#AskT-Bone – Ep22 – Talking With Patients About Associate Dentist Doing Treatment


Welcome back to another episode of Ask T-Bone on the T-bone speaks podcast!

I’m your host Tarun Agarwal and I love receiving questions. These questions are great, there some of them are very simple, some of them are more philosophical in nature and some of them are clinical in nature. So if you’re listening to this podcast and you have questions all you have to do is visit www.tbonespeaks.com and scroll down and submit your question. We never use your name so don’t be hesitant about whether you’ll feel embarrassed or not, just ask the question, and it’s also a great way to leave us feedback on the show as well.


So today’s the question submitted was:


What verbal skills do you use to explain to the patient that if they need a feeling you won’t be doing it?


And I think really where this stems from is my proclamation that in 2017 I will no longer do fillings in my practice. Ane for those of you that are new or haven’t heard me talk about this, let me take a couple of moments to kind of explain what I’m saying. it’s not that fillings won’t be done, and quite truthfully it’s not that I won’t do any feelings at all, it’s just that I’m not a fillings dentist anymore. Honestly it’s beneath me, in a way, okay? And by that I mean I have learned so much, I’m not the same dentist and quite honestly fillings are the most basic of basic dental procedures you can do, and I think a first, second, third year dentist is more than capable of doing those, and I need to focus my time and attention on more complicated dental procedures and things that will grow me professionally and honestly provide me satisfaction. I don’t get a lot of satisfaction out of doing fillings. So, for those fillings that I will do in my practice, they will be part of an overall treatment plan, where we may be doing two crowns and a single filling in a quadrant. Or maybe it’ll be an anterior bonding case more of the Cosmetic type case, where the “filling” is involved there vs. a traditional “hey I got a class 2 cavity and I need that filled.

But that, we will allow our associate Partners in the practice to take care of those things.


So that’s where that question kind of really comes from and so, but things back I’ve been in practice 15 years now in my office and I built a relatively loyal patient base, many patients who wait to see me, many patients who require seeing me, or demand to see me, and it’s flattering but it’s also a very very scary proposition to say no to people. And I think really what it boils down to is, how you explained it the urgency that you create and your mindset that you have and the mindset that you give to your team members.


So let’s talk about some ways of upgrading this and getting over this.


So number one, I believe you have to create some scarcity, and what do I mean by that?


It means that you can’t continue to work 5 days a week and say you’re not going to do feeling. honestly you can’t work 4 days a week and say you’re not going to do feelings. Because you’re too available, you are too there, there is too much time that you have to fill. So for me to say that I’m going to do not filling is I have to be less available. And I don’t mean that I’m off doing other things, it means I need to spend my time not just in the mouth but on the practice or planning cases. Some of these complex cases take planning time. It’s not just in the mouth time, it’s not just chair time. Is also the mental time that goes with these. So, you know, you have to start scheduling out mental time in your schedule to work on cases, to plan your implant, to plan complex cases, to put together treatment plan, to do all of these things. And what you got to do is instead of saying “I’ll do that after work” you need to reach a point where you say, you know what? I’m going to schedule this here in the production from those cases, will offset the time that it takes in the planning, or you will charge at the planning time as part of the overall production the case. So you have to not be available as much. So for me if you’re working 4-5 days a week, you’re not ready to say no more feelings. For me you have to be down to 3 days, 2 and a half, 2 and three quarters, 3 days someone that ballpark and that’s where I’m at personally. I’m at Monday-Tuesday-Wednesday 8 to 5, and quite honestly I’m going to cut out 2 hours on Wednesday afternoon and I’m going to start building in time in my schedule for me to have case reviews with my treatment coordinator and assistant, because we have enough more complex cases. I don’t need to use the word big case, is a complex cases.


You know even patients that need four quadrants of fillings and crowns and little things like that, that’s a complex case that involves planning, that involves, you know, putting together a blueprint of a plan of action that we will going to do there. So I got to start scheduling that time or it starts intervene to my personal balance, which it already has. So I need to create a time.


Number two: Also a scarcity is, you got any book down a little bit another, word you can’t have holes in your schedule one day from now, or you can’t let your team members let patients know you have holes in your schedule. I call it the cost of lost opportunity, so when you had don’t have holes in your schedule, when you don’t have availability, that’s that Crown you can’t say yes to that walks in with a broken tooth, because you are too busy doing the filling. So we got to get there. Now, really what the question also boils down to is:


How do I talk to a patient about this?


And the truth is as you look at your patient, you look them in the eye, and many of us won’t be passive aggressive, and we want our team members to do it, okay? But he is the truth. Our team members can set the stage, our team members can make a suggestion, but your patience trust you. So you’ve got to be the one to look at them and say:


“Mr. Jones, to be quite honest with you, dr. XYZ in our practice handles all the fillings, I trust him or her to do fillings on me, I personally trained him or her, and I know they’re going to do a great job for you. I’d love to invite dr. X to come in here and meet you, so you can you can see why we love him or her so much in our practice”


And when you look at your patience and you tell them that, they’re going to be okay with it. But the truth is some won´t. And that’s okay. You know, the other way around that, so for those that aren’t, then your next availability is 8 weeks, 6 to 8 weeks of out.


“Mr. Jones I don’t want this cavity grow I really want to get it taken care or. Dr. X has as a sooner availability than I do in my schedule, you know, between everything that we’ve got going on, my next availability is almost 2 months from now, for this type of Dentistry. So really let’s go ahead and get it scheduled Dr. X is going to do a great job, and you’re going to be very happy”


You know, that’s what it takes, you just have to sit down with your patient, look him in the eye, and tell him. I say this from experience, because I struggle with this, I absolutely struggle with it. You know, part of it was my ego love to hearing the patient say: “I only want to schedule with you” But then the frustrations had in. I was working more, I was having to work late, I was putting stress on my team, putting stress on myself, I was you know, next thing you knew I had big cases, and things are moving the direction that we’re filling in middle spots with fillings and this fillings take almost as much mental effort as some of these larger cases do. So, just be prepared. First thing you have to do in my opinion is, number one, you have to truly be ready for this, and that means that, financially you are stable and secure, mentally you are stable and secure, healthy, you know, you’re all those things in place, you have a good team around you and you’re doing it for the right reason. You are doing it because, not because you’re lazy, but you’re doing it because your practice is ready for that. And then you got to be ready to cut down to 3 days a week, because in my opinion if you are needing to work 4 days or 5 days a week, you’re not ready to give away the fillings yet, okay?


So thank you again for listening, hopefully this is been helpful. If you have additional questions please don’t hesitate to visit www.tbonespeaks.com and submit your question!

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