Treating Emergency Patients

The Significance of “New Patients Requiring Emergency Dental Treatment”

Challenges:

Every dentist has experienced situations when a new patient requires emergency treatment and one seems “not to have the time” or the clinician seems not to embrace the importance of the moment. At Dental365, we need to express our philosophical values and a series of logistical considerations which will more clearly outline our goals and objectives.

General Considerations:

• First of all, “new patients requiring emergency dental treatment” needs to be recognized as one of the most important groups of patients necessary to provide sustained practice growth. This group of patients should be perceived as one of “the crucial lifelines” of a contemporary practice.

• Secondly, we need to emphasize the enormous differences between a “new patient seeking routine care” vs. a “new patient that requires immediate emergency care” vs. “a patient of record that requires emergency care”. All three categories are important but the “new emergency patient arguably requires the highest magnitude of focus and attention.

• Our philosophy: As dentists, we need to understand that we are in the “service and relationship business.” Experience has shown that when we have the ability to help a patient that has immediate needs (pain, broken teeth, infection…), they tend to be the most loyal patients in our practice. They tend to never forget how well we took care of them and are an amazing source of new patient referrals. It also represents a source of enormous professional satisfaction.

• Accordingly, we suggest an almost “drop everything” concept where we get the patient in on the same day to address their immediate needs and to provide palliative treatment if possible. Providing convenient, accessible, affordable care in a time of need cannot be over emphasized as it represents among our most important core principles. “Next day care or an appointment when we have time”, is not an acceptable approach.

• Logistics: it takes time and experience to “make time when there seems to be none” and to provide attention where it does not seem possible. Please review the following suggestions that should be helpful to provide emergency care to this “niche” group of patients.

What to do and what not to do

• ”We live in a want it now society”: research has shown that our culture demands fast and immediate service and gratification (ie Amazon). This same concept needs to be applied to our group in terms of providing immediate access for “Amazon-like” emergency dental care at Dental365.

• ”Making time when there is no time” requires thought, preparation and a team effort with the entire staff. One suggestion is to simply find time in a schedule where you might have the opportunity to “do one less procedure” or shorten treatment time on one patient to make room for another.

• ”Earlier is much better than later”: when a patient calls first thing in the morning, try to see the patient ASAP. Since you do not know the patient’s specific needs, it will give you a full day for appropriate treatment or referrals.

• ”Never think of the “emergency patient” as an inconvenience” to your day. Never say, you don’t have time to see the patient. Rather it is an incredible opportunity to help a person in need and grow your practice.

• ”Have a well-choreographed plan in place”: have your team in order. Expect emergencies, know who the endodontist or surgeon will be on a particular day if their services are needed.

• ”Be locked in”: meaning “make this patient feel as if ”they are the only patient you have.” Be empathetic to their specific needs despite the distractions and time limitations of your day. If you appear stressed and bothered, they will pick up on your negative emotions.

• ”Keep it real”: patients often come in with unrealistic needs and expectations. You need to respectfully let them know what is possible or not. Educate them with their diagnosis, treatment options and prognosis.

• ”Stay in your lane”: in an attempt to try and help a patient, never provide emergency treatment if it is not within your purview. Do not extract teeth or start endodontics, if it exceeds your comfort level or training. Understand when to refer.

• ”Breathe”: dentistry is difficult and when it “feels too much”, give yourself a few minutes to mediate, breathe deeply and understand, it will be OK. We have all been there so you are not alone.

• ”Time management”: there is a difference between greeting the patient on time vs. actually starting treatment. Try to “greet” both groups on time but regularly scheduled patients need the higher priority in terms of starting treatment. Emergency patient will be more than “happy” to wait once you meet them on time as they know you are trying to help them.

• ”Be honest”: explain to your regularly scheduled patients that you had an emergency that required immediate attention and apologize for delay.

• Have this group of patients leave the office “better off than when they walked in”. If they need a crown and time will not allow a provisional, then repair the tooth with composite, smooth down a rough edge. Do whatever is necessary to make them better.

• ”Never have the patient leave the office in pain”: even if you need to give a local anesthetic and then need to see a specialist in another office, please provide some type of pain relief. If appropriate don’t be shy to use antibiotics. In terms of highly effective pain relief: Advil 400mg (two tablets) and one extra strength Tylenol 500mg may be administered in the office.

• ”Don’t be a guesser and don’t make mistakes” if you are not sure of the source of pain, do not provide any treatment. Tell the patient that “at this time, you can only provide them with a tentative differential diagnosis” and you do not want to provide treatment that may be unnecessary. You can always say, “It may only take a day or two, but things will be more clearly manifested or at times, will improve on their own. In the meantime, please call me anytime if the pain gets worse or becomes more localized”. In other words, if you are not sure, provide no treatment but offer reassurance that you are there for follow-up support.

• ”Think about the patient experience”: think about how amazing it is to have a patient call the office in pain, have the opportunity to be seen on the same day and then have treatment to relieve the pain or address a complaint in a matter of hours. This is special service that will exceed all patient expectations.

• ”Train the staff”: our auxiliary staff must understand under these conditions, we are “not running behind or running over”. Rather we are all working together to provide timely and personal care to patients that have immediate needs.

• ”The follow-up phone call”: It should be considered mandatory to call these patients and “see how they are feeling”.

Hopefully, these Dental365 philosophical guidelines and protocols will be helpful to successfully manage this extremely important group of patients.