patient then does not complete the necessary treatment and the likelihood of success drops. Patients are not aware that the two providers do not share records. When treatment is completed, we do not have a magic wand to wave to alert us to the patient’s treatment progress. Treatment falls between the cracks. The patient falls between the cracks.

Provider’s perspective

Often adequate information is not shared between the offices. If the referring practice’s team fails to send the referral, notes, and images to the specialist team promptly, then the specialist’s team must hunt down records. Seemingly endless calling and emailing between the offices asking for information becomes routine, and inefficiencies set in.

Once the specialist team has the necessary information to treat the patient, the team is then able to appoint and treat the patient appropriately. The specialist team then fails to communicate to the general team that the treatment has been completed and to instruct on the necessary healing times and follow-up needs.

The patient does not receive the best care, steps are missed, and care is delayed. In our experience, both offices vent their frustration and blame the other. When neither team takes responsibility for its part in the mutual patient’s care, then the doctor-patient relationship is broken. The relationship between the two offices is also broken. No one wins.

Solution

We talk with our clients about taking a concierge team approach enhanced through teledentistry technology. This approach can offer your patients a warm introduction to the specialist and team and also continue the exceptional communication your team and you already offer throughout their treatment.

Your patient needs to visit a specialist. Your team communicates with the specialist’s team members, informing them of the patient’s diagnosis. Your office then sends the patient’s images and provides the referring team a teledentistry appointment for the patient.

Your patient and the specialist virtually meet via a teledentistry platform in your office. A live video consultation puts the patient at ease and creates a rapport between all parties. The patient leaves the referring office with the specialist appointment scheduled. Now both care teams are aware of the patient’s needs, enabling them to create a treatment plan together that best fits the patient’s needs.

Once the patient receives the treatment, the specialist then communicates back to the referring team to inform of the next step and the general team continues the patient’s care as determined. The key is communication. Both doctors and their teams must be in continual communication with one another.

Outcome

By creating systems to improve communication between the referring doctor and specialist, you close the gap. Your case acceptance may rise while your patient retention and satisfaction also increase. Your team benefits from a streamlined, secure exchange of clinical data. The patient receives the best experience and care that both the referring and specialty teams have to offer.

Don’t just be a good specialist or a good referring doctor. When you close the gaps, you’ll be successful for your team, your colleagues, and your patients.

Upset the Apple Cart! Create a Superior Patient Experience

Upset the Apple Cart! Create a Superior Patient Experience

By Laura Barnes, Transitions Management Coach

Does it ever feel like you are trying your best, but are in a continuous loop of the same results? The competition always seems to be more innovative or have more financial resources?  If so, it’s time to upset the apple cart!

Most dental offices strive to provide exceptional care for their patients as part of their philosophy but operate on auto-pilot once the practice is well-established.  One common thread of discussion among all practices revolve around how to find new patients and attract them. However, the real question is how to keep them engaged, but even better, be a spokesperson for your practice.  Consider this…a friend asks about a recommendation to see a newly released movie…you don’t recommend a movie that you like, you recommend a movie that you LOVE! Be the dentist your patients LOVE!

The solution is to design their experience with your office for emotion, not experience.  As dentists and teams, we usually focus on the systems and procedures to provide excellent care.  While these are important and the cornerstone for success, sometimes we forget that the patient is a person-  a person that wants to connect with us on a personal level. It should be our goal to help them feel comfortable and connected with us….to pleasantly surprise them by hosting a (mini) surprise birthday celebration for them, mailing a handwritten note, or remembering to inquire about a new grandchild.  These efforts do not need to be expensive…the goal is to out-think the competition, not out-spend. The most memorable moments center around how you make your patients feel!

What do YOU do to create a “WOW” experience for your patients that gets them talking about you and your team to their friends, family and colleagues? How do you challenge the status quo and upset the apple cart??

Business Connection or Pyramid Recruit?

Business Connection or Pyramid Recruit? 

By Corinne Jameson-Kuehl, RDH, Owner

It's that time of year where everyone is making goals and excited about achieving them. Statistics show within 6 months of the new year, only 9% of those who make resolutions actually stick to the goals they make.

Many of us start the year off strong with goals to make new and better business connections. We look to align ourselves with businesses that share similar philosophies and modes of action. It makes sense to be attracted to growth-minded people that will drive business and assist potential mutual clients to success. What doesn't make sense is when individuals want to connect for the purpose of pushing their home-based business product, or for the self-serving goal of gaining your hard earned network list.

It is wise to approach any new business connection invitation with the following cautions:

           1. What is the mutual purpose of making this connection?

           2. Will this new connection take away time and energy from my vision and values of what  

               goals I am looking to accomplish?

If there is any doubt on the intention of the new connection, simply ask them why they would like to connect with you. This question will help you make an efficient and advantageous decision immediately.

Are the holes in your schedule haunting you?

By Corinne Jameson-Kuehl, RDH, DrBicuspid.com contributing writer

It's that time of the year again with lighter schedules, last-minute patient cancellations, and the dreaded no-shows, which means team members walking around the office acting like zombies and seeking "something to do."

Corinne Jameson-Kuehl, RDH.

There will be holes in your schedule if you allow the following five devaluing phrases said to patients and attitudes into your practice:

1. "Do you want to reschedule?"
2. "What time works?"
3. "If you can't make it, no problem. Just give us a call."
4. "You can wait to have that procedure until next year."
5. "Do you want to just call us?"

It is the entire dental team's responsibility to prevent the scheduling holes and evaluate how the scheduling communication is occurring. The commitment to patient retention and engagement while desiring full schedules at all times should be the obvious office goal. Being aware to "create the appointment demand" and to "build off the schedule" will lead your patients to respect their appointed time, and your day will end with a successful and productive schedule.

Best practices

The best way to implement the expectation that appointments are to be scheduled in advanced is to start with new patients. The new-patient letter should detail your appointment expectations and how you provide reserved appointment times as a courtesy to the patient's schedule.

“It is the entire dental team's responsibility to prevent the scheduling holes and evaluate how the scheduling communication is occurring.”

Establish the scheduling of the next appointment as the norm by leading all patients into scheduling at the patient walkout/dismissal. In a friendly tone with the importance of their time emphasized, ask your patients, "Now, let's get you scheduled for your next visit. Do you prefer a morning or an afternoon appointment?"

Once the first appointment of the day is established, build off your schedule by offering the best fit for your patient's request while simultaneously filling your schedule.

Get into the habit of knowing your patients' work and personal schedules, so it is easier to lead the appointment conversation. Someone who is a stay-at-home parent or a retiree may have a more flexible daily schedule and could be scheduled at those hard-to-fill appointments times, such as 10 a.m. or 2 p.m.

Building off the most popular times is the best way to fill your day. For example, if you look at a certain day and notice your 7 a.m. and 4 p.m. slots are already filled by consistently reliable patients, offer the 8 a.m. and 3 p.m. and so forth.

Time frames

Continue to set patterns by scheduling patients in the same time frame. For example, keeping the continuing care appointments the same day and same time six months apart will establish the long-term date, such as creating the standard Tuesdays at 11 a.m.

Setting a behavior pattern also ensures a more successful remembrance by patients and makes a cancel or no-show less likely. You can also use a third-party system, such as Solutionreach or Lighthouse 360, to kindly remind patients of their scheduled appointment time, while meeting the patients' preferred electronic communication style.

Emphasizing the "busyness" of your office schedule is important. Whether you are incredibly busy or not, it doesn't matter. It's important to create the demand and teach patients to understand how important their reserved appointment time is. They should understand that it may be challenging to get another visit scheduled with their favorite hygienist if they cancel.

Options for scheduling

Your team has to let patients know the standard in the office is scheduling hygiene visits. Remind them that the office does this for all patients as a courtesy so that the most convenient time for the patient can be secured.

The following are good options for moving the conversation forward:

• "We can always follow up and can provide a reminder if you need one."
• "Let's get you scheduled, and then would you please kindly check your schedule and call me back tomorrow if that date and time does not work for you?"
• "I would be happy to call/text/email you tomorrow. When would be a good time to discuss your appointment?"

When patients say, "I don't know where I'll be in six months," your staff can say something playful, such as, "I know where you will be. Here again with me, same place, same time. Now let's get you scheduled."

No matter the scheduling conversation, it is imperative the clinical and administrative teams communicate through both detailed chart notes and verbally with the patient at the end of the visit. This will ensure excellent customer care and that no questions are left unanswered.

Because you value and respect your patients' time, teaching them the value of respecting the scheduled appointment will prove to be an effective way to diminish the holes from your schedule.

“Custom Dental Solutions empowers business owners to grow their business THEIR way.”— Corey Jameson-Kuehl, Owner