How do you handle Exams at your office?

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Tooth

Orthodontist
20+ Year Member
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Exams are a critical component of a dentist's livelihood. After all, no exams means no treatment. But, let's face it, exams aren't very profitable in and of themselves. So how does your office handle exams?

I'm particularly interested in knowing how the solo practitioner handles exams.

Recall exams are pretty straight forward. Just send them a postcard or give a reminder phone call. They're done by appointment.

The question is how to best handle New Patient and Emergency Exams. The assumption is that if they walk into or call your office, they usually want to be seen. The problem is that you're already seeing scheduled patients. If you make them wait and "fit them in", it can make you "rush" your work which doesn't seem professional. But if you give them an appointment and tell them to come back another day, there's not much to stop them from going down the street where the other dentist can see them.

So, how does your office handle New patient and Emergency exams?
 
New patient exams are scheduled through hygiene. Patients are told on the phone that depending on their periodontal condition they may or may not get "just a cleaning" on the same day. An assistant takes the x-rays and while I am looking at the x-rays the hygienist is doing the probing. I come into the room and check the teeth and anything that looks funny in the x-rays. While the hygienist is cleaning them (if they just need a simple prophy) I do the tx plan on the computer. The assistant prints off the tx plan and the hygienist presents it to the patient.
 
New patient exams are scheduled through hygiene. Patients are told on the phone that depending on their periodontal condition they may or may not get "just a cleaning" on the same day. An assistant takes the x-rays and while I am looking at the x-rays the hygienist is doing the probing. I come into the room and check the teeth and anything that looks funny in the x-rays. While the hygienist is cleaning them (if they just need a simple prophy) I do the tx plan on the computer. The assistant prints off the tx plan and the hygienist presents it to the patient.

Thanks. It's nice to see how other people do it. Efficient, productive, and well delegated. Nice.👍

Does your hygienist discuss Optimal, alternative and minimum tx plans or just one?

Do you handle "high roller" treatment plans yourself?
 
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New patient exams are scheduled through hygiene. Patients are told on the phone that depending on their periodontal condition they may or may not get "just a cleaning" on the same day. An assistant takes the x-rays and while I am looking at the x-rays the hygienist is doing the probing. I come into the room and check the teeth and anything that looks funny in the x-rays. While the hygienist is cleaning them (if they just need a simple prophy) I do the tx plan on the computer. The assistant prints off the tx plan and the hygienist presents it to the patient.

Thanks. It's nice to see how other people do it. Efficient, productive, and well delegated. Nice.👍

Does your hygienist discuss Optimal, alternative and minimum tx plans or just one?

Do you handle "high roller" treatment plans yourself?

In my office we do things very similar to how The Hammer does. New patients, in non emergency situations come in through the hygiene schedule 99% of the time, with either myself or my partner doing the exam/treatment plan while the patient is in the hygienists chair.

If it's an emergency patient, then their either seen 1st in one of my chairs or my partners chairs, the emergency is taken care of, and then their scheduled back with hygiene for a cleaning and comprehensive examination/treatment plan.

I always start out discussing optimal treatment, then if for whatever reason (lack of interest, $$, whatever) the patient isn't interested in that plan of action, we take it from there. As I'm discussing treatment options with patients, I basically start off by saying that I begin by planning treatment needs out as if it was my own mouth or per say my mother's mouth.

As for "high roller" treatment plans, well to be honest with you, the vast majority of the time you don't know when a treatment plan will end up being a "high roller" or not. I've had plenty of folks who have shown up to my office driving a brand new 50k plus car, whose mouth needed a bunch of work, and I thought (atleast subconsciously) that they'll end up receiving a high dollar amount of tx because they'll want every saveable tooth saved, and they wanted just minimal "get me out of pain" treatment. As well as plenty of folks who on first glance you might think that they'll want just minimal dentistry done and end up being a paid in cash, upfront 5 figure treatment plan. The bottomline line is that you just don't assume what type of tx a pateint wants, just present their dental problems/needs to them and then between discussions with you, whoever handles the business/payment side of your practice, and often the patients spouse/financial interest you'll arrive at the "final" treatment plan.
 
Thanks. It's nice to see how other people do it. Efficient, productive, and well delegated. Nice.👍

Does your hygienist discuss Optimal, alternative and minimum tx plans or just one?

Do you handle "high roller" treatment plans yourself?

Usually there was just one treatment plan. If a patient needed extensive treatment then I would talk to them about phased treatment.

When it came to "high rollers" my office was a little bit different. I was mostly doing full mouth and implant supported prosth so the "high rollers" that I saw were already expecting to get a big tx plan. I would usually go over the treatment plan and answer any questions then my assistant would go over the fees. I gave her a percentage of the cases that accepted treatment.
 
Usually there was just one treatment plan. If a patient needed extensive treatment then I would talk to them about phased treatment.

When it came to "high rollers" my office was a little bit different. I was mostly doing full mouth and implant supported prosth so the "high rollers" that I saw were already expecting to get a big tx plan. I would usually go over the treatment plan and answer any questions then my assistant would go over the fees. I gave her a percentage of the cases that accepted treatment.

Do you guys ever encounter patients who insist to talk fees with the doctor instead of the assistant? How does one handle patients who try to haggle down the price?
 
Do you guys ever encounter patients who insist to talk fees with the doctor instead of the assistant? How does one handle patients who try to haggle down the price?

Of course. If you practice in Cali's coastal cities with offices on every corner and a huge foreign populations, it's in their cultural instinct to bypass the manager and demand to talk to you. We're heading ever so close toward a doubledip recession so people's purse are tight and conditioned to not pay full price on anything. I have bargained often and successfully with the gym, the landscaper, the realtor, Macy's, Bloomingdale's, and even at Tiffany's so I don't expect other people to blindly pay whatever first fee I quote them. You don't have to deal with them directly but you can authorize your manager to give them the discount.
 
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