Consultants Tiff and Britt share more insight on what’s being talked about in practices across the country. This episode’s focus: solid co-diagnoses. Hygienists, when you’re chair-side, it’s time to start asking yourself what doctor would do, give the patient a heads up, and make recommendations to doctor. This method absolutely improves the patient experience. Tiff and Britt also talk about how you can implement this WWDD mindset into your practice.
Reach out to Tiff and Britt: [email protected]
0:00:05.6 Kiera Dent: Hey everyone, welcome to the Dental A Team podcast. I'm your host Kiera Dent and I have this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant treatment coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices coaching teams. Yep. We don't just understand you, we are you. Our mission is to positively impact the world of dental. And I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A teams. Welcome to the Dental A Team podcast.
0:00:52.2 Kiera Dent: Hello, Dental A Team listeners. This is Kiera, and you guys, you are in for the best treat of your life, Consultant Takeover. That's right. Get ready. They are dropping some dynamite. Our consulting team is incredible guys, and we are so blessed and so fortunate to have them sharing tips and tricks with you today. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.
0:01:13.3 Tiff: Oh hey Britt, how are you?
0:01:17.7 Britt: Oh, I'm doing awesome. I get to podcast with you, so it's always a good day.
0:01:22.2 Tiff: I do love these days so much. We say it all the time, but like I really do truly love these days. I feel like it's the one time like right before we podcast, we get to catch up on life. It's the one time like you and I have one-on-one time. So, I love it. I love it, I love it. I love it. And I always save some of my favorite like hygiene ones for you because I love being able to do the dental assistant side and the hygiene side and like wrapping them together. So I surely did that again for you today if you're ready for it.
0:01:49.9 Britt: I mean, I'm ready for it. It's always my favorite. I love putting on my hygiene hat from time to time as I know you love putting your assistant hat on.
0:01:57.5 Tiff: I do. I do. I got to assist this... Well, kind of. I had an office. I was out on Monday and the assistant team just is struggling to like really provide the doctor with what he needs and his appointments are taking a little bit longer. He's frustrated but he didn't know why. He's like, I don't know. They just don't know. And they don't know what they don't know and he doesn't know what they don't know. And it was so much fun. It like filled my soul. I got to stand chairside and literally just direct her. I said, okay, with your left hand pass this, grab that, with your right hand, grab this. And he was like, oh my gosh, this is beautiful. And she literally, it was so cool because I've done this at a couple of practices, but this one obviously was this week, but I got to like watch her go from this like, sucking spit, like this is so cool to be standing here, assistant.
0:02:43.5 Tiff: She was beaming, her, like she was literally glowing. She was so happy. And she came running out of the room afterwards and she said, Tiff, I never... Like, nobody's ever taught me that. I never knew I could do those things. Literally no one's told me to do that. And I was just like, oh, thank goodness. 'Cause it can go one of two ways, you know? And she was so happy and the rest of the day they were just all on cloud nine. They're like, we're allowed to touch things. And I was like, yes. Tell him. Don't be grabby. [laughter] It was so much fun.
0:03:13.8 Britt: That's what I'm here for. That's what I'm here to do and help support you.
0:03:15.6 Tiff: Exactly. Yeah, it was really cool. And I think, like you said, I love putting my assistant hat on and I really, really do. And it's just, we do so much in office for so many different aspects of it. And I honestly forget sometimes that like that's an aspect that we hit on because we spend so much time on the business side and the culture and the systems and protocols and duties than to stand chairside and figure out how we can save time and make a patient experience better. That's one of my favorite things to do. And it was cool.
0:03:45.8 Britt: I know and it's like you can do it on the assistant side. I can do a little on the assistant side, not a 10. My mom taught me a few things 'cause she is still an assistant. But I love doing it on the hygiene side of things that you can just speak to it. It's like I've stood in your shoes and I know what's going on and it's like, hey, here I can see where you're struggling. It's like if you can just bridge these gaps for doctor, right, step in, help him bridge a few gaps, it makes everybody's life so much easier.
0:04:10.6 Tiff: It's so true. It's so true. I was my other, one of my other offices I was with this week, that's one of the things that we talked about, like bridge the gap so that it's not awkward or uncomfortable. Like do that introduction for your doctor because he or she is walking into this party that you've been having and they're just like this outlier of like, hey, like what's been going on? And it's kind of like walking in on two friends, right? You have like two friends that have been chatting and having so much fun together and then they get quiet as soon as you walk into the room and you're like, what really is going on here? Like that's what I feel like it feels like when you walk in a room and they're just like, oh, doctor's here.
0:04:46.9 Britt: Is it me? Did I interrupt something? Like, am I not supposed to be here? What's going on?
0:04:53.8 Tiff: Yeah. Yeah. I like bridge that gap, introduce them. So anyways, I love that. Those are awesome things. We do so much in office. It's so much fun. And I actually, I know like I just came off of travel and you're just so amazing, Britt, you're like, take your time. Like you get some rest and I love that. But I actually really love too that we're doing this podcast coming off of travel because I'm all hyped up and like I just did all of these amazing things with these incredible people and got to like just be in the presence of some amazing people this week. So I'm all hyped up and like ready to rock out. So thank you for being here today and thank you for volunteering to podcast with me on an off day.
0:05:31.5 Britt: It's a privilege to. [chuckle]
0:05:34.7 Tiff: Oh, thank you. Well, I thought, I thought today would be appropriate, especially coming off of being in practices and doing the assisting stuff. And I did work, you know, with hygiene teams. We were doing handoffs and stuff and I think one thing that's been coming up relevant for a lot of my practices recently, and I know I've been chatting with Dene and she's been seeing the same thing, and Dana with her calls like, and I know you still have calls with clients too and you're seeing some of these things pop up as well of really getting that good co-diagnosis. I was chatting with a doctor this morning and he is like, my schedule just sucks. And he's like, I don't know if it's my new patients. I don't know if it's this. I'm like, well if you're not getting a good co-diagnosis, your diagnosis will drop, right?
0:06:15.0 Tiff: That co-diagnosis is gonna help so much. So it was like so relevant, it just keeps coming up. And I thought more people just need to hear how easy it can be because I think we over complicate it. And one thing that the Dental A Team is really, really good at, is making acronyms and making them, we make some really great acronyms. Kiera's brain is just always going on that, making acronyms and making it applicable to things that are going to increase some sort of statistic in the practice that ultimately increases the patient experience. And one of those is, What Would Doctor Do? We call it WWDD. And I hope that my nineties kids really appreciate that and I really, really, really want some of those rubber bracelets, you know, because that's where the rubber bracelet thing started. I don't know if you guys remember that or not, but it was definitely started there. So, What Would Doctor Do?
0:07:08.3 Britt: We're from the same generation, So I'm like, why would they not know what that is? Like automatically my brain when I hear it... Anyways.
0:07:15.7 Tiff: Automatically, I know, but then I go into office and I say something and all these young dental assistants fresh out of their journey just starting their new journeys, they're just staring at me like, this chick. And I'm like, okay, I'll explain myself in the '90s, a long time ago, we had these really cool things.
0:07:35.2 Britt: It's not as funny when I have to explain it, but like let's...
0:07:37.0 Tiff: Yeah, totally lost on them. That's fine. But the doctors are always like, oh my gosh, that's amazing. So, we need bracelets. That's our next step. But we call it What Would Doctor Do? And the reason we did that is because it's literally that simple, chairside. So first off, I think co-diagnosis, to wrap that up, is not a diagnosis. This is a recommendation of things that you think doctor would want to do and saying it in a way that's like, this is what I've seen before, right? It's noticing that there's a problem. Because I think there's so many times that we as supports team, right, the support team notices that there's a problem. We see this, we take an X-ray, dental assistant takes an X-ray and she's like, dang, that's a big fracture. And then walks away and doesn't say anything, you know?
0:08:26.0 Tiff: So it's like, why would you not be like, wow, are you having pain on that tooth? Because I'm no doctor here, but I'm seeing something on this X-ray and I wanna make sure I point it out to him. But first, like, what is this like for you? Let me ask more questions. Because now the patient is more aware, right? The patient is like, ah, this is a problem, right? You're getting the information that you can pass off to the doctor. That's your co-diagnosis, is really just bringing the awareness to the situation. And Britt, as in the hygiene chair, like where do you see that co-diagnosis? 'Cause dental assistant, it's like, oh, it's usually a limited, right? It's like a limited comes in or a comp comes in and we take the X-rays, they're already telling us. But on your side, on hygiene side, you guys are like ground zero and sometimes noticing things that you're like, did you know you had a broken tooth back here? They're like, I don't have a broken tooth. And you're like, oh, you kind of do. Right? So like how does that work on the chair on the hygiene chair side for that co-diagnosis to really start?
0:09:26.3 Britt: Yeah, it's huge on hygiene side, all fronts. But like hygiene, right, we see our patients back, they know us well, like the relationship between a hygienist and their patients are usually like pretty close or we're building that relationship so they really get to know us. And I think it's important to point that out, one, that we're building that relationship, and two, like you think about it, if as a hygienist, if I saw five things going on in this mouth and I say nothing to that patient and the doctor comes in and says something, I'd be like, I thought we were friends. Like, what's going on here that you didn't even mention any of this to me? And now doc's coming in and having to be like the bad guy and surprising me with all these things. Whereas like as a hygienist, we spend the most amount of time in our patient's mouth, right?
0:10:14.5 Britt: Being able to identify things that are going on. We're taking those X-rays, we're taking those photos for our patient. Like we are gonna be the ones to notice things first, and hygienists, all our team members, but hygienists like, you know when you see something like, I guarantee you, you know, when you see something. So just making sure we're bringing attention to it for the patient to let them know what we are seeing. And I think some hygienists can get a little iffy on like, well, I can't diagnose things. Absolutely. You can't diagnose things. We're not asking you to diagnose anything. We're asking you to identify anything that you see and start making the patients aware of it. And it may even be like, hey, here's what I'm seeing. I wanna make sure doctor takes a look at this because sometimes when there is a darkness, it can mean that there is decay or there is a cavity there.
0:10:56.4 Britt: So I wanna make sure doc takes a look at it to see if it's anything that needs, you know, that we need to worry about or that we need to go ahead and take care of for you. That type of a thing. So even if it's just bringing attention. Then there's those things that you're like, I know for sure there's something that's gonna have to happen for this tooth. Absolutely. Those ones I can speak a little bit stronger to of like, hey, here's what I'm seeing. I know doctor's gonna take a look at it and wanna be aware of it, just wanna let you know it's there. Often when I see this, it might mean that there is a cavity there or there is decay there. Doctor will come and take a look and confirm it. If it is a cavity, it may need to be filled or depending on the size.
0:11:35.5 Britt: I always like to give patients a heads up and allow them to go through like those emotions of change and realizing something is happening. So if it's gonna be something bigger like a crown of like, hey that does look like a pretty decent spot or there's a large filling there and I see there's some darkness around it, if something needs to be done for it, it may need something like a crown to be able to hold that tooth together to get you a more stable like restoration on there. Doctor's for sure gonna take a look at it. I'll make sure he takes a look and determines what we need to do for it. So, play through scenarios in your brain, like there's some small ones that might be yeah, bring attention to it, something might need to happen or like for sure something needs to happen. How can I talk through it to bring some attention and let them know what might need to be done for it?
0:12:16.9 Tiff: Yeah, I love that. And that right there is the What Would Doctor Do? Right? So when you're seeing something like that chairside really thinking, what would doctor typically do in this scenario or this situation? And I think you mentioned like bringing the awareness to it, mentioning it, bringing that awareness up so that the patients aren't jostled I think is a good word, right? When doctor comes in and he's like, oh my gosh, you have a whole broken tooth. And it's like, I would do the same thing. I'd be like, girlfriend, I would literally look at you, like that Britt, we have been here, I have seen you, like even on my first appointment I would be like, we've been here for an hour and like I had no idea that this was coming. So it's a shock value.
0:13:00.8 Tiff: And I think that it does a couple of things. I think I personally think it decreases, when you allow that to happen, I think it decreases the patient experience because I think that then the patient, the patient's already uncomfortable, I'm sorry doctors, but you are not a comfortable person to come in and like be, look, they're waiting for you to tell them bad news. And so they're already in a state of like uber awareness, so they're already uncomfortable, Now you just shocked them. Now they're even more uncomfortable, they're confused. They're going through the doubts, they're having to go through all of those emotions as soon as doctor says it. And so their patient experience can be increased by being given the opportunity to go through some of those emotions and ask some of those questions before doctor comes in and then doctor comes in and confirms it or says sometimes it's like, oh my gosh, I do see that and I think I wanna watch it.
0:13:49.5 Tiff: That's totally fine too, we'll talk a little bit about that. But I think bringing that awareness actually increases the patient experience where a lot of hygienists I've chatted with that have been against something like this, they like to say things like, well, it's not for me. My patient doesn't wanna hear it from me. You know, it's scary. Doctor doesn't always agree, kind of things like that. But I really do think that it increases the patient's experience and I think it decreases the amount of time the doctor has to stay in your room. Hygienists, I love you, but one of the biggest things I hear is either he doesn't get to me in time or she spends too much time talking. Well, guess what? What is in your control? That's in your control. If you can prep and already have some of these conversations with your patients before he or she gets in the room, he or she is gonna spend less time in the room having the conversations 'cause your patients already know.
0:14:44.3 Britt: That's one of my favorite things, Tiff. Like, If anything like that's one of my favorite things is patient experience, absolutely. And efficiency. Then I'm like, what can I do to make it as smooth as possible? And you know, those times when it's like, yeah, doc in hygiene, like we're just clicking, we're just moving along. And the better you get at this, the more you're gonna feel that we're just clicking and we're moving along. And I wanna kind of chime in a little bit with hygienists, I want you to think about it. Us doing this to help doctor, reverse the roles. It's like when doctors talk about perio or don't talk about perio, when it's like, I just spent 20 minutes talking about perio, doc comes in, it's like great, everything looks fine. Like, it's like the equivalent to me, if I say nothing and doc comes in and has to say everything, it's like when doc does that to me.
0:15:28.9 Tiff: I love that.
0:15:29.5 Britt: When I've talked to perio and they come and they're like, great, awesome. Everything's good to go and mention nothing about like this 10 millimeter pocket that's...
0:15:38.9 Tiff: I love that. I am using that. That was brilliant. I love it. And it makes me think too of how frustrated which I would be too is how frustrated a hygienists get when a new patient starts on doctor and they come over for a prophy and it's never just a prophy. There's always something else. So I love that. That was so smart, Britt. I love that.
0:16:02.0 Britt: So that's like the, that's the how we help each other. Like that's the symbiotic relationship between the two of us and how we work together. Like yes, I'm focusing on perio, doctor's always gonna be confirming and diagnosing, but like I want him to help me out in the perio realm too. This is is how I help him back, him or her.
0:16:19.0 Tiff: I love that. I love that. Good job. Good job. All right, so What Would Doctor Do? Is literally what would doctor do? So when you're seeing something, what would doctor typically do in this scenario? He would mention it. Is it a case where you can confidently say like oftentimes in this scenario, I see up to potentially a crown. Have you ever heard of a crown? I always really liked as a dental assistant to like worst case scenario it, and I know it's a rabbit hole and sometimes you can like, ah, I don't wanna freak people out. Well, I would much rather be like, hey, this is a little bit on the bigger side, so while he may be able to do a filling, he'll tell you, but like, I wanna talk to you about a crown just in case we get to that point.
0:16:58.7 Tiff: Because I would hate to be like, oh, we probably just, you know, I've seen him do a lot of fillings that are this size and he comes in, he's like, this is massive, it needs a crown. Now we're still at the same situation, you might as well not said anything. So What Would Doctor Do? Like try to make your best judgment. If you're not comfortable saying treatment, then don't say treatment. I'm totally open to that. Again, this is mentioning it and bringing up that awareness. It does not mean that you have to know exactly what he or she is going to do. And also, a caveat to that. It doesn't mean that they're always going to agree with you. Your doctor might come in and you might say, hey, I noticed on this tooth, there's a dark spot we kind of talked about potentially decay. If you see that.
0:17:39.0 Tiff: I told her it may be a filling. And they may be like, oh, you know what, actually it's just a shadow on the x-ray. You're like, oh, thank goodness. A lot of us like to take that personally and we take it as we are wrong. And he or she doesn't ever want us to say that again because we looked a certain way in front of the patient. It's typically not the case, you guys. I always took it as oh, thank goodness, I was worried and I know I got her freaked out, but guess what? We're all in the clear. And they're like, oh good. So then when he is like, but this tooth over here that you mentioned does need a crown, they're like, okay. Like I'm just, I'm glad it's just the one, right. Sometimes it's gonna work out that it's everything you saw, but sometimes it's not.
0:18:17.6 Tiff: Or sometimes I would just ask a question of like, hey doctor, I saw this and I don't, I'm actually not sure what it is. I let her know, like, I do see something here, but it could just be an anomaly. Have those conversations with the doctor. You guys are learning together and you're learning each other over time. I know, I knew my doctor like the back of my hand. Right? I worked with him for years and I could, I always knew. And then one day he is like, nope, I think I'm gonna do this. And I'm like, what? I've never heard you say those words before in my life. We're constantly changing, we're constantly evolving, we're learning new things, we're learning new techniques and we have to be open to the idea that things are going to change and their diagnosis isn't always going to be the same. It should be fairly consistent so that it is semi-predictable. But you have to be open to the fact that we're all changing and growing together. So there's still gonna be a learning curve there. So, calibrate.
0:19:15.9 Britt: I know. And I think always come in with like your pivot things that you can say, right? It's gonna happen. I say even like with phone, I'm like over time you'll get creative with your verbiage on things and any way that I can make my team, my doctor or the patient the hero, I'm gonna do it.
0:19:31.5 Tiff: For sure.
0:19:31.6 Britt: So like in that situation, like I'm not gonna take it personally. I'm like awesome. Like you know, Dr. Tiff is the best. So like great, I'm glad that there's nothing that needs to be done and she would know if there is something that needs to be done. So, anytime you can highlight, like take it as a chance to instead of like, oh my gosh, I made a mistake, which people can get nervous over. Like I did my job in trying to prep him and that's where doctor is the diagnosis and make him the hero that, great news, like awesome. Or if it's like we talked about crown or filling, I'm like fantastic. If it doesn't have to be a crown, I love that Dr. Tiff is gonna be able to take care of it with a filling.
0:20:03.3 Tiff: Exactly. Totally. Totally. I love that. I love that. All right, so how do we get prepped, you guys, to be able to do something like this, to be able to implement this? Because I know I have a lot of doctors who listen on here. I've got a ton of team members too, but I was just in my practice yesterday and one of the first things that the associate dentist said to me, I said, oh I've been in dentistry for this long, I do this, I do the consulting, whatever. She goes and you're on the podcast. And I said, ooh, you're listening. So I know we have so many doctors and associate doctors, all those people on here and they're like, these are really great tips, but like how do we do it? And that's something that Dental A Team I think does differently, is we definitely make sure that we have the actionable pieces always there for you.
0:20:47.1 Tiff: So how do you implement something like What Would Doctor Do? , that co-diagnosis? First and foremost, I think you guys need to get on the same page. So doctors, have a meeting with your team, with your dental assistants and your hygienists and really define what does co-diagnosis mean in your practice? What do you as a doctor, as the provider, what do you want that to look like for you? Take some of our suggestions, take our pieces and you guys run with it and create what works for your practice. So schedule a team meeting. I would do it within the next two weeks 'cause this is fresh on your mind, I want you to get it rolling. So figure out the protocol for that. What does co-diagnosis mean for you? And then from there, I would schedule calibration meetings with your team, dental assistants and hygienists and just have those maybe like once a month.
0:21:33.1 Tiff: Britt, do you think like once a month, kind of having that conversation of like how has it been? You can look at cases and then guys, start tracking the metrics that go behind this. The metrics that you will see increase with co-diagnosis are diagnosis, up. So you'll diagnose more treatment because your awareness is more present to where you're at. It's not because they diagnosed it for you and told you what to diagnose. They brought you present to the room by transferring the information to you. Your brain is not in a million other different places. You are present in the room that you're at and you're diagnosing better because you're here in the now. So do not take it as your team is telling you what to diagnose and don't only diagnose what your team is saying. It is to bring you present. Okay? So build the protocol, figure out what that looks like, schedule some calibration meetings, and really just get that center focus going on what you want that to be.
0:22:28.5 Britt: I like what you said there, on like getting it implemented, like it would be a good thing like every month and as you guys get stronger then it's something that we'll check in on. And this can be calibration. If it's even like quarterly, make sure you go through some cases. And it can be perio and it can be restorative, right? Look at it, let's calibrate, let's look and see what would we do in these situations.
0:22:50.0 Tiff: Yeah, I love that. I love that. And I think if you're doing it monthly, then shift to where it is quarterly later. 'Cause I think only monthly doctor calibration meetings are really necessary to continue. So yeah, I love that. So metrics should be, diagnosis should be up. And then your case acceptance should be up. You guys, your patients should be more willing to accept the treatment because they've heard it multiple times with that co-diagnosis. So watch those two metrics. So build your protocol, what do you want that to look like for you? Schedule the meetings, and then track your metrics. If you're not tracking the metrics and you're just arbitrarily creating new systems and implementing new things, how do you know that it's even working or changing the game? You're just changing things to change them. So make sure you're tracking those metrics. Look at your diagnosis, look at your case acceptance, look at your production and your scheduled appointments. Alright, those are your action items, you guys, I hope you wrote them down because I surely did. I'm constantly writing notes over here.
0:23:42.2 Britt: And then when you guys meet and go through that, What Would Doctor Do? I think let's, let's break it down a little bit more, Tiff, on like go through the procedures that you do within your office, right? Go through like if you see X right, then I would do Y, right? Like what the options are, like walk through all the different procedures so that the team kind of really starts to know and just understand that this is helpful. I'm gonna plug it in a couple ways. One, it just helps with our current team and absolutely case acceptance, getting our schedule full, but also it's gonna help when you onboard new associates, right? When I'm really confident with my co-diagnosing and I know it, it's real easy for an associate to come in for my team to help support them as they kind of get to understand our philosophy.
0:24:27.6 Tiff: I love that. I totally agree, totally agree. And then I think that as you have those associates come in, that's more calibration and that's where the communication with the team and the doctors really comes in. So reach out to us when that comes up because that's a whole 'nother podcast episode. But take these things. This was awesome Britt, thank you so much. I knew we could really like get nitty gritty with this one and we had a ton of time today, so this was fantastic. It was super fun. I appreciate you being here.
0:24:53.5 Britt: Absolutely.
0:24:54.1 Tiff: All right guys, you know what the wrap up is. That's it. That's a wrap. Go do What Would Doctor Do? Get yourself some bracelets if you feel inclined. Let us know how that works out for you. Have so much fun with it. Let us know how it goes. You can email us at [email protected]. You guys, we really do love hearing from you. You can ask questions, but celebrate your wins with us. Let us know how this goes for you. And also, you can let other listeners know too by dropping a five star review below. I'm telling you guys, they really do help because when you listen to these things, you implement it and you're like, holy cow, this actually worked. This is what I did. Then people who are thinking about listening to this and they look through those comments, they're gonna see that and they're gonna say, oh my gosh, okay great, let me take what they said and what this doctor said and they're gonna combine it. So drop us a review down below. We love to hear from you guys and email us. We'll catch you next time. Thanks, guys.
0:25:47.7 Kiera Dent: And that wraps it up for another episode of The Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.
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