Key Tools For Communication and Case Acceptance

In our clinical practice, we come across many situations daily, where good communication is key for case acceptance and happy patients. Today, I want to talk about the importance of some communication tools we can use as clinicians to reach out to our patients effectively and give them the best possible treatment. 

When we are in dental schools, patients don’t have to pay for the treatment provided by students because they come in through a public quota system. This is great for student clinicians because the friction for case acceptance is practically non-existent and you can get a lot of work done on patients clinically, without worrying about the associated costs. Patients are more accepting of different treatments and procedures there. 

But when we graduate and enter private practice, on top of everything else that we have to consider as a fresh graduate, we also have to make a lot of monetary based decisions. It’s crucial to have competent communication skills and systems in place to get through to patients about what’s going on in their mouths. You should be able to communicate the risks and benefits of different procedures skillfully and ultimately get case acceptance with your patients. Without case acceptance, you will never be able to build your books.

Fellow dentists, you can take all the CPD in the world, acquire all the skills you want, but if you’re not a good communicator and you aren’t able to get case acceptance on procedures, then patients won’t come to you to get the care they deserve. 

Essential Tools For Patient Communication 

The first thing that I want to talk about is intraoral cameras. Most practices have intraoral cameras and apart from the obvious medico-legal reasons for taking photographs (diagnosis and pre & post-operative documentation), intraoral cameras do a fantastic job of communicating relevant information about the teeth and oral cavity to patients. For example, if there’s a tooth with a broken amalgam restoration, you can either tell the patient with your words or you can show the patient the same on a screen, getting case acceptance easily. Therefore, having strong communication skills can go a long way with patient compliance and understanding. 

Another great tool you can benefit from in your clinic is a DSLR camera. In my initial days as a dentist, I started using an old camera body and a 100 mm macro lens I bought second hand and a ring flash from Amazon to get me started.. I was shocked at how much of a game changer it was for me at the time. Of course, getting used to a DSLR and integrating it into your clinical practice does take a little time. There is an initial steep learning curve to be able to use DSLR cameras effectively. 

Firstly, you need to place physical barriers between yourself and the camera to ensure infection control. During the procedure itself, there are so many steps involved that it becomes an inconvenience almost. You have to first prep the tooth, de- glove, take a photo, and then put the gloves back on again. DSLR cameras are often chunky and heavy, which can get tricky to handle. There’s also the added hassle of learning the different settings and parameters of your camera before you are able to take good pictures. 

I mostly employed my camera for clinical examination of new patients where I would take and collect relevant photographs to help me with the treatment planning process. I would use my extra-oral cheek retractors to photograph the patient’s smile in different views like the buccal and occlusal views. I would then upload the photos onto my computer and show them to my patients during the case discussion. I would talk to them about the diagnosis I had made based on the photos and what my reasons were. I would then explain to them what the entire treatment would consist of. In particular, I found occlusal arch photos to be extremely helpful in explaining my findings and pointing things out to patients.. I started implementing all of this routinely in my practice, and found my case acceptance going through the roof.  

Use iPads For Case Acceptance

The final tool I want to talk about is the iPad, for which I have to credit Dr Bharat Agarwal. I went to a talk he did on case presentation and technology; And one of the things he spoke about was using software like ‘keynote’ to annotate photos, and show patients what was possible in terms of treatment planning. 

After the talk, I straightway went and  purchased an iPad and started using it.. It was the best investment I made in my early days as a clinician.  During my patient examinations, I would transfer all my patient photos onto my iPad, and sit down with the patient and scroll through the photos together. Patients found the iPad to be very attractive and user-friendly. They could zoom in and zoom out on any tooth with caries, cracks, or recession. On the photos, I would circle the problem areas and write down notes about what I thought the treatment plan should be for that particular tooth. For example, one tooth would need a filling, another tooth would need a crown

For complex cases, I would re-call my patients on another day. I would put together a proper presentation for them in the meantime; whether it was smile makeovers or full mouth rehabilitations. I would lay out the treatment options for each tooth and write the costs associated with them. When they came in next, l would go through the entire presentation with them on keynote. The value I was able to sell to all of my patients through this was just unbelievable!

One thing I want to mention here is that along with excellent communication skills and case acceptance, new graduates also need to make sure their clinical skills are at par. These tools can help you gain case acceptance but be careful not to bite off more than you can safely chew!

Start Photographing Your Cases

To summarize, I think it’s important to take photographs and maintain documentation for several reasons: (1) medico-legal purpose; as evidence of what you’ve done and why you’ve done what you’ve done, (2) because it’s an effective communication tool to help patients understand what’s going on in their mouth, and finally (3) to present the treatment plan you envision in your mind to patients, so that they agree to the treatment you want to provide. 

If you’re a clinician who hasn’t been taking photographs in the past, I highly recommend you start now. Start small, with an intra-oral camera or a simple point and shoot camera. You can then progress higher to a DSLR camera with macro lenses and ring  flashes. It may feel cumbersome at first, but the photos you click once you get the hang of it will be truly invaluable. Lastly, I recommend getting an iPad to explain your treatment plans to your patients. The patients can interact with their own photos too, by zooming in or zooming out on their teeth. This makes a difference of night and day in terms of case acceptance and the volume of work patients will say yes to. 

That’s all for this week.

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