There are 32 white structures in your patients’ mouths — and it’s not the only thing you need to treat. Dentistry is important for whole-body health, and each body that comes in is different from the next. It’s time to drop the one-size-fits-all approach and create a patient-centric care plan! To share how, Kirk Behrendt brings back Katrina Sanders, The Dental WINEgenist, with tips for customizing a care plan to fit each unique need you see in your practice. To start creating care plans that your patients actually want, listen to Episode 771 of The Best Practices Show!
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Episode Resources:
Main Takeaways:
Quotes:
“Dentistry today really has required the clinical application of what we do to fit into a one-size-fits-all model. Here's what I mean by that. As a dental hygienist, if I were to go and interview a dental practice across the street and I asked the doctor, ‘Tell me about your hygiene department,’ the doctor across the street would tell me, ‘Well, we allow you 60 minutes for a prophy patient. We allow you 60 minutes for a perio maintenance patient. We allow you 90 minutes for scaling and root planing. New patients are 60 minutes.’ Every single patient is fit within this one-size-fits-all model. All the stuff that you need to do on Mr. Jones needs to fit within this window of time. And unfortunately, that one-size-fits-all model doesn't work when patients are presenting with all different kinds of unique needs.” (9:40—10:37) -Katrina
“The concept of dentistry wanting to stay tethered to the comfortable, the known, the “this is what we've always done”, that's a fear-based mindset. ‘I don't want to change because this is what's comfortable and this is what we know.’ But you know this very well, Kirk, because you work with practices who are in that change, abundance, growth mindset where the fears of, ‘Oh my gosh, this is going to be disruptive. It's going to change how we bill things. It's going to change the kinds of conversations we have. Patients might have questions. Patients might say no.’ I mean, all of these things that our little lizard brains tell us when the opportunity for change comes in front of us, if we can work through those things and say, ‘But there are solutions for all of those things,’ the result, the outcome, the opportunity is greater health, happier patients, healthier patients, and a more predictable outcome for our patients. That's what we're here to do in dentistry, is it not, is to make sure that our patients have healthier, more predictable outcomes.” (11:43—13:02) -Katrina
“The problem right now is that we're not in a healthcare business. We're in a sick care mindset. Wait until it hurts. Wait until it's a problem. Don't take the nutritional panel until your hair is falling out. Then, we're going to go ahead and test your blood and see if you're nutritionally deficient in something. But dentistry has been trained in prevention. We've been trained so beautifully in prevention, and that's where I think we have the opportunity to take our training, our education, and expand that to really serve the unique needs of our patients today.” (17:20—17:51) -Katrina
“There are things that have to be standardized. Those are things like capturing your patient's medical history. That needs to be standardized across the board. Your patients need to provide that medical history. We need to be asking questions of patients from a standardized mindset. Then, within your practice, you have the opportunity once you capture this initial data to really go on that unique patient-centric journey. This is where I think dentistry has solutions available, but we're not exploring them fully.” (18:28—19:05) -Katrina
“I think the first issue with dentistry, particularly when it comes to vital signs like this, is that we're afraid of upsetting the patient. We're afraid that if we tell the patient, ‘We can't see you today,’ that we're going to upset the patient when the reality is what we should be doing is saying, ‘Hold on a second. This is bigger than your mouth right now. Your heart muscle is literally beating off the charts. This is a problem, and we need somebody to address this.’ I hate to say it — my heart hurts to say this — but I know there are people listening who work in practices where even if the patient's blood pressure is off the charts, they are told, ‘Just clean them anyways.’ That becomes another challenge because then we start to question, why are we even taking this blood pressure on these patients? Why are we taking it? Why are we recording it if we aren't going to be stewards of the patient's health and become an extension of medicine like we truly are?” (21:48—22:54) -Katrina
“The bigger question that I have for dentistry is, once we know these things, once we know their blood pressure is high, once we know they have cardiovascular disease risk, they have a family history of cardiovascular disease, they have some of the other comorbid sign stages or symptoms of high blood pressure, or elevated C-reactive protein levels, we know that they're prediabetic — oh my gosh, how many patients are prediabetic? So, we know that. What are we actually doing differently with those patients? Dentistry's favorite answer is to say, ‘Well, we ask them what their A1C is,’ or, ‘Well, we tell them to go to the doctor and have their blood pressure evaluated.’ But the truth is, we also have tools in our toolbelt in dentistry that have been well evidence-backed and well documented to help address cardiovascular disease or diabetic complication risk. So, really, what it should be is, why are you billing out the same CDT codes for your diabetic patient as you are for a non-diabetic patient if you're telling that patient that the disease that's showing up in their mouth is linked to their diabetes? So, that's where I think we have the opportunity to really step beyond.” (22:55—24:21) -Katrina
“One of the biggest issues with dentistry today is that we love to sit back and talk to our patients about, ‘How was your recent trip to Costa Rica?’ and, ‘How are the kids in cheerleading camp?’ and, ‘Oh my gosh, do you shop at that grocery store down the street? Did you know that they've got a sale on ground beef today?’ We love to have these beauty shop and barbershop talks with our patients to try to build trust. But the reality is that advocating for your patient and saying, ‘I'm concerned about you. Here's my plan to work with you on this very unique special plan,’ that's what changes the game.” (29:14—29:53) -Katrina
“Here's what I first would like to challenge dentistry on. I believe that our conversations with our patients should sound very similar to the very conversations that our patients have with their physicians.” (31:16—31:29) -Katrina
“We are so fearful that patients are going to say no and reject us because they see the things that we do as elective or optional. And let's be honest, there are things that we do in the dental operatory that are elective or optional. But when it comes to providing comprehensive healthcare to our patients, this is where we have to think bigger, and this is where we do have to integrate research.” (38:40—39:05) -Katrina
“We are so afraid of the patient's — pun intended — inflammatory reaction that it holds us back from telling the patient the things that they actually do need . . . I think that's important because we're so afraid that they're going to say no or have additional questions, when the reality is we should be leaning in when they have more questions. It means they want to understand.” (43:30—43:58) -Katrina
“Very rarely do my patients come in and go, ‘I have gum disease, and I'm concerned.’ My patients are asking for their free cleaning that their insurance covers and whiter teeth. Those are the two things they want. So, now I can use something like hydrogen peroxide custom delivered trays with my patient, and we're both happy because not only am I improving the success of my patient's clinical outcomes, but that hydrogen peroxide improves whitening for my patient. So, now they're getting both. My patients love it because then they're bought in. Then, they're excited. They're involved. They have ways that they can empower themselves to be successful at home. Now, we can extend the reach of our clinical care to the patient's home care, and that is what allows us to truly partner with our patients.” (52:20—53:26) -Katrina
“This data has been done and replicated many times where they have looked at the main reason, the number-one reason why patients decline treatment plans from us, which seems like such a crazy concept in dentistry. Why is it that they would come in, they trust us enough to walk in through a front door, they sit down, we've got the lab coat on with the alphabet soup after our names and the certificates on the wall and all the things, and we tell them, ‘You have this disease, and you need this treatment,’ and they say no, and they get up and they leave? So, this data has been done many times. Why is it that they get up and they walk out the door? When you take a look at the data, it is unbelievable, the disconnect between dentistry and patients. Because I'll tell you, Kirk, I stand in rooms full of dentists and hygienists and I ask them this question. Before I give them the answer, I say, ‘Why do you think they decline their treatment plans? Why are they walking out the doors?’ The room erupts with answers ranging from insurance, they can't afford it, it's too expensive, they won't pay for it, they don't want to pay out-of-pocket, they just want the free stuff. That is dentistry's response. That's what dentistry thinks. The truth is, resoundingly, the largest body of patients that decline their treatment plans do it because they don't trust their dentist. They don't trust their dental hygienist.” (57:40—59:10) -Katrina
Snippets:
0:00 Introduction.
1:55 Katrina’s background.
8:34 Why dentistry has a hard time changing.
13:08 You have the ability to change lives.
17:59 How to create a patient-centric care plan.
21:00 Be stewards of your patients’ health.
28:02 Advocate for your patients.
30:56 How to start the conversation with patients.
44:00 What do you do with your last 25 minutes?
53:26 Crawl before you walk, walk before you run.
57:22 Final thoughts.
1:00:38 More about Katrina and how to get in touch.
Katrina M. Sanders RDH, BSDH, M.Ed, RF Bio:
In the ever-changing world of dental science where research, technology, and techniques for patient care are constantly evolving, dental professionals look to continuing education to provide insight, deliver actionable steps, empower, and create a dramatic impact within their clinical practice. With wit, charm, and a dash of humor, Katrina Sanders enchants dental professionals with her course deliverables, insightful content, and delightful inspiration. Her message of empowerment rings mighty throughout her lectures and stirs a deep sense of motivation amongst course participants.
Katrina is the Clinical Liaison for AZPerio, the country's largest periodontal practice. She performs clinically, working alongside Diplomates to the American Board of Periodontology in the surgical operatory. Katrina perfected techniques during L.A.N.A.P. surgery, suture placement, IV therapy, and blood draws. She instructs on collaborative professionalism and standard-of-care protocols while delivering education through hygiene boot camps and study clubs.