Orthotown April 2020 - 53

How about structurally?
To ease traffic flow, before we did the
build, we took a day's typical schedule
and used different-colored pencils to
draw the traffic patterns in the office, to
look for "choke points." We realized that
we needed to create more room in some
areas, so some hallways are 6 feet wide
to make it more comfortable to pass by,
and the area coming out of sterilization is
8 or 10 feet deep, so you don't have people
running into each other. We also wrapped
our compressor room in 1-inch-thick
rubber, so you don't hear the compressors
throughout the office.
I moved my personal office right next to
the clinic and I have what we call a "virtual
patient" chair-a computer in the clinic
where I can do all of my aligner setups
without disappearing into the office, so
the patients can see me working, and I also
don't have to take anything home. I have
one staffer whose role is to pull the setup
for the next patient onto the computer, so
I can be ready for it.

Tell us about your practice
protocols related to scheduling
efficiency.
We strive to do same-day starts. When
we have new patients, the idea of them
starting treatment the day they come in for
the exam is discussed at the first phone call.
If someone goes to a doctor, they don't go
to the office and only discover what's wrong
there; similarly, orthodontic patients already
know what they don't like about their smiles.
If they come in prepared to start treatment
that day, it's a different mindset.
All new-patient exams are scheduled
for 55 minutes, of which I spend seven
minutes. This appointment includes the
record taking, diagnosis, patient education
and financial planning.
We treat patients following the
"sagittal-first" philosophy, treating the
AP aspect of the malocclusion first, at the
beginning of treatment, using the Motion
3D Appliance. Appliance placement is
a 20-minute procedure, so we can bond
while they're there or do the scan for the

retainer, or both. If the patient is in Class I
and doesn't require Motion 3D, the bracket
placement procedure is also reduced in time
because we no longer do full bandings or
bondings on the initial visits; we bond the
upper and lower anterior teeth, to get them
used to wearing braces, and have them back
about a month later to bond posterior teeth.
If they're aligner patients, we use 3Shape
scanners to scan them while they're there,
to get them started.
The other thing we've done for efficiency
is record the patient instructions. There's
an education booth just off the clinic area
where the patient and parent sit down and
get the home care information that normally
would be delivered by an assistant. Because
of that, appointments can be of a more
consistent length; we move patients away
from the treatment chair into viewing the
video, and the assistant can see another
patient. An actual start appointment takes
about half an hour now.
Our treatment protocols are really
well-defined now, with a few rare exceptions.
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Orthotown April 2020

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