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November 2008 | Modern Hygienist You can’t work alone Ultimate recalls are a team effort.
Often, one of the integral steps in creating an ultimate recall visit is working with an ultimate dentist. Rather than feel “trapped” by this, I’d like to share what I value about one of the doctors I work with, so that you know what to look for (or what to suggest) to yours. I want to be clear that a doctor’s clinical skills are very important—I could write a separate article on that—but the focus here is the way his or her interaction with you, the dental hygienist, can make a difference. The scenario I’ve worked with Dr. Antonio Cifelli of Mercerville, N.J., for less than two years, but it took only one afternoon of temping at his office to realize that he is a five-star ultimate dentist. Approach. Dr. Cifelli’s is that he will not allow me to wait for an exam. When I stop by his treatment room to inform him that a patient exam is needed, his immediate response is always, “Two minutes, Eileen.” When he says, “Two minutes,” he means two minutes. This man walks the walk. He understands the value of staying on schedule, not only because it’s important to his hygienist, but also to waiting patients who have the courtesy to be punctual and expect to be seen on time. Flexibility. If he cannot get to my treatment room in two minutes, Dr. Cifelli asks Judy, our assistant, to move the patient to a spare treatment room; this might happen once a week. He doesn’t want me to get bogged down with cleaning and set-up, so after that handoff I’m free to move on to the next patient’s set-up and care. This aspect of the practice runs like clockwork and makes a tremendous impression on patients. Dialogue. During the exam we interact in a way in which Dr. Cifelli recognizes me as a co-clinician and co-diagnostician. Some of you are thinking, “Hygienists can’t diagnose.” My advice: Don’t get bogged down with legalities here. Your dental hygiene diagnosis is legal and valuable. The exam should be interactive between you and the doctor. I’ve had my share of experiences where the doctor arrives at exam time to take over, leaving the hygienist in the corner to chart. If this is how the practice leader prefers it, you may have to just go with it, but it is—in my opinion and experience—certainly less effective. Dr. Cifelli asks the patient whether he or she is having any problems, and then turns to me for my perspective. My response might be: “I am concerned about tooth No. 3. I can get an explorer into the margins of that huge old amalgam. I showed Susan the fracture lines with the intraoral camera and I’ve explained what you might recommend. Doctor, do you think this tooth needs to be crowned?” Affirmation. I believe I’ve covered all bases with this response. At this point, Dr. Cifelli puts down his instruments and says loudly and clearly to the patient: “Susan, Eileen is absolutely correct! This tooth has changed from how it appeared at the last visit, and the best way for us to treat it is by restoring it with a crown.” He goes on to elaborate how we will do this. If the patient had any doubts, they were erased when her two co-clinicians collaborated, and she now realizes what she will need to do to move forward. Bonus. Some of the other little things Dr. Cifelli does to make recalls run smoothly include: 1) If I’m taking films and he has no patient, he is standing by my treatment room with his hand outstretched and the offer to develop them for me. 2) He is willing to say, “I don’t know, but I’ll find out,” to any question I might ask him. He has no need to appear omniscient in front of the patient.
If you have ever brought an “area of concern” to a dentist who has treated that concern with a less than respectful response, you know full well what this can do to dampen your hygiene spirits. I don’t expect every dentist to agree with my assessment of how a tooth should be treatment planned, but I do expect that I deserve a respectful response to my assessment. Eileen Morrissey, RDH, is a contributing editor for Modern Hygienist.
This column provides readers with suggestions on how to improve the services provided to patients at recare visits in the private practice setting. Each column will focus on a single aspect of the patient appointment.
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