What can dentists learn from opticians?

I really like going to my optician!  The service is wonderful, the frames are funky, the prices are (re-assuringly) high and I always feel very well looked after.

Their examinations are really inexpensive.  I have the choice of an NHS examination (for not very many ££) or a private examination, for around £35.  My examination takes around 45 minutes and the process is full of technology to test my peripheral vision, look for signs of glaucoma, assess my retina with photography etc, before my optician proceeds with the more conventional sight test.

My prescription hasn’t changed in a while, but as I wear vario-focals most of my waking hours, I still relish the chance to buy some new frames.  If you’re long-sighted like me, you will have come across the paradox of trying to choose new frames when you can’t see them clearly in the mirror ~ without wearing your glasses!  In my optician, the dispensing optician simply takes a quick digital photo to show you how you look in the new frames.  Brilliant! Then ~ there’s choosing the lenses.  Should I go for the cheaper Japanese ones or the more expensive German ones? (Inevitably I buy the German ones, why skimp on your eyesight?)  Having sorted out my eye-wear, the dispensing optician mentions prescription sunglasses and the choosing starts all over again.  Anyway, I generally walk out about every 18 months or so having spent between £500 and £750.  And very pleased with my purchases and their service. (See http://www.mallonandtaub.com)

So what can dentists learn from this?

In most NHS practices we come across, the dentists request 15-20 minutes for a new patient and 5 mins for a returning patient.  Equivalent times for the private practices we work with are, 20-45 minutes for a new patient and 10-15 minutes for a returning patient.  Clearly, in either type of practice the fee won’t cover the cost of the time involved and so we all understand it’s a “loss leader” (as do the Opticians).  However, what the Opticians know is that there is a correlation between the length of the examination appointment and the average spend of the patient…

In dental practices, I think the dentists believe the purpose of the examination is to look for disease and if they find it, create a plan to get rid of it and then offer the plan to the patient.  That’s why it takes 5 or 10 minutes.  An experienced dentist doesn’t need long to to do this and it’s very likely that half of this short amount of time is spent writing up the patient’s notes on the computer.

However, the likely result of working in this way is that most treatment plans are short (inadequate even?) probably a single tooth intrinsic restoration with a “scale and polish” added on.  If the plan is bigger, then in our experience, a high percentage of patients are likely to decline all or some of the treatment (or, annoyingly, book an appointment, then go home and cancel.)

Many Breathe Members are experimenting with longer examination appointments and the evidence they have suggests that,

The practices we work with who spend longest on their examinations, have the highest average patient value.

This is how they structure their new longer examination appointments:

  1. Start the appointment in a non-clinical area in order to establish soft facts and build/re-build  rapport. Use this time to establish the patient’s current situation.
  2. Ask the patient if they are happy with the way their mouth feels and the way it looks.
  3. Co-Examine the patient. That is, involve the patient and the nurse. Talk about what you can see and the consequences of what you can see. Be informative.
  4. Use an Intra-oral camera.
  5. Use an Extra-oral camera.
  6. Show the patient the pictures.
  7. Show the patient the radiographs and explain what you can see.
  8. Identify all of the problems to the patient. Don’t take responsibility for these problems. (Make them the patient’s problem).
  9. Offer the patient a hierarchy of importance of the problems you have found.
  10. Ask the patient if they would like to fix the important problems?
  11. Offer the patient a choice of options to fix their important problems starting with the best options and the costs.
  12. Make a recommendation as to how you would like to treat the patient.
  13. Ask the patient if they would like to proceed.
  14. If the patient is not sure, ask them what they would like the next step to be, for example would they like to come back to discuss in a week’s time?
  15. Accompany the patient to the reception desk and explain to the receptionist what the patient would like to do.

In our members experience, a version of this type of examination is likely to take 45- 60 minutes for a new patient and 20-30 minutes for a returning patient.

These practices are behaving more like my favourite optician.  Their patients feel really well cared for, listened to and understood. The levels of trust are high and, crucially, their dentists have time to co-develop and communicate a bespoke treatment plan that their patients are willing and able to say yes to.


If you would like to increase your average patient value, please contact me for a chat on:
m. 07770 430576
e. simon.hocken@breathebusiness.co.uk

Best wishes


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