Dr. Kalli Hale explains that consultations will not turn into case acceptance unless patients fully understand their condition and your explanation of their treatment options.
by Kalli Hale, DDS, MPH, D.ABDSM, D.ABSB
Until you can take every ounce of responsibility for the consult failing, you will continue to tell yourself “My patients don’t want airway treatment.”
There are procedures dentists are excellent at explaining. For example, a filling. I would hope your restorative case acceptance rate is high. Discussing sleep related breathing disorders (SRBD’s) is wildly foreign to dentists and without serious additional education, you will lack the confidence to talk about it. Explaining to a mom that her 9-year-old son’s bedwetting can be ameliorated with a nighttime habit corrector appliance, takes true understanding of the physiology by which bedwetting occurs. But that’s just the beginning – you also must connect with that mom on a level that allows her to trust you to take care of her child with something “fringe”. I don’t know about you, but bedwetting wasn’t in my dental school curriculum.
Treatment planning interceptive orthodontic treatment for children, and traditional oral appliance therapy (OAT) for an adult, takes skills unlike what we were taught in dental school. Today, there is a tremendous amount of resources for education in dental sleep medicine. Most sleep dentists understand the etiology of bruxism; but if you cannot properly explain how it could be something worse, in a way that the patient can relate, they won’t let you help them. Tooth grinding has become so normalized in dentistry thanks to occlusal guards, most patients are surprised to hear it’s actually something serious. We must fill in the blanks so they can connect the dots that their symptoms are common, but not normal.
My consultations are held in a separate room from the operatory. I sit eye to eye with my patients to go over their sleep study, showing them the digital scan of their teeth and discussing exactly how their sleep symptoms relate to their bite. Using the verbiage “this doesn’t age well” or “this isn’t aging well” has helped patients to understand that continuing down the current path can have expensive consequences. I love helping patients realize that improving their sleep will improve the longevity of their health and teeth. If you can get on their level and utilize the knowledge you have in a real-world way, you will succeed in treating more patients.
When you are analyzing your case acceptance rate and it’s below 60%, review what you said in that consultation. Were you paying attention to the patient’s body language? Did you ask them if they had questions about what you went over? If that patient does not schedule for treatment, ask your treatment coordinator (TC) what hesitation was expressed. Find out if they had to explain anything that you should have. Identify holes in your own understanding, then fix it. Cost is an excuse; don’t lie to yourself that all your patients are broke. I have maintained a 90% case acceptance rate over the years, in an entirely out of network practice. How you approach these patients, and the verbiage you use around their treatment options, is the difference in your success of increasing airway cases in your practice. As I mentor dentists all over the country, I realized we have one thing in common: the desire to serve our patients well. You are incredibly privileged to do what you do for a living, with a unique ability to transform the longevity of your patients’ lives.
To quote Einstein, “If you can’t explain it simply, you don’t understand it well enough.”
Besides clear and simple consultations, branding your practice for success can lead to increased case acceptance. Read Marc Fowler’s article for a checklist on how to start increasing your practice’s success. https://dentalsleeppractice.com/11-steps-to-branding-your-sleep-practice-for-success/