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Thursday Troubleshooter: Handling dental patients who get downright mad about paperwork

Nov. 1, 2018
This dental staff has patients who complain about filling out their medical histories, and some get downright angry. What's the best way to handle these situations?

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QUESTION: Does anyone have problems with patients not wanting to fill out an updated health history? We have them fill out a new one every two years, and some people get downright mad. What can we do about this?

ANSWER FROM SALLY MCKENZIE, founder and president of McKenzie Management:
I would first evaluate your process regarding how you ask patients to update their health histories. Is a new health history put on a clipboard and handed to them by the front office staff when they arrive?

If this is the case, I would consider having the hygienist, assistant, or even the doctor sit eye-to eye-with each patient and ask them if they are still taking XX medication, still receiving treatment for XX, and whether there is any change in their health since they were last seen at your office. I would try to make updating the health history a little more personal.

If a patient gets mad, I would suggest the staff person look concerned and surprised. They should then ask the patient to help them understand why filling this out is upsetting to hin or her. This will give patients a chance to express any concerns and grievances and give the staff person a chance to explain further why health histories are important.

ANSWER FROM AMBER AUGER, owner of Millennial Mentor:
Imagine you walk into a preventive dental appointment and the business team hands you a stack of five pages to update. You only kept the appointment because your preferred hygienist had no other openings, despite the fact that you have a tight schedule that day. At this moment, it’s easy to become frustrated if you do not understand the value of the paperwork that’s handed to you.

Because we in the dental profession are medical providers, it is essential that we understand a patient's whole health. Without this knowledge we are not able to fully assess someone’s health, evaluate their oral health risks, or determine if any treatment is contraindicated. You should be updating medical histories at each appointment, with a full update biannually, or when there are extensive changes in a patient’s health.

Patients must understand why it is so important for us to gather their health information, and this should help prevent them from becoming angry. I often tell patients that I won’t be able to properly educate them and help them prevent disease if I don't know their full risks. I cannot evaluate their full risk without knowing what medical conditions, medications, allergies, and habits they possess.

Some patients simply dislike paperwork and feel extremely overwhelmed when they’re given a big packet to fill out. For these patients, I often offer to help them fill out the forms and I ask them the questions verbally. Once the health history is completed, I thank them for allowing me to do my job properly. I’ll say something like, "It may not seem like high blood pressure is a big deal, but for patients who are on this medication, dry mouth is a concern. The lack of saliva in the mouth allows bacteria to linger longer, and this dry mouth can increase the risk of tooth decay. My goal is for you to never have a cavity again, and with proper home care you shouldn’t have any."

Acknowledge that the paperwork may feel like overkill to them, but it allows us to provide the best treatment for their specific risks. This will build the patient relationship and bring value to the information they provide.

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