Patient time in the waiting room is a precious resource
[ Words: Dr Paul O D’wyer BDS MSc (Healthcare Mgmt) ]
In the past, this column has looked at some reasons why patients attend the dentist. I’ve also looked at various actions dentists can put in place to encourage patients to attend – and particularly I’ve looked at quality assurance and quality improvements – all from a patient’s perspective.
One area that is worth a little further exploration is that important time when the patient is sitting in the waiting room. I realise that in an ideal world the patient should be ushered in to see the dentist at the appointment time. However, we live in the real world and not the ideal world.
Dentistry by its very nature is fraught with the unexpected. How often have we booked in Mrs Murphy for a “routine” examination, only to find that they have a loose crown, broken tooth, or leaky filling which needs immediate replacement?
Overruns on time are inevitable. How we manage these overruns and the knock-on effect of them is worth a column in itself – and I will revisit this in due course. However, let’s concentrate on the fact that our patients can sometimes spend more time in the waiting room than in the dental chair.
People are curious. This applies to your dental patients as much as anyone else. What may seem mundane and routine for you in your regular surgery day can captivate the curiosity of your patients. For example, with advances of imaging and radiography, we can very clearly identify tricky extractions or curvy roots for endodontics. A clearly demonstrated curved rooted lower molar – which you know in your heart and soul will require a surgical approach – might well be easily captured using your intra-oral X-ray machine. With this in mind, a digital photograph or print out – coupled with a brief description (nothing too graphic!) can help to educate your patients. How many of us are challenged from saying the same “lines” each week and month – explaining the same phenomena – such as “dense bone”, lifting a flap “cutting the gum” or challenging root morphology “curvy roots”?
With this in mind, I recently visited a practice where a simple (250-word) presentation on surgical extraction in clear short sentences was laminated – along with a large glossy clinical pre-operative radiograph (8 x 10 photograph) clearly showing the same. This was placed in the eye-line of the patients in the waiting room. It was in large font and against a white background. A similar short synopsis was also carefully placed in the waiting room in relation to the examination/check-up. For that particular example, a simple charting using a cartoon picture of the arches was used.
I asked the dentist about the presentations and they replied that they served a number of purposes. Aside from the obvious educational value of the posters, they “primed” the patient to better understand the upcoming dental visit. It allowed them the comfort to ask questions and, importantly, helped to inform them for consent for upcoming procedures.
By clearly annotating the various protocols involved with treatments, we can more readily help secure that most important item: consent from our patients. Recent evidence and advice from medical insurance societies suggest that more needs to be done to adequately secure informed consent, particularly as the onus on demonstrably securing that consent gets ever more demanding.
The value of the “cooling-off” period is particularly highly prized and clearly advocated by the Dental Council of Ireland. This time period, between initial examination/treatment planning and the provision of the treatment – e.g. diagnosing a repeatedly infected wisdom tooth and its removal – is vital in underpinning and demonstrably showing consent from patients. Same-day treatment, while occasionally necessary to relieve pain/symptoms, can be problematic should issues arise after treatment is provided – leading to disgruntled patients or worse, a complaint.
I would, therefore, see the time that a patient spends in the waiting room as a precious resource to be utilised to the maximum – rather than squandered on out-of-date magazines or demographic-specific whitening offers.
There is merit in utilising the time and space there to better inform patients, laying down the background to common procedures and clearly showcasing the range of expertise and quality patient care you already provide.
We as clinicians often forget that for patients, this visit to the dentist may be one of only a handful during a decade. Using part of that time to actively educate and inform them, with smart, clear and easily created infographics or posters seems like a very reasonable and smart move.
When putting this idea into action, have a think about the many “classic” examples you’ve seen in your own practices, e.g. the classic crown, classic bridge, denture, surgical extraction etc.
By simply annotating these and creating a “guide” showing the “What is…” you can build trust, reduce misunderstanding, strengthen consent and underline your own professionalism.