THE TIMES: We live in very interesting times. Life moves very fast and the focus of most businesses today is the so called “bottom line”. Although this is a very important consideration, because businesses can not survive and sustain themselves without a profitable bottom line, I wonder, “at what cost?”
WHAT IS THE COST TO OUR PATIENTS: Dentistry is no exception, in that it is a business. But what is our business? Dentistry is a people business. We take care of people. Unfortunately in the quest to improve the bottom line, the approach that started to become popular in the 1980s, evolved into what has been termed the “mass market” practice. In this approach, the more people that can be moved through a practice in a day, translates to profit. I feel that the cost of this approach is that there is no time left to service our patients in a way that they deserve, they are treated like machines and we fix the oral parts, they lose the personal touch that was once of central importance in a dentist/patient relationship, the solutions offered to ameliorate the found problems are often not personalized but rather become cookie-cutter solutions that repair the machine but are not always the best solution for that individual.
WHAT IS THE COST TO THE DENTIST: There is also a cost to the dentist. The dentist is stressed, for he must work quickly so as to be able to fit more people into his schedule, he doesn’t have time to get to know his patients and build the type of relationships that fuel his soul, he is often forced to cut corners to stay on time which leaves the dentist feeling unfulfilled at the end of a busy day, knowing that he did not always perform his best work on a given patient. In the end, the dentist burns out, loses his passion for helping people, and becomes a tooth mechanic as opposed to a physician of the mouth.
WHAT IS THE COST TO THE DENTAL TEAM: In this type of environment, the dental team is also stressed and rushed and can’t always help the patient to the best of their ability. These types of considerations are what dehumanizes the approach to care in many dental offices. Is this what people really want?
WHAT DO PEOPLE REALLY WANT: I believe that in the effort to be efficient, profitable, and “high tech”, that something has been lost. We need to bring back “relationship” to our interactions. How can I deliver the best possible care to people I don’t really know? How can people get their needs satisfied if their dentist doesn’t take the time to find out what they need and truly want?
Most people come to us with some degree of anxiety. Perhaps they have had one or more negative experience in a dental office … a filling gone wrong, a crown that is uncomfortable and just “doesn’t feel right”, a cosmetic procedure that doesn’t look attractive, orthodontic treatment that has left a person in pain experiencing headaches and jaw pain … perhaps they are afraid that it will cost too much money to receive the treatment they feel they need … maybe they don’t trust dentists for one reason or another … perhaps they feel like they have become invisible, just a number, just another cog in the wheel of the busy dental office. I fear that this can only get worse with the advent of corporate-style dental offices.
It is in the light of these attitudes that I decided 5 years ago to venture out and start my new dental practice. My goal was to slow down, see fewer people, take the time to listen to my patients and really understand their fears, their desires, their health challenges and attitudes, and to discover what they really want. Once I know the answers to these and many other questions, I can be in a position to provide my patients with the best treatment to suit their unique needs. In a typical dental office setting it would not be unusual for a new patient to be seen first by the hygienist to have an examination done, the data collected, and then the dentist would look at the information, develop a treatment plan, tell the patient what they “need”, and then book appointments to perform this work. The patient is often overwhelmed by this “whirl wind” experience, does not feel listened-to or understood, and is confused, not certain that they are getting treatment that they in fact need or want. The patient becomes a passive recipient of care. They are not empowered to create excellent oral health.
In a relationship-based practice, I will spend approximately one and a half hours with my patient on the first visit. I understand that this approach is not for everyone because many people want to get in and get out in record time. I feel however, that given the fast pace of life in today’s world, there are many people who crave sincere, helping relationships with their health-care providers. It is for those people that I have built my office. During that one and a half hour visit I can take the time to find out what the new patient’s previous dental experience has been like, how they feel about being in a dental office, do they have any fears or concerns, what was their parent’s oral health like, did their parents wear dentures or did they keep all their teeth, what are their oral health goals, how do they take care of the rest of their health … Only after all this information has been gathered do I perform the examination. It is done as a “guided tour” of the mouth. I want my patients to fully understand and appreciate what I find in their mouths, and the risks that the newly uncovered conditions might pose to their future oral health. Only after I am certain that my patients know what their oral health status is, will I schedule a follow-up appointment to co-create a Master Plan for Health. We will set goals based on the patient’s “wants” and develop a plan to help them get there.
This is intended to set the stage for a trusting, long-term partnership between me and my patients. In this relationship to create health, my patients become active participants in the development of their unique oral health goals, the plan to help them achieve those goals, and the treatment/maintenance habits required to turn it into a reality. We become partners in the creation of their healthy mouth.