Surviving Katrina, Part 3

March 1, 2007
This series has been walking WDJ readers through Dr. Martha Carr’s rebuilding of her practice near New Orleans through a gift from Jameson Management.

This series has been walking WDJ readers through Dr. Martha Carr’s rebuilding of her practice near New Orleans through a gift from Jameson Management. The series is about a Hurricane Katrina victim, but it also can be a guideline for your practice. Read on for:

  • proven methods of practice development that are valuable to any practice,
  • how to handle challenges - no matter how many or how great, and
  • how to be prepared for disaster.

Perio program and communication skills

The American Dental Association tells us that 80 percent of Americans have some form of periodontal disease, so we always coach practices so that their periodontal program is in great working order. The main shift for Dr. Martha Carr and her team seemed rooted in their deepest philosophy focus. A lightbulb came on as they adopted the concept: We need to offer patients health. It’s our duty to do that.

Dr. Carr’s sweet nature, coupled with the hesitancy of a newly graduated hygienist, makes the entire practice and all its systems seem easy and friendly. When addressing periodontal problems, this approach may not serve a practice or patients well. So focusing on the goal of offering health gave Dr. Carr a new confidence and inner strength to build a periodontal program, complete with excellent verbal skills.

For example, now they might now say something such as the following:

“In looking at your comprehensive periodontal evaluation, it looks like something has changed. What we’ve been doing isn’t going to work anymore. We need to make a plan to return you to health.

“We’ve just completed some continuing-education courses where new, credible research was presented that indicated that this periodontal concern may affect your organs and overall health. So we want to make sure you understand the potential connection your gum health has on your entire body.”

When Dr. Carr and her team first tried these verbal skills regularly, we asked what objections they were getting so we could work on addressing them. They just smiled and said, “What objections?” There weren’t any objections. Their patients were thrilled with their exceptional education and sincere interest in their immediate and long-term health needs. Other verbal skills coaching and conceptual brainstorming (such as thinking that there’s no such thing as a small cavity - it’s decay in the mouth) also proved helpful.

One issue that may have been touchy in another practice was that the hygienist who’d been in periodontal therapy was still in the practice; she just moved to the business area. Some team members might be afraid to embrace changes, or afraid patients might think, “Why didn’t the previous hygienist pick up on this?” As we all know, periodontal disease is unpredictable because it is episodic. With that in mind, Dr. Carr and her hygienist mastered verbal skills such as the following:

“Regardless of the condition that existed in your mouth at your previous appointment, what I’m seeing now is this. This condition may not have been at this stage before, but I need to bring it to your attention now.”

The former hygienist knows no one is labeling her as an unsuitable caretaker and, in fact, now jumps in to help the doctor and new hygienist present their philosophy of periodontal therapy. Patients don’t feel like they weren’t cared for during previous visits. New information always changes our positions on appropriate care for patients.

Dr. Carr and her team also mastered body-positioning skills. A great communications tool that shows patients you’re focused on them is where you position yourself. Are you looking them in the eye? Do they appear comfortable as they listen and respond?

Technology implementation

As Dr. Carr and her team found themselves in the midst of a technology purchase and subsequent learning curve, we noted that the team gave full effort, saw it through, and never gave up. They decided to use digital radiography with a remote, so instead of the sensor being on a cord, information is relayed via remote. Yes, there have been days they’ve felt like it gets in the way, but they’re finding their way outside of their comfort zones.

Coding

While we almost always help practices work through proper insurance coding, Dr. Carr’s team definitely needed help with it. Like many great dental professionals, they tried to treat periodontal disease without using periodontal codes. Dr. Carr was so concerned about her patients perceiving her as fair that she and her team tried to help patients by charging fees using only the preventive codes.

After exploring this system in greater detail, they realized that to help patients regain health, they must code exactly what they deliver. So if they do root planing and scaling and charge out a code that indicates no subgingival work, they now see this as unethical. Now their communication skills match their level of understanding, and they’re able to express to patients the need to correctly code the treatment delivered. Incorrect coding in the preventive codes may show that adequate treatment was not delivered to patients with an active disease process.

Emotional recovery and team development

In the beginning, Dr. Carr said that hope was the first and greatest beneficial aspect of her relationship with Jameson Management. Listing what needed to be done offered her a plan in which to invest her heartbreak’s energy.

Now, after giving birth to a little girl and building her practice back from Katrina’s wrath, she and her team have developed into a cohesive group that includes her Jameson Management partners. As tokens of her appreciation to JMI’s Cathy Jameson and the two authors, Dr. Carr gave us gifts such as CDs, cardholders, Mardi Gras-style king cakes and more. She also presented us with silver medallion necklace drops featuring a banner, fleur-de-lis, and heart to signify “I know what it means to love New Orleans.” They were crafted by a local artist.

On the airplane trip home from the consult, someone noticed one of our new necklaces and said, “So, have you been working in hurricane relief?” Tears came to Leslie’s eyes. She changed her “No, I’ve been working as a dental consultant,” answer to a proud “Yes. Yes I have been.”

Dr. Carr and her husband often say, “We’re so blessed.” Not only do they have this gift from Jameson Management, Inc. that’s helping their practice thrive, but they have a healthy baby girl. They found a great husband-wife dental team to work four days a week during maternity leave, and they have team members singing their praises and working diligently. The hygienist-turned-business person told Jameson Management rep Jess Webber what she planned to collect that month. The practice surpassed that goal with three days left in the month. So she called with a new lofty goal, which they also met by month’s end.

Dr. Carr is one of those people who puts positive energy out there and it comes back to her multifold.

To be continued

We will continue to report on Dr. Carr’s progress throughout the upcoming months via at least one more feature.