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The Ultimate Handover in Your Dental Office by David Moffet, BDS, FPFA

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If I do nothing else with your time today, I want to share with you what I have learned over the years: specifically, how to create perfect protocols that increase treatment acceptance and reduce no-shows, reschedules and cancellations, all through better patient handovers.

There is a spectrum of dental belief, for lack of a better word, that our dental patients fall into. And it's not an evenly distributed spectrum—nor do we want it to be so. Imagine this spectrum as a line.

At one end of the line, all the way on the left side, we have patients who leave our offices with little or no idea of why they have to come back, what they're having done when they do come back, and what will happen to them and their teeth if they do not act immediately and return when we tell them to.

These patients are confused. Or worse still, they're not sold on the program. They don't believe us, they don't understand what we're going to be doing for them, or they don't have the knowledge and understanding of what will happen should they chose to avoid or delay their treatment.

After all, it's not even hurting at the moment, they say.

At the other end of the spectrum, on the right-hand end of the line, are our wonderful, loyal patients. These are the people who do understand the reason and purpose of their next visit. They know exactly what they will be having done, they know why they're having it done, they know what will happen if they delay or avoid their treatment, and they would like to come in earlier to have their treatment done sooner if a time in our schedule becomes available.

Ideally we'd like a practice overflowing with patients at the understanding end of the spectrum—at the right-hand end of the line. And it should be possible.

Every decision we make in our office moves the patient either to the left or to the right on this spectrum. The aim of our office should be to ensure that all of the patients we see complete all of the dental treatment that is presented to them.

Truth be told, we all know that there are people walking around out there in the big wide world with huge dental liabilities that they know about. These liabilities are getting worse by the minute. Most of them know the specific nature of their dental issues because their dentists have told them, yet they've still not taken any action. These patients have shifted to the left side of the spectrum.

And they've done so because they do not understand exactly what they need to have done, and why it needs to be done. These patients don't have what I call "a clear next step."

Clear next step
It's not hurting, so why should they get it fixed now? Why can't they wait until later? Or wait until it starts to hurt? The real question is, why does this confusion exist in the minds of our patients? After all, we're dentists. We've told them what needs to be done. Don't they understand us?

The problem is, the reason our patients leave confused is because we've failed to check off on all of the essential things that we should have told them.

And most of the time, we've been so brief with them that if they've heard us telling them what needs to be done, they've not heard it thoroughly enough for the information to truly have meaning to them, or they haven't heard it enough times.

That's why I'm an advocate for the patient experiencing multiple handovers throughout his or her visits. The patient needs to be handed over by the dentist to his or her dental assistant. The dental assistant needs then to hand over the patient perfectly to the front office person, who then also needs to clear everything up with the patient again.

The handover
And of course, in each of these handovers, the patient must be included. This is because every time the patient hears the information passed on in the handover, a little more sinks in to his or her mind. In general, I find that dental-office handovers are not long enough and do not involve enough people.

This brevity creates confusion for the patient. How often do we see that the front-desk handovers can be so brief they're almost curt? For example, "We need a one-hour appointment for a crown on 12."

Sadly, this is what I often hear at the back as well. The dentist will simply tell his or her assistant what he needs next. The patient isn't included in the exchange. And so we have a patient with little or no commitment to the continuation of his or her treatment.

There is no clear next step—and yet, it only takes a minute more to convey a clearer message.

So here's what should happen.

First, the dentist should be communicating with the patient throughout the appointment about what he or she is doing and how things are progressing. At the end of the appointment, as the chair returns to the seated position, the dentist must take command.

He or she needs to come around in front of the chair, connect with the patient visually and in person, and take the following 10 steps.
  1. Outline exactly what treatment the patient received, including the number of teeth restored, the number of surfaces, and the depths and severities of each and every tooth restored.
  2. Let the patient know what he or she should expect to feel following the appointment, including any possible discomfort and the reasons why.
  3. Communicate a clear message of exactly what the patient is having done at the next appointment. This is not meant to be a laundry list; rather, it should cover exactly which teeth will be addressed next time, and the reasons why.
  4. Let the patient know exactly when he or she should be seen next. It is the dentist's responsibility to create a sense of urgency for the next appointment. If he does not, then it is difficult for the person who schedules your appointments to create that urgency.
  5. Inform the patient clearly exactly what will happen if he or she does not proceed with the treatment as planned. The patient needs to know what the consequences will be when the next appointment is delayed or ignored.


The final steps
These are the five clinical stages of the dental-patient handover. The dentist must now personalize the handover to maintain connection with the patient. It is this connection that solidifies the relationship with the patient. Without it, there is only transaction and trade. Trade is what we do with commodities. Our dentistry should never be treated as a commodity. The last five steps ensure that this is never the case.
  1. Sincerely thank the patient for his or her time today.
  2. Thank the patient for being a great patient today.
  3. Farewell the patient with genuine wishes of good health and well-being.
  4. Connect, if you can, with some wishes about any personal information, some positive occurrence or event in the patient's future.
  5. Look for a way to go above and beyond the patient's expectations for the day.
This information may have been something the patient mentioned to you, or it may have been something the patient shared with another team member, that has now been passed onto you. Patients love to feel that they are being treated as a person—not simply as a set of teeth.

Always look for a way to exceed a patient's expectations. And this is not difficult, because it's likely that no other dental offices in the area are doing this.

Conclusion
When you follow this simple 10-point plan for creating the ultimate dental handover, and you make it your office protocol for all handovers, including hygienist handovers and dental assistant handovers to the front office, you then create a simple, watertight system that works perfectly. It will strengthen your relationships with your clients and patients, and move them toward that right side of your spectrum.

They will have much more of a connection with you and your team, as well as much more clarity about the importance of their treatment plan. And if every patient leaves with connection and clarity, our appointment schedules will be all the more full, and ultimately, our patients will receive better care.

Dr. David Moffet is a dentist from Sydney, Australia, and the author of How to Build the Dental Practice of Your Dreams: (Without Killing Yourself!) in Less Than 60 Days. He is the inventor of The Ultimate Patient Experience, a patient-retention system he used to build and sell his dental office. Moffet now spends his time writing and lecturing, as well as coaching private dental clients in the United States, Great Britain, Australia and New Zealand. His focus is on helping dentists improve their practices by focusing on customer service and patient retention. He can be contacted at david@theUPE.com


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