Everything Dental Blog March 2020

Temporary Closures

The American Dental Association’s declaration to limit patient appointments to emergency care has resulted in dental offices reducing their hours, implementing Tele-Dentistry or voluntarily shutting down their operations. In some areas around the country, dentists who specialize in emergency care, are struggling to provide care without the necessary PPE. They are advocating for the same status hospital workers have, so they can obtain greater quantities of PPE. These dentists manage patients in pain and keep them out of the hospital ER. Their efforts are instrumental in opening up hospital space for the inflicted and very ill.

Temporary Closure Checklist

Henry Schein Dental has created a temporary closure checklist for the dental profession. This checklist provides the dental office with recommendations on how to protect their capital equipment and technology investments during a work stoppage. Here is the link: https://www.henryschein.com/us-en/images/corporate/20DC6995-Office-Closing-Check-List.pdf

*There is a great deal of preparation in closing down a dental office. There are two expensive and vulnerable pieces of equipment that require the dentist or facility manager’s attention. Shane Adams, an equipment technician aficionado says: “At minimum, run these two machines a few minutes weekly”. This prevents rust and contaminants from harming your capital investments.

Throughout the USA there are strict ordinances and guidelines regarding social distancing and gathering. Your patients and your team members are worried about their jobs, their families (especially the elderly), when their kids will go back to school and when life will be normalized. All of this uncertainty and life-style inconvenience, compounded by partial or complete isolation, has resulted in anxiety, mental fatigue and depression for many Americans. It has been reported that mental health ‘mobile applications’ and ‘Tele-therapy services’ are experiencing a huge boom across the globe.

Last week the president evoked the Defense Production Act. This decision was meant to encourage and accelerate industries participation in the war against Covid-19. Many large dental manufacturers have suspended normal manufacturing operations so they can re-tool their machinery and ramp up production of PPE, surgical ventilators and other products needed by health professionals on the front lines. While this was a bold action, it came late and we are struggling for the supply levels to meet the demand.

During my thirty year career in the dental distribution business I have witnessed and participated in various product/medicament shortages. Many of these shortages were the result of lopsided currency exchange rates, availability of raw materials, manufacturing issues, regulatory mandates and bad business decisions. Historically, these supply chain issues rarely last longer than a month or two but we are in unchartered waters. This pandemic has interrupted and in some cases, halted business activity completely. It has taken its toll on us emotionally and will impact our personal finances, retirement strategies and it’s testing our fortitude.

Tele-Dentistry Now

Tele-Healthcare is one of the fastest growing sectors in healthcare today. The Covid-19 virus has accelerated interest, engagement and the adoption of Tele-Dentistry. Every day, hundreds of dental offices are signing up with a Tele-Health company to communicate, triage and provide a treatment or therapeutic (RX prescription) for their valued patients.

Over the next five years Tele-Health will become more pronounced in our dental landscape. The scope and functionality of the Tele-Health platforms vary with need and application. Some are simple patient/practice texting platforms. This provides instantaneous communication between patient and caregiver. Many platforms employ ‘live’ video conferencing and integration with the dental offices practice management system. This allows health providers that are mobile or off-site to share (send and receive) EHR, X-rays and full arch scans. Providers can collaborate, patients can get a second opinion and auxiliary dental professionals can send images directly to the lab. In addition, these secure Cloud based platforms are able to push data directly into the offices appointment book for follow up or to schedule more complex treatment. Tele-Health is already standard of care in rural, underserved and senior living communities. Tele-Health is ominous. It can serve anyone who has a phone or computer.

What we need is leadership and action.

I have been taking dozens of calls from dentists around the country regarding the coronavirus pandemic. Initially, the calls were about inventory levels and the availability of PPE items. Then the concern shifted to patient cancelations, soft schedules, uncompleted treatment, managing employees, employee furloughs, layoffs and the financial challenges that lie ahead.

According to many experts the average dental practice, furloughed for a month will lose over $50k in production (receivables), while still paying out a good percentage of their average monthly expenses. If this were to go on for an extended period of time, it could change the dental landscape and the US economy for a very long time.

What can a good leader do now?

In times of uncertainty, we must protect our families, the business, our employees and our valued customers [patients]. Use this down time to work on initiatives that have been talked about but never got started. Work on staff training and review every office policy and process to make it more efficient, user friendly and more patient centric. Focus on work that will yield dividends when you re-open the office and ramp up your activity.

Focus on patient communication. Consider a multifaceted, patient marketing and communication program. Check in on your patients. Send a text, email or snail mail from the office regularly. Call patients that were about to start, that are in the middle of or those that just completed a big case/surgery. Let them know you are concerned about them. Use social media to update your valued patients about the latest information from the CDC and regulatory agencies regarding the virus. Be sure to make your patient encounters thoughtful, informative, compassionate and inspiring.

What we say and how we say it: Work with your team on phone etiquette and phone skills. You and your team will receive lots of questions from patients pertaining to the virus and other medical related inquiries. Do not ad-lib. Train your team on effective and compassionate patient communication during this pandemic.

The following are questions that you and your team may have to respond to:

Patient: “My Company’s business has been impacted by the Coronavirus and my boss may cut my hours. I think I should hold off from doing that crown or buying that new iPhone.”

Patient: “The stock market is down and my 401K is taking a hit, I think I’ll hold off from doing that all – on- 4 implant case.”

Patient: “My spouse had the virus but he’s much better now, should I keep my appointment?”

Patient: “I have an auto-immune disease and I have to cancel my appointment today.”

Patient: “My son in law said that I should stay home and avoid public spaces because I am old and have a respiratory condition. I have to cancel my appointment”

Staff member: “We are running out of masks – How are we going to treat patients?”

Staff member: My husband has a cough and fever, I know I should probably stay home but I have to work because I need the money. What shall I do?”

Signage

Create a sign for the waiting room that states your commitment to exceed CDC and OSHA guidelines. Let your patients know that every surface in the office is disinfected and scrubbed several times a day and every treatment room is cleaned after each patient. Show them that you use disposable items with each patient to ensure their health, safety and well-being.

Website/On-Hold telephone answering system

Update your website and on-hold phone system to address your Covid-19 business policy and hours during this crisis period. Let your patients know that you are taking every precaution to ensure their safety and health. Keep up with the CDC and other public health organizations to provide optimal care and to update your messaging. 

Other suggestions:

Establish your risk – Meet with your accountant (virtually) and create a risk assessment. Discuss your business and create a financial plan to manage a three weeks, two month and five month partial and total business closure. Make sure to bounce your plan off of other professionals, your advisors and influencers in the dental community. Talk to neighboring doctors and have ‘what if’ conversations. Think of ways to collaborate, partner, merge or consolidate into one larger facility.

Educate employees – Talk to your team about your policy and concern for high risk family members, co-workers and patients of record. Encourage them to be positive leaders and patient focused. Your team will learn quickly and they will follow your lead. Be cognoscente of your behavior because it speaks louder than words.

Discuss your brand with the team – Share your vision and mission for the here and now. Recruit team members to be marketing (social media) ambassadors for the practice. Let your patients and the surrounding community know that your practice is committed to them. Talk to the team about ways you can capitalize on being kind and philanthropic to your neighbors.

Be extra careful about cleanliness and professionalism – when business resumes. Patients will have a heightened awareness and focus on cleanliness and disinfection. The reception area, waiting room, bathrooms and ops must be spotless so that you convey the right message.

Show compassion and understanding if a patient cancels because they are medically compromised or just scared of contracting the virus. Be proactive. Identify ‘at risk’ patients and geriatric patients and develop a special Covid-19 protocol just for them. Reach out to those patients and let them know you are thinking of them and that you are their healthcare resource.

Join the Tele-Dentistry movement. Consider the opportunities in patient communication, off-site dental consultations and collaboration, emergency dentistry and mobile dentistry.

The Future of dentistry will be much different than it is today!

  • Patients will have a higher dental IQ.
  • They’ll have access to the Internet of Things
  • Artificial intelligence and machine learning will advance every technology we have and it will lead to new ones and better healthcare outcomes.

What do you think the post COVID-19 dental landscape will look like?

We are in it together. Stay Safe and Be Well!