Speed can be dangerous, but doing something in less time can be fun. This is part three of tips that will save you at least 10 minutes every time you use them. Keep in mind that some of these actions are done multiple times a day. So, it’s not just the 10 minutes you save. It is the cumulation of time savings and speed that add dollars to your bottom line. Here is a link to a YouTube video I would like you to watch from start to finish: https://youtu.be/RRy_73ivcms. It shows 1950 Indy 500 tire change compared to one in 2013. At least in this case is was done more efficiently, safer, and quicker. Welcome to speed in motion with a better result. Slow is smooth, smooth is fast.
Let’s continue looking at practice tips that will save you at least 10 minutes every time you use them.
- Use a mouth prop every time you work on a patient. It allows the patient to relax on the prop while allowing you to work longer before breaks for the patient. It also minimizes muscle trismus following longer procedures. While there are newer mouth props with lights, suction, and isolation, even the old fashion McKesson medium mouth prop can save you 10 minutes every time you use it. The nice thing about using the same size mouth prop every time is that you perfect your systems based on the amount of room this size mouth prop gives you. You will streamline the equipment and systems that will automatically make you faster.
- Bur blocks: Practicon (practicon.com) neon 9-hole FG block color-coded. These blocks allow quick set up. A locking arm prevents burs from falling out during cleaning and ultrasonic cycles while giving you plenty of options in burs with 9 holes to use. Part of a tub and tray set up is learning how to streamline everything. Learn to find burs and diamonds that can do double duty, resulting in fewer bur changes, easier familiarity with the burs for the clinical staff, and never allow other doctors in your office to be able to alter the number and type of burs without complete consensus from all those concerned.
- Nitrous Oxide: I could count on one hand the number of patients each month that I worked on that did not get nitrous oxide. Everyone loved it. Those that didn’t, I felt like charging them more. It minimizes conversations, leaves the patient without ability to track time so that everything you do seems to be easier and smoother, helps the patient relax, masks the smell of burning teeth, helps muscles in the jaw area to relax and makes me look like a super star to the patients. They think all my stupid jokes are great.
- Post op: Use Dexamethasone injectable after every major procedure. Add a ml. or two at each tooth in the buccal fold. This will result in no pain, no swelling, and no muscle trismus. Medrol 4mg (pill) give them 12-15 one tid. And this will eliminate all inflammation. The only contraindication is Insulin dependent Diabetics. This strategy makes you look like you walk on water. No pain after treatment, no swelling, no muscle trismus, and the patient will tell everyone they know about you (you can’t find a marketing strategy that works this well). Medrol 4mg: Comes as a dose pack or you can order as single pills. Great for lingering soreness following any procedure.
- Pre-op: Two extra strength Tylenol plus 2 ibuprofens have the same efficacy as Vicodin. This will literally smooth out any patient if their stomach can tolerate it. This is also great in conjunction with Medrol 4mg for druggies: No pain and you did not write them a narcotic script.
- Topical: Profound Gel (AKA Tricaine Blue and DepBlu). Lidocaine 10%, Prilocaine10%, Tetracaine 4% topical anesthetic. Available from: [email protected] (855.876.3060). This stuff is incredible. Two minutes and you can use a scalpel on the spot you placed it on. Great as an infusion with mop headed syringe in the sulcus around teeth that your hygienist is doing root planning and scaling on. Also great for loose baby teeth without having to numb to extract.
- Perfect treatment templates: I have yet to see any office with great templates for treatment. The standard to shoot for would be having them so complete that your dental school proctor would smile and a prosecuting attorney at your malpractice case would cry. These notes are so complete that it takes 30 seconds or less to click and drag your entire treatment notes on to today’s patient record. This takes time to create and it’s worth every minute you spend because once done, there will seldom be a time that any other notation will be required. This can save at least 10 minutes every time you or your hygienist see a patient. NOTE: Make sure you have the current copy of Charles Blair’s Coding with Confidence. Great for speeding up coding at the front desk but also the descriptors used for each procedure have passed the test of time to become the perfect description for that procedure in any court of law or insurance company review process. Do this and you should have an increase of 5-7% in reimbursement for treatment. You must have informed consent with every treatment so make sure you use the legal description in your treatment notes as well as a signed informed consent: “I have given the patient the advantages, disadvantages, risks, and alternatives to treatment and the patient has requested us to proceed with the treatment”. Here is the short list of needed documentation to have in every patient record: Blood pressure on every patient, every time; informed consent; notation of “no change in medical history”; number of carpules and type used; teeth numbers; description of the treatment; notation that you gave the patient written and oral post-operative instructions; and finally a statement that the patient “tolerated the procedure well”. Failure to document guarantees years of emotional upheaval and weeks of litigation in a court of law. This is a huge time savings when you consider that if it is not in the record, it never happened.
Each tip adds up and each minute saved creates dollars in the availability to perform more procedures. This is how you Summit.
Michael Abernathy, DDS
PS. If you’re thinking that that these saved minutes don’t really amount to much and aren’t all that valuable, consider this: If you saved just 10 minutes per day this year, and you work 200 days this year, that adds up to 2000 minutes. Do the quick and simple math and you will discover that comes to 33.33 hours. Multiply that times your average hourly production to see how much extra you get to put in your pocket this year. Or just take an extra week off! It’s your choice. (MG)