Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 56
Practice Management
Practice Management Diary
Your Out-of-Town Patient
When your patient in fixed appliances goes off
to college or boarding school, do you transfer
treatment responsibility to an orthodontist near the
school? In our Berkeley, California, practice, we have
developed a protocol of continuing our supervision
of the treatment while the patient is attending
school out of town.
Dr. Gerald Nelson
San Francisco, CA
PCSO Bulletin Contributor
Why Keep the Patient in Your Practice?
◾ In our practice, appointment intervals are typically
six to eight weeks. This means that if you
see the patient in August, their next visit is in
early October. If an orthodontist near the school
can do that visit, we can do the following adjustments
during the Thanksgiving and December
vacations.
◾ In the spring, many schools will have two
breaks, and the school-side orthodontist may
need to see the patient only in February and
possibly in May. We can usually prepare the
treatment stages so that the cooperating orthodontist
needs to make routine adjustments
during those few visits.
◾ The financial arrangements are kept in place. The
family continues the regular payments to our
office, and the school-side orthodontist bills us
for any adjustment appointments done. This is a
great relief to all involved, especially if the patient
has insurance benefits. Insurance companies are
often inefficient at transferring providers.
◾ The treatment plan remains consistent, the
treatment time estimate is more likely to be
met, and the appliance does not require major
changes.
As Jack Webb Would Say, " What's the M.O.? "
When we first hear that a patient will leave our
practice for the school year, we immediately
evaluate the patient's status to see how the school
schedule will coordinate with our treatment schedule.
For example, if we have begun treatment with
the lower appliance and a biteplane, should we get
the upper appliance on before the patient leaves
for school? This would probably avoid delays, since
we don't want to have the school-side orthodontist
placing any appliances. We will also ask the patient
56
if he or she will be home for the school breaks and
the summer vacation, because if they don't plan
to return, we would rather transfer the treatment
responsibility out of our office.
The second step is to contact an orthodontist near
the school and discuss the arrangement. We want to
locate someone who is comfortable with cooperative
treatment, who is willing to bill us fairly, and who
will communicate freely. After pursuing this system
for several years, we now have connections with
orthodontists in the major university areas. We have
even handled orthognathic surgery cases in this way.
One of us will make a personal call to the orthodontist
and propose cooperative treatment, explaining
that when the patient leaves for school, we will
send a report of the current treatment status and
propose an adjustment for the next (October)
visit. We do the same after the winter holidays. We
ask for a letter or phone call after the school-side
visit to advise us of the details of the adjustments
accomplished. We ask that they bill us for a typical
monthly payment or higher as they see fit. If the
orthodontist agrees to participate, we prepare the
following copies of the records:
◾ Head film tracing
◾ Digital photos of the pretreatment panogram
and cephalogram
◾ Pretreatment intra- and extraoral digital photos
◾ Digital photos of the models
◾ A letter outlining the diagnosis, goals, treatment
plan, and treatment history, which also briefly
delineates the cooperative treatment protocol
These records are sent immediately after the first
phone call to the orthodontist. We invite him or her
to look over the records and let us know if there are
any problems with the arrangement.
Final Comment
If you do the initial groundwork and communicate
regularly while the patient moves back and forth
from home to school, I believe that this system
provides more efficient and trouble-free treatment
for the patient.
PCSO Bulletin Spring 2023
Pacific Coast Society of Orthodontists Bulletin Spring 2023
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2023
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 1
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 2
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 3
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 4
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 5
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 6
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 7
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 8
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 9
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 10
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 11
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 12
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 13
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 14
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 15
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 16
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 17
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 18
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 21
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 22
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 27
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 28
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 29
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 30
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 33
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 34
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 35
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 36
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 37
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 38
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 39
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 40
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 41
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 42
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 43
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 44
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 45
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 46
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 47
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 48
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 49
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 50
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 51
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 52
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 53
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 54
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 55
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 56
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 57
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 58
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 59
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 60
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 61
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 62
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 63
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 64
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