Efficiency thinking

(2005)

Our minds can be trained to think slightly different, creating an environment in the clinic for improved clinical efficiency. It costs nothing to change the way your mind thinks! Some suggestions are:

  1. Doctor time is the most important asset in the clinic. Everything an assistant can do, the doctor does not, and he/she is free to provide another task that requires the higher knowledge and skill.
  2. Materials should be selected for each individual case to conserve Doctor time, not create more work to get the job done. For example, nickel-titanium alignment wires are known to be much more efficient of doctor time, as wire changes are reduced, although more expensive in the catalogue. It is cheaper to wash your clothes by hand, but using a washing machine frees you to have fun that day.
  3. Diagnose more so you can work less in the clinic.
  4. Doctor energy to complete a case is much more important than 24 months to complete the case. How many times does the doctor spend heaps of time at the “end” of the case to get the patient finished? Can this be avoided?
  5. Case fees should be consistent with the doctor energy needed to complete the job. 5-10 very efficient cases can be done with the same amount of doctor energy as one very difficult and inefficient case. Inefficiency can be caused by errors in diagnosis, the use of poor quality materials, and patient non-compliance. With fixed (low) fees, clinical efficiency improvements can generate the same amount of revenue as practices with high fees with the same amount of doctor energy. Patient source to any given practice is not equal.
  6. Appointment intervals need to be better managed to be more conservative of the time available in the dental chair (for another patient), and to be considerate of the patients’ time and energy to come to their appointments. Variable appointment intervals, depending upon the force activation, the range of activation, and the time for the tooth movement to be completed should determine the next appointment interval, NOT the “monthly” appointment!! Contractual agreements may need to be modified to account for this change.
  7. Less wire changes is beneficial to clinical efficiency, especially if a band or bracket comes loose in the process. Dental assistant time is important to efficiently service the volume of patients in the day.
  8. Less Bracket repositioning by obtaining the best position the first time (indirect bonding), avoiding the return to lighter archwires to realign, and moving the tooth to the final position in “one stroke”, is clinically efficient.
  9. Doctor has “nothing to do” at the adjustment visit except to evaluate, decide what needs to be done, what to do at the next visit, and what interval is appropriate should be an objective. If the doctor must “sit down” to work on the patient, then what is wrong that needs fixing? Can this be avoided in the diagnosis next time?

It should be emphasized that ALL of the above suggestions are said with the same “finish line” in mind. Each doctor will have his/her consistent place when the patient is “finished”, with improvements in the quality of finish always welcome by all.