Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 56

Practice Management Diary

Patients First

Dr. Jeffrey Nichelini
American Canyon, CA

Last month we received my favorite compliment
to date. An established adult patient turned
to an obviously new patient and said, "This
place is great, it's like Cheers: everybody knows
your name, and they treat you like family." The
comment was not meant for me, but I overheard
it, and I could not have been more proud. I was
pleased to have a patient who was not only
satisfied with her smile but recognized that she
was being treated in an environment where her
happiness was prioritized, and I was proud that
my staff had successfully cultivated the environment to convey this feeling.
The caring, family-friendly personality of the
office didn't develop by accident. It's the result of
a few policies that subtly influence staff behavior
and lay the foundation for how we approach our
patients.

▫▫ First Names: We treat patients, not proce-

dures, which means we address and reference
people by their first names. For example, we
use phrases such as, "Kim has finished her
paperwork," instead of "Your exam is waiting
for you" or "Kim is ready for you in chair 3," instead of "Chair 3 is ready for a check." In a busy
office, it is easy to let work become routine
and impersonal, but if staff are required to
know and use names, it allows them to relate
better to the patients they are helping, and
it sounds better to any parents and patients
that may be in earshot.

▫▫ No Judgment: We do not offer judgment or

criticism. A large portion of our job is to act as
cheerleaders to encourage good oral hygiene
or compliance with wearing elastics, but it is
important that this is accomplished without
sounding adversarial.

*▫ Oral Hygiene Instructions: Avoid state-

ments such as, "You're not brushing,"
or "You're not brushing well enough."
If a patient presents for an adjustment
and has poor oral hygiene, our first step
is to remove their arch wires and ask

56	

them to visit the brushing station. It's
important to ask them to brush before
giving instructions, because it establishes
a baseline. If the patient returns with
sparkling clean teeth, you know they are
capable of good brushing, so you can
compliment their effort and limit your
instruction to reinforcing the importance
of maintaining clean teeth. If a patient
returns from brushing their teeth and
there is still abundant plaque, then the
patient needs to be shown spots they are
missing, how to improve their technique,
and also where they are doing a good job.
Remaining objective and offering compliments is a great way to keep patients on
your side, and it avoids putting overprotective parents in a position where they
feel the need to defend their kids. How
many times have you had the mom of
schmutz-mouth teen exclaim, "But he
brushes after every meal!"? It's hard to
argue when they see the plaque with
their own eyes.

*▫ Elastics Compliance: We ensure patients

not only know how to place their rubber
bands but also that they understand
the goals of rubber bands. If we have a
patient who is not wearing their elastics enough, we take progress pictures.
After two to three visits, if no progress is
evident, it is really easy to have a conversation with patients and parents about
the importance of full-time wear without
sounding accusatory when we can show
pictures of what is needed and they know
the reasons why.

*▫ Missed Appointment, Late Appoint-

ments: We express concern for patients
who miss appointments or are late,
but we do not threaten fees or consequences and almost always accommodate them at the time they present to
the office. Certainly this policy will be
controversial, but we believe it is not our

PCSO	Bulletin	 	 Fall	2019



Pacific Coast Society of Orthodontists Bulletin Fall 2019

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Fall 2019

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Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 2
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