Heading to clinic soon, tips for patient education/ treatment plan acceptance??

[Faux]

I was thinking about buying some educational models, maybe even a tablet to show animations for certain procedures if they're unaware of how they work/benefits.


I was wondering if this was a good idea? I'm curious about how other dental students handle their patients when it comes to treatment planning and case acceptance. Experiences, tips, advice?

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[Iowalegacy]

I'd go search the forums on Dentaltown. Case acceptance probably has a good number of threads already over there by practicing dentists.

 

[DrJeff]

Just be honest with your patients, and speak in terms that THEY can understand (Personally over the years as a result of this I've developed 3 or 4 ways to explain almost every procedure I do - think 3rd or 4th grade level explanation, high school level, college level and then pure, 100% "dental speak" level. I have seen, and far too often have been 100% guilty of trying to explain a clinical situation to a patient in a way that makes perfect sense to me, but leaves the patient here something akin to "Mrs Smith, what my examination has found is that you have blah, blah, blah, blah" all the while Mrs Smith is nodding her head at me like she understands what I'm saying. Learn to make sure that your patients really do understand what their problem is and what you can do for them to fix it

Sometimes, while you may connect and educate your patients, it may take a while for them to agree to the treatment that you propose. So don't take a first time, or even sometimes 2nd or 3rd time rejection by the patient of some of your treatment proposals as an offense, just keep educating them, and reminding them of what THEIR clinical situation is, and very often they'll be accepting that treatment proposal

 

[JeffM]

IDK about at school but at the office I work at the dentist will put the xray on the TV and specifically show what is wrong and where the decay/infection is. She also sometimes has me use the intraoral camera to show the patient their teeth on a live feed and point out where the decay is. This usually makes the skeptical patients a lot more willing to get treatment.

 

[sgv]

1. Never over sell...Lower their expectations so they aren't ever caught off guard with slow treatment or repeat appointments
2. Every large caries is close to the pulp and might need endo...warn them that you might hit the pulp due to extensive caries approximating the pulp and that it might need endo etc. b/c on that one chance event that you hit it, you'll be glad you warned them so they don't think you screwed something up
3. learn survival rate of rpd (<10 years), core build ups (like 5 years), crowns, etc. it'll help them figure out how much value is in a restorative plan.
4. ask open ended questions about any confusing treatment or problems/diagnosis...you want them to be on the same page regarding subsequent appointments and plans
5. write good tx notes and contact notes - every once in a while you'll get a problematic patient and you'll be glad you had something in writing if shtf...dschool gets tons of psychiatric patients
6. for every new patient at a dental school, make sure they understand that everything you do is going to be super slow but they're compensated by thorough care and reduced fees
7. for complex prosthodontic cases, make sure you meet up with your prosth attending in advance in their office or something to review what needs to be done prior to and at the next appointment...b/c it can be really confusing since you won't know anything
8. for props, i literally just pull up google and show them what an implant, abutment, crown looks like

 

[LaughingGas]

1. Never over sell...Lower their expectations so they aren't ever caught off guard with slow treatment or repeat appointments

Amen to that.

 

[THS]

When treatment planning a new patient, I like to offer 3-4 treatment plans that I order from "best" to "good". The best option tends to be the most expensive, and the good option tends to be more budget friendly. As dental students, most of our patient population is looking for affordable care, and sometimes it's too easy to not mention implants and suggest an RPD right away, because we pre-judge a patient's ability to pay. Even if it's often true, we have to give a patient all of the options. Keep in mind that no treatment is always an option for patients as well.

Another mistake is not paying attention to the patient's habits and history when treatment planning. I had a patient come in with rampant decay, and with #11 and #12 decayed to the cej. My first thought was that it would be a great implant case. But this patient's history showed self-neglect for a long time, only getting work done when something hurt. This isn't the type of patient that would benefit from dumping a lot of their money into implants if they aren't going to care for them. I am still working on her "phase 1" treatment (extractions, endo, perio, operative), without a definitive plan for phase 2 (fixed, removable, ortho). I'll have to see if this patient is ready to get serious about their oral health before we decide which way to proceed with restoring her missing teeth.

 

[Munks]

Another point to mention is that, in the eyes of the patient, often times their wants > needs. If a patient really wants his non-decayed fractured #8 fixed with a crown, and you start off talking about 4qd SRPs, there's a good chance you will lose the patient's interest and trust. In practice, often times it is best to start with what the patient wants first (barring any severe needs like abscesses, etc), and then getting to their needs. This shows that you are paying attention to their concerns, that you are actively listening, and by some equivalence, that you are trustworthy as a doctor.

Often times in dental schools this gets especially difficult because there are systems in place and things go according to the system (urgent > disease > restorative > maintenance, etc). So in your situation in school clinic, it is at the very least a good idea to start with mentioning their chief concern, and then getting to what they need. Even just mentioning it makes a difference.

Using the same example you have two scenarios (very simplified 😛). Which sounds better?

"Okay Mr. Jones we finished your exam, based on what I can see you have very bad gum disease etc so we're starting with 4qd SRPs. Then, it looks like a few of your fillings have new cavities underneath them that need replacing, and finally there's the tooth in the front that's chipped that needs a crown"

"Okay Mr. Jones we finished the exam. I can definitely see what you're talking about that front tooth being broken, and I know that was the main reason why you came to our clinic. I do actually see some other big areas of concern that I would like to talk about if that's okay. [etcetc]. I will talk with the instructors if we could start with that front tooth first, but even if we do have to start on the actual disease parts first, I want you to know that fixing your front tooth is my top priority."

Even if you just said the second bolded sentence and nothing else, just the fact that you're acknowledging it gives the patient peace of mind that you are listening to him. All too often dentists, especially students & recent grads, make the mistake of rambling on to the patient about what all he/she needs, without listening to why he's there.


EDIT: Gosh I wrote a lot. Wrapping things up, while it is definitely a good idea to keep models, use animations, drawings, xrays, etc to visually show the patient his/her situation, I would say it is even more important to have good discussions with the patient, listening, making connections, etc, to earn their trust. You can show a patient his cavity, but if it's not his concern, he's not going to want to fix it.

 

[Kareful]

I'm not even in dental school yet, but I'm enjoying these tips! Thanks y'all!