Orthotown September 2016 - 10

embrace progress // column Continued from p. 8 During good times, we had noticed that the limiting factor to what could've been a productive day was a column of patients who were ready to have their braces removed. Being old-fashioned, we felt like we should do it, even though the staff removed the appliances, took X-rays and got the patient ready for us to remove acrylic. (I know that many offices across the country have staff remove acrylic, and there are devices that are quite good and safe at this, but we still preferred to utilize handpieces.) We discovered that hiring a hygienist helped us with those tasks that most orthodontists don't enjoy-namely, removing braces and checking retainers. Timeconsuming, labor-intensive, nonproductive visits. Need I say more? Oh, I know that many of you will rail about how your patients want you to do the work, and that they enjoy giving you the big hug at the end. Nice, but convince yourself to get over it! With hundreds of positive patient reviews over the years, I can count on one hand the ones that mentioned the orthodontist specifically. Most loved the location, hours and staff, the free coffee and, of course, their beautiful new smiles. To increase productivity, we scheduled the hygienist in the office that had no doctor present, thereby operating under "direct supervision." (In other words, on non-doctor days.) This allowed the two doctors to staff other offices for production while the debanding was occurring at the third office. Our hygienist did post-treatment conferences, reviewed instructions to the family dentist and generally used her patient skills to "wow" the patients. The orthodontists would review before-and-after photos and X-rays, 10 SEPTEMBER 2016 // orthotown.com coach her on the script for each patient at debanding, and write it in the chart at the visit before the "big day." Our hygienist wasn't content with just doing several debandings per day, so she quickly added other procedures that we felt comfortable with her doing, ethically and legally. For instance, how many of you dread retainer checks? They typically go like this: The patient comes in wearing his retainer and is either happy or has a concern. If there's a minor shift, you-as the orthodontist, being proud of your work-offer to fix it to check for third molars. (This is similar to the discussion of recurrent caries under crown margins in the dental office.) I can't tell you how many times I came to the office the next day to find study casts on the desk, and a note saying that the patient would like to do limited clear-aligner therapy to manage a relapse that was caused by poor retainer wear, bad habits or wear and tear. There are certainly offices that have a similar workflow in place and depend on only well-trained assistants. But if you want to expand your workflow, hiring a great employee to whom you can delegate tasks is more profitable and less hassle than hiring an associate. In addition, getting your for free or for a reduced fee, then tie up your schedule ... again, taking time away from current or potential patients. On the other hand, when the hygienist reviews the patient, she may ask how he's feeling, see if there are concerns and offer remedies for any relapse or retention. With good office protocol and procedures, these appointments can lead to production in minor retreatment, or diagnostic X-rays systems in place for delegation will force you to define your system for treatment-and this will come in very handy when you do start thinking about selling your practice. I'm speaking from experience: The shortcomings and strengths of your practice come to the surface when you ask someone else to do the work. Dentists utilize hygienists to keep the appointment book full; maybe you should, too! n A return on investment in time http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown September 2016