Multiple providers, multiple philosophies: How to bridge the gap between dentists in the same practice

Creating a common practice philosophy could be one of the most valuable things you do for your practice, says author Heidi Arndt, RDH, BSDH.

By Heidi Arndt, RDH, BSDH

One of the biggest struggles I see working with dental practices with multiple doctors is the challenge the hygiene team has juggling several different treatment philosophies, and trying to prepare patients for different doctors’ diagnoses.

Here’s an example: When the hygienists see a cracked filling, they know Dr. Smith will want to watch it. However, they know Dr. Jones will want to restore the tooth and possibly recommend a crown.

Dr. Smith supports the dental hygienists’ findings and recommendations regarding periodontal treatment, no matter what. However, Dr. Jones often questions the dental hygienists’ findings and tells patients, “Let’s see how you are at your next recall appointment.”

This is a frustrating scenario for the hygienists to deal with. The longer this scenario plays out, the more the hygienists will stop educating and prepping patients toward restorative, preventive, or periodontal treatment. The result will affect the success of your practice and the health of your patients.

Creating a common practice philosophy could be one of the most valuable things you do for your practice. Here are some guidelines.

1. Develop a group philosophy through written protocols and systems. These protocols and systems should cover everything that happens from the time the staff makes first contact with the patient to last contact with the office. Be clear, specific, and ensure everyone understands and commits to the philosophy.

2. Meet with your team. If you’re struggling with implementation, and the situations above are common in your practice, then you should meet with your team and get their honest assessment and feedback regarding the inconsistencies in the practice:
• “Do you feel there are differences between the doctors’ treatment philosophies?”
• “What do you see as the major difference?”
• Use some case studies to spark discussion with the team.

3. Doctors, schedule a meeting together and discuss the responses you received from the team. If your team was willing to give you examples, review the examples together and discuss everyone’s philosophy with the cases represented. Although there may be different opinions, use this opportunity to learn from each other and come to a consensus on how you will diagnose and what treatment you will recommend in the represented cases. Here are some questions you should consider discussing:
• When do you recommend a crown versus a filling?
• What type of radiographs will you take on new patients?
• At what interval will you update radiographs on your patients?
• When (and on what teeth) do you recommend sealants?
• How can you support the recommendations made from the hygiene team in relation to periodontal treatment?
• When do you recommend an onlay vs. a crown?

4. Come together. Once you’ve reached a consensus as a doctor group, you should bring your team together again with new or revised protocols/systems, and teach them your common treatment philosophy. Then be sure to answer the challenging questions again that were presented to you at the first meeting. This workshop will be powerful and productive!

5. Put these systems and protocols into practice and discuss them regularly. This is not something you can discuss once and expect to stick. This needs to be a regular discussion with your team. And remember, if you add new team members, you will need to bring them up to speed with the group philosophy.

If you have a team member (doctor or hygienist) who is not following the team philosophy, be sure to address the person right away, before they erode the efforts of the rest of the team.

A common philosophy will create consistency and synergy. These are all things your patients, your team, and you are looking for.

Editor's Note: If you’re looking for a guide to creating a consistent philosophy in your practice, contact the author at heidi@enhancedhygiene.com to schedule a time to discuss your needs.

Heidi Arndt, RDH, BSDH has worked in the dental field for 18+ years. Her experience ranges from working as a treatment coordinator, dental assistant, and practice manager before graduating from the University of Minnesota with a bachelor’s degree in Dental Hygiene. In 2011, Heidi founded Enhanced Hygiene. She is dedicated to helping dental practices realize their total hygiene profit potential through the development of their hygiene team, quality patient care, patient-centric service and by empowering the entire team.

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