Why People Choose Your Office – and what you can do about it In a world where the profession of dentistry is facing commoditization with the development of Dental Service Organizations (DSO’s) and large group practices, those of us who are committed to private fee for service comprehensive care are facing increased competition. We also face competition from those who choose to practice with large budgets for advertising yet still practice “one tooth dentistry”. One more competitor is the societal trend of decreasing attention span. With the entire world’s knowledge lodged in our smart phone we now find the average attention span in America has shrunk to a meager 9 seconds! It is interesting to note that throughout the current Covid-19 pandemic people have continued to visit their dentist. What have we been doing right? We already have a reputation for being a place that is clean and follows proper safety protocols. We have a reputation of being trustworthy and we focus on treating people one person at a time. These are all good traits. However, to continue to grow in a competitive world we need to analyze our competition and ourselves. Then we need to create an environment of mutual engagement between our office and our clients. This is not a “paint by numbers” exercise. You and your team must create, own and commit to a philosophy that fits your style and execute it. Here are some road maps and benchmarks available to help. Doctor, start by engaging and educating your team to be the best that they can be by modeling the behavior you want to see in them. Commit to high quality Continuing Education for you and your staff. Join a study club and associate with like-minded members of your profession. Engage your new patients with a patient centered experience from first contact onward. Make a special effort to create a first visit that includes time for getting to know one another on the behavioral level and includes a true comprehensive exam. Make sure that your patient understands that you respect them as “the expert” in choosing what outcome is right for them at this moment in time. And, that your office is “the expert” at determining the various outcomes that are available based on the situation they are bringing to you, the findings of your exam, the technology available and the time and dollars they choose to spend. We want to know, and the patient to know, that we are the right office and this is the right time to begin to work together. To that end, after time spent to get to know one another, we always ask permission before any clinical exam. We ask whether it is OK for us to tell the truth about what we are seeing at this moment in time. If we do not get a “yes” we do not move forward as “No” means that the patient does not want to take responsibility for their own health. We believe the patient determines the outcomes we can achieve and owns the outcomes. We can provide the means needed in terms of care, skill and judgement. We must mutually agree to the costs involved in terms of dollars, time, life changes or other factors. You need an office that feels “hospitable” to your clients not a Ritz Carlton. The goal for you and your team is to educate and engage your client to the point that they trust that you have their best interests at heart.
Be Your Own Doctor In the 1720’s John Tennent wrote a volume entitled Every Man His Own Doctor, in which he espoused the values of certain remedies of the time. Today we would consider this work like that of the snake oil salesman of the old west. However, his larger point is that we all must take an ownership interest in our personal health and the health of those we know and love. Rather than looking for a “magic elixir” we need a correct diagnosis before starting any treatment. Often getting a definitive diagnosis of a condition or set of symptoms is very difficult. Treatment based on, “snake oil” or symptoms alone can be deadly. This topic is precipitated by the recent passing of a close friend, and of a family member. Both were the victims of undiagnosed pancreatic cancer. This is not to speak ill of the medical profession as pancreatic cancer is an insidious disease. It can mimic many other problems and have multiple nebulous symptoms. That is the point of this short post. In both cases I am familiar with; the persons were living normal lives and appeared happy and healthy well past the point, in retrospect, when the disease was clearly active. It is only retrospectively that one can see that symptoms were clearly present but were being ignored in favor of trying to treat erroneously diagnosed more common disease symptoms. We allow this approach because the disease is not familiar to most of us and we are not used to having to be aggressive advocates for a definitive diagnosis of our symptoms. My point is that if you or a loved one does NOT have a history of cancer, diabetes, gall bladder problems, digestive tract issues or urinary problems and one or more of these items start to appear, focus on a definitive diagnosis more than treatment of symptoms. In the health care system of today our providers are constantly pressed for time. As such it is often easier to treat symptoms. If the symptoms go away, then by default, they have defined the disease and cured the problem. The point of demanding that you have a definitive diagnosis in the face of what appear to be routine symptoms of a common problem takes great courage. You and your family or loved ones will need to be advocates for one another in seeking an answer. Let’s take Pete (a pseudonym) as an example. At age 73, active, mildly over weight and in good health. Over a period of about six months he noticed that he was getting really tired after his morning two mile walk. He was having bouts of diarrhea for no reason. He went to his MD who ran some blood tests and suggested that he might be pre-diabetic, suggested dietary changes and some medication. Over the next month and a half Pete lost weight but his other symptoms did not change. More and different medications were prescribed with no significant change. About a month later Pete began to show signs of Jaundice. Cancer screening was done and found pancreatic cancer. In three weeks Pete was dead. In Bob’s (a pseudonym) case there was a family history of cancer. He had been having digestive and urinary issues for some time. When he started losing weight his MD also ran blood tests and suggested pre-diabetes. Bob’s course of treatment and disease progress followed closely to Pete’s and he passed away shortly after his cancer diagnosis. At this time there are no reliable screening tests for pancreatic cancer. However, there are procedures that can be used for diagnosis. These include imaging tests like CT and MRI scans. Endoscopic ultrasound is possible as well as biopsy. Pancreatic cancer is not easy to diagnose in its early stages. In both cases the confluence of symptoms should alert the patient, loved ones and physicians that a definitive diagnosis that includes the possibility of cancer should be pursued. In both cases treatment recommended and followed did not resolve symptoms. As soon as that occurred additional more aggressive testing should have taken place. Would an earlier diagnosis have saved lives? Perhaps, perhaps not. It would, however, have given both our examples, and their loved ones, some time to consider their alternatives. For peace of mind and better outcomes, trust but verify. Be assertive and require that you are provided with a definitive diagnosis rather than accepting treatment based on symptoms alone.