Increase case acceptance in your dental office by implementing the Hygiene Handoff! 


What happens when the doctor enters the hygiene treatment room in the final 10 minutes of the appointment without the hygienist preparing the patient properly? He/she diagnoses needed treatment, offers it to the patient and the typical patient response is, "I will think about it!" Right out of the gate, the patient is overwhelmed.

Sound familiar? There is a way to make the hygiene exam more effective, leading to excellent treatment acceptance. We call it, "The Hygiene Handoff." If you think of the hygiene appointment as a 60 minute clock, the first 15 minutes are designed to be the pre-diagnosing stage when necessary radiographs and intra-oral photos are taken and displayed on the monitor. At this stage, the hygienist can pre-recommend care that she/he expects the Dr. may see during the exam.

The long standing question is "How do we increase treatment acceptance?" We must psychologically prepare the patient for the doctor's diagnosis. There needs to be communication transparency between the doctor and the hygienist. Let's break the process into a series of steps:

  1. Note areas of the patient's dentition that need attention and take intra-oral photos.
  2. Present most troublesome x-ray on the monitor in front of the patient.
  3. Educate the patient about that which is obvious, ie. A deteriorating margin between the filling and the tooth. Explain what could be happening with respect to recurrent decay etc.
  4. Suggest in this scenario what you expect the Doctor might say, "Mrs. Smith, bearing in mind the size of this filling and the fracture we are seeing on the photo, I would imagine the Dr. will recommend a crown to protect this tooth."
  5. Listen to the patient's comments and respond accordingly.
  6. When the Dr. enters the room to do the hygiene exam. Allow him/her to renew the relationship with the patient for a few moments. Now go ahead and brief the doctor on the hygienist's preliminary findings.
  7. Tell the doctor "why" you believe the patient wants to complete this treatment. "Mary and I have been discussing this troubled filing in tooth number 18 and one of the things she sure wants to avoid is to have to experience any discomfort if it were to fracture off at the gum line. Mary also would like to avoid a root canal if possible as well."
  8. As the doctor does the exam, he/she will comment in one of two ways. "Mary. Heidi is one of the best hygienists I have ever had the pleasure of working with and she is exactly right in all that you have discussed prior to my arrival." Dr now has confirmed the diagnosis and should then ask the patient, "So how soon would you like me to take care of this tooth for you?" When the patients says, "right away, doc!" Turn to the hygienist and say, "Please save 8 units in my schedule as soon as possible for me to do Mary's crown!" What if the pre-diagnosis is NOT what the Dr. would recommend: "Mary, Heidi is absolutely on the right track with all that you have discussed prior to my arrival. I am thinking we could look at this tooth again at your next hygiene exam in 4 months and see how it is doing. If it becomes sensitive or changes in any way, be sure to call right away and we will get you in to do the crown." Now ask, "How does this all sound to you?"
  9. Upon handoff to the business office, be certain to debrief with the receptionist about the appointment time you have given the patient, and the "why" the patient is scheduling the crown for example. Now financial arrangements can be made more smoothly.

Look at ways of capturing as many opportunities as possible in the hygiene treatment rooms.

What is the doctor's treatment philosophy? For example, it is a known fact that the doctor treat periodontal issues first. Educate the patient about this fact and why it is important to have a healthy foundation.

When patients are or become a member of the "healthy mouths" club, always find a reason for returning for the appropriate interval of time between appointments. Be excited while sharing what is new in the practice and/or what is new and wonderful about dentistry altogether. Provide tidbits of information on whitening, straightening, electric toothbrushes, and why fluoride is good for the adult patient for example. This type of "news blast" keep the patient in the "dental state of mind" for the full 60 minutes that you are together and creates value in the "reason for returning."