Practice Promotion Through Continuity of Excellence

Endless Opportunities

Practice promotion includes an infinite number of possibilities that can grow and develop a practice. An external marketing plan might focus on involvement in community activities and school programs, or top-notch communication with general dentists and other referral sources. With the Internet becoming a viable way of communication, more offices are even developing a Web page to inform the community of the services the orthodontist provides. With the increase of computer use in many homes, we now have the ability to download the patient information sheet and health history to a patient family. They are now able to complete and upload the information back to the office prior to the their first visit to the orthodontist. This eliminates the problems related to a patient forgetting the medical history or not having all information available at the initial visit.

Internal Marketing

An internal marketing program may concentrate on the role of the treatment coordinator, excellent telephone and interpersonal communication skills, or positive reinforcement programs to enhance patient cooperation. Quality information packets and logo design has more impact than ever before. A pleasing office design and demonstration of adherence to OSHA guidelines are also common practices to show patients are parents you care. There is no limit of excellent practice promotion ideas and demonstration of excellence.

Develop and Use Systems

As a practice grows, so does the need for systems. As a clinical consultant, I have the opportunity to visit many offices each year, assisting the clinical team in enhancing practice promotion through patient care. As you develop your marketing plan, you may also wish to focus on the quality and continuity and service you provide to your patient families in addition to the new ideas you would like to try. Answering questions such as, "Are we being as efficient as we can with out treatment and the number of appointments without compromising quality or relationships? Are all the clinical team members giving the same high quality care with consistent attention to detail? Are we seeing our patients on time? What can we do to reduce the number of emergencies we have in our practice?"

Regular Training

With several orthodontic assistants delivering patient care, it is easy for each individual to develop her or his own way of approaching procedures. Some may check for loose bands and brackets consistently at the beginning of the appointment, some may check later in the appointment. Some assistants may get out all the supplies prior to the beginning of the procedure and others may get up and gather supplies during the course of treatment. Even the amount of detail in giving instructions may vary greatly depending on time availability, personalities or the amount of experience of the assistant. 

In nearly every office I visit, I notice variations on bonding procedures. From the time the etchant is on the teeth, to the method of isolation and moisture control. Because each chairside works by his or herself, it is easy not to be aware of the differences in the delivery of patient care. 

In considering continuity of treatment, a detailed procedures manual is helpful. Noting the order of steps in the procedure including the materials needed, at what point the doctor is to come to the chair and how the procedure is to be performed will allow each assistant to follow a course of action that has been proven effective. Including "why" each aspect is important helps the learner to retain the material. Vocabulary words, the use for each of the appliances used in the practice and the reasoning behind archwire sequencing are questions I frequently hear from staff members.

One of the exercises I do while consulting in an office is the "Checklist for Every Patient." There we identify step-by-step what is to be done with each patient when they are seen for treatment. We answer the questions of what instruments or trays should be prepared in advance, what should be said and done prior to beginning the procedure and what information should be researched by the assistant prior to doctor's arrival at the chair. The information relayed to the doctor might include archwire sizes and auxiliaries used, the direction and size of elastics worn, whether the patient is wearing a removable appliance and the familiarity of the treatment plan. We also determine what else the orthodontist want the assistant to evaluate- rotations, spaces, bracket placement, root position as examples. It is important for each clinician to be reviewing the same agreed upon checklist for consistency. Next, what additional information does the doctor wish to be told? Does the doctor want to know information such as estimated completion date or start date, what was scheduled for today, what has already been completed and any observations noted by the chairside? Does the doctor prefer this information be presented verbally or written where she/he can visually review the details?

Reduce Repair Appointments

If you see 60 patients a day and have 6 emergencies, it means for every 10 days you work you are putting in an additional day to take care of emergency patients. When we look at the lost production that emergency appointments cost the practice, it is worth your time to determine what can be done to avoid emergencies. Physically checking and double-checking the ends of archwires at the end of every appointment (even emergency visits) saves unnecessary visits to the office. Turning the distal ends of archwires during space closure will allow the patient to go longer between appointments. Using bumper tubing where there is a long inter-bracket distance can make the patient more comfortable and can also save a call or return visit. These are just a few suggestions that can be considered for practice promotion through patient care.

Stay on Schedule

Does each assistant perform the procedure in the agreed upon time frame? Of course everyone works at a slightly different speed; this is to be expected. To design a schedule that works well, a time frame should be identified for each procedure including at what point during the procedure when the doctor is to be at the chair. When evaluating your procedures, also determine if the procedure can be completed with the doctor coming to the chair only one time. This helps to keep your schedule running smoothly and reduces wait time. This also allows the scheduling coordinator to be accurate when telling the patient approximately how long the next visit will be.

Patient Education

Continuity in information and education is also a key factor in practice promotion. Designing the specifics of what is to be covered as well as suggested ways of approaching the various personalities of our patient families is helpful to improve compliance and reduce stress on the staff members. During a staff meeting, the doctor and team can agree upon what specifics should be covered during instructions, what examples are appropriate and the approximate time frame of these instructions. The timing for these instructions is also important. After a long initial band and bond appointment, both the clinician and patient are tired. The parent may or may not be available to hear the instructions. You may wish to consider a time for instructions where both the child and parent is available, alert, and interested in the education process. It is important that the front desk team also know the instructions for specific appliances, as patients will often ask them for information or confirmation of appliance wear.

Appearance

The importance of staff attire seems obvious, but it's easy to bring a top to the office without being ironed. I see more and more offices with a designated staff member in charge of washing, drying and ironing uniforms so each clinician looks neat every day. Wearing coordinated uniforms designed to compliment the decor of the office brings a sense of completion to the clinic. If you want to take it one step further, consider coordinated street clothing for the administrative staff, using the same colors as the clinical uniforms.

Continued Improvement

Once again, ideas to improve ourselves and our practice are unlimited. Practice promotion is multi-faceted, each area being an important component to the success of the practice. In designing a realistic plan, it is helpful to choose one area at a time, be detailed with the information and expectations then practice until it becomes habit. Assign promotional duties to individual staff members and set a due date. Let them take a base idea, incorporate their personality and the office mission, and take it to a new level. If we encourage the team to step outside of the 'box', there is no limit to their creativity and enthusiasm to make changes. Then move to the next goal. Excellence is about continued improvement. 

Lori Garland Parker is co-founder of Network Consulting, a practice management consulting team where she focuses on organizational effectiveness and clinical efficiency. She can be reached on email at: lori@consultingnetwork.org or by phone: (888) 552-9512.