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703: The Profitable Hygiene Equation: Optimizing Workflow Services for Success – Miranda Beeson & Courtney Dalton

Written by ACT Dental Team | Mar 11, 2024 8:00:00 AM

Are your hygienists always running out of time? If they are, it’s not them — it’s your systems that need improvement! To help you optimize the hygiene workflow so you can be more profitable, Kirk Behrendt brings back Miranda Beeson and Courtney Dalton, two of ACT’s amazing coaches (and excellent hygienists), with a framework for making those 60 minutes more efficient. To learn the strategies to make your day flow smoother, listen to Episode 703 of The Best Practices Show!

Learn More About Miranda and Courtney:

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Episode Resources:

Main Takeaways:

  • Implement the 20-20-20 concept.
  • Prepare ahead to make appointments efficient.
  • Set clear “connection time” expectations with patients.
  • Be aware of your patient’s personality and communication styles.
  • Keep patients engaged through co-discovery to get them on board faster.
  • Utilize technology, such as imaging and AI recording software, to your advantage.
  • Perform a time analysis to determine which of your 20-20-20 needs improvement.

Quotes:

“Time is the new rich, and time is a hot commodity in the hygiene world.” (8:51—8:57) -Miranda

“When we look at work-life balance, not having enough time in our schedule or feeling like we are impacted by the clock does impact our work-life happiness, and that balance, and that burnout factor in the office — and physical pain. Ergonomics is a big topic in the world of hygiene. A physical repetitive stress injury is what took me out of clinical hygiene, so this one hit home for me. We put our bodies through a lot as hygienists. When we don't have the structure and the efficiency within our workday, and we don't have enough time within our schedule, and we don't use that time well, that physical pain is going to impact us to a greater degree as well.” (11:21—12:01) -Miranda

“The first strategy to help [the first] segment of the appointment be more efficient is preparation. Preparation, preparation, preparation. The more prepared we are, the more successful that flow will be in the first 20 minutes. One thing in particular is chart prep. I can't express enough how important taking a look — I like to say the day prior — and being prepared for the day to come the next day and then having that information at huddle.” (18:26—18:56) -Miranda

“I do also [like collecting patient information the day before]. It's one of those tasks that we add to the end of the day checklist so that you can come in a few minutes prior to when your huddle starts, turn your op on, get the sterilization area rolling, do the things you need to do to prep your room, and then be present for huddle. So, you're bringing all this valuable information with you. Is there unscheduled treatment? Are there perio concerns? Did they have a specialist visit sometime in between now and the last visit? These are things that you want to bring to the doctor's attention so that your day flows as smoothly as possible.” (19:05—19:42) -Courtney

“The more that you're prepared the day prior for what's to come, and then sharing that amongst the entire team at morning huddle, the more efficient your day will flow.” (19:54—20:04) -Miranda

“Make sure that we have our equipment prepared. If I know, like we've done our chart prep, I have three patients who need a full-mouth series of X-rays tomorrow, I'm going to make sure that I have a sensor prepared and ready. If you have a NOMAD and you need to make sure that's near or in your room, you can talk about that at huddle too. What if you're sharing one NOMAD amongst three hygienists or five team members? You can work out the kinks of how you might get tripped up with your radiographs if you're all fighting over the NOMAD . . . Having your Rinn in your room, laid out and ready to go. If you're taking photos, do you have your mirror? Do you have your camera? Being as prepared as possible with your equipment rather than having to leave the room multiple times throughout the appointment, because that does take time and decreases our efficiency.” (20:06—20:54) -Miranda

“Same thing with our room inventory and stocking, taking a look. Again, it’s part of your checklist, either in the morning or in the afternoon. Or maybe it's your midday checklist of like, ‘Let me look in my drawers. Let me make sure I have everything that I need.’ If I know I'm doing sealants the next day because of my chart prep, do I have sealant material here in my op? Do I have the dry angles? Do I have everything that I'm going to need?’ Making sure that you keep a nice, consistent inventory in your operatory so that you're not having to come and go, and come and go, because that can break up the appointment and you can reduce some of that efficiency.” (20:55—21:26) -Miranda

“A new patient visit is going to be quite different, and oftentimes an office does have additional time worked into the schedule. Or you might have 60 minutes, but you also have 30 or 60 minutes carved out with your doctor for part of this. So, we're really speaking more to the periodontal maintenance, the prophy recare visit, during this webinar when we're talking about this 20-20-20. So, you may be updating your X-rays this visit, and the next time the patient comes in, I'm going to do that full periodontal recording. Now, I would still say, for your periodontal maintenance patients, we still want to spot probe. We want to be checking each time they come in. But if we took extraoral photos today with our 35-millimeter camera, next time we're taking intraoral photos, maybe just a couple of them to touch up and see a comparison. So, you don't have to do all of these things each time. And in your preparation, ‘What did I do last time? Oh, I did some intraoral photos last time. What am I going to do this time so we're not having to feel backlogged by catching up on everything all at once?’” (21:35—22:35) -Miranda

“Most of us in dental hygiene have — we talk about DiSC a lot — that S or I personality style where we do like people, and we want to have connections. And so, it's really easy to get lost in that. But chatty patients, no problem. We have a couple of strategies that can help you out. The first one is you want to give time expectations for catching up at the start of the appointment, especially if it's a patient that you know is chatty — someone that you love. We could go have coffee, honestly. Like, do we need to do this right now? So, those are the people that when they come in, you want to say, ‘You know what? I can't wait to hear about your son's wedding. I'm sure it was fabulous. I have five minutes for us to just chat, and then we have to get rolling. But do you have pictures? Tell me what's going on.’ You set that time parameter so that at the end of five minutes, you can say, ‘Oh, gosh. Our five-minute catch-up time is up. But I'll tell you what. I'm going to go ahead and get started on your radiographs today, and you can keep filling me in as we go. We'll have a couple of little breaks here and there,’ and then you can get rolling with your appointment.” (23:20—24:20) -Miranda

“When you have that patient that loves to chat as soon as you know you have to leave their mouth, here's a little tidbit for you. Just start telling a story. Like, if you have to turn around to get another piece of equipment or change instruments — and you know those people that immediately start talking the second your hands aren't in their mouth — I'd be like, ‘Oh my gosh, I started a new series on Netflix. It's called such-and-such,’ and I'm just talking away while I'm getting the next thing ready.’” (24:35—25:02) -Miranda

“Sometimes, we don't think about what we can do. Sometimes, our brain goes to, ‘Well, I'm going to add on 15 minutes to this appointment because this patient is chatty,’ when actually, that's crushing our schedule. That's not making us efficient. That's decreasing our overall ability to see and take care of our patients when there's a better solution.” (25:10—25:31) -Courtney

“We also want to utilize technology to our advantage. So, we want to ensure that our cameras and scanners and equipment are up to date. They're integrated with our software. If there's calibration that needs to be done, we have a systematic approach to making sure that we're calibrating our equipment and using that technology day in and day out. Our practice management software is PMS. That's what that stands for. So, your Dentrix, your Eaglesoft, your Open Dental, your Curve, most of them have templates for recording chart information. So, if you have a predetermined auto template set up for the health history and the systemic health data collection, it helps to make your notetaking more efficient throughout the appointment because you can, in that moment, just check the box, fill in the gap, check the box, fill in the gap. It leaves you from sitting at the end of the day having 20 minutes of paragraph that we have to write out about what we talked about and what data we gathered during that part of the appointment.” (25:48—26:43) -Miranda

“We can also use voice recorded or assisted perio charting. This is something that some people absolutely love, and other people feel like it slows them down a little bit if you have a good flow for your charting. But when you are having to chart furcation involvement, separation, recession, bleeding points — if it's more than just the pocket depth, it can be really helpful to have either voice recorded or . . . an assistant that, again, at the morning huddle knows, ‘I have a challenging perio patient today. I'm going to need some help recording my perio chart.’ That can help to make that timeframe more efficient when we're gathering that periodontal data.” (26:43—27:23) -Miranda

“Even if you're the only person in the room that's recording them, if you are not saying your numbers out loud so your patient can hear you, you are missing out on a huge open door to the periodontal health conversation.” (27:32—27:44) -Courtney

“One of my favorite things to tell a patient is, ‘We're going to be doing your periodontal evaluation. Now, what that means is we're checking the health of your gums and your bone, and I would like you to be a part of this. So, I'm going to be calling out some numbers, and they mean this. Your job, while I'm doing this, is to listen to the numbers that I'm saying out loud. And you have one other job. That is to feel for anything that's tender or uncomfortable, because if something is tender or uncomfortable, that means there's infection, more than likely. So, two jobs for you while we're doing this. Listen for the numbers, and feel for any discomfort,’ because otherwise they're just laying there thinking like, ‘She's stabbing me.’” (27:46—28:23) -Miranda

“The other thing is, from a technology standpoint, setting up efficient perio charting flow. So, each practice management software, you can also set up the flow in which you want to record that data. I have my own flow. I always started in the upper right on the buccal and worked my way around and came from the lingual. Everyone has a flow that they feel more efficient in charting. So, set up your software to mimic that flow. That's going to help for you to have a good rhythm when you're documenting those periodontal data numbers.” (28:46—29:17) -Miranda

“The next thing around the diagnostic segment is intentional patient communication. So, what teams will often share, things that we observe — and I've observed it my own self and really struggled with this early on in my hygiene career in the first probably five or six years, was I have so much information that I have to share with this patient. And that can take so much time. But if we're really intentional about the way we communicate with our patients, we can trim that time down and still get our message across. I would actually argue that the message would be received even better than that information dump.” (29:18—29:55) -Miranda

“[Co-discovery] means learning together with your patient. So, the co-discovery process is sharing what you're doing as you go. We just gave an example of that when we were talking about, ‘Listen for this. Feel for that. I'm going to be doing this.’ If you do that before you even start perio charting, when they sit back up and that assessment is over, you don't have to go into this giant long spiel and try to get their engagement when they're diagnosing themselves. All you have to say is, ‘You were listening for this, and you were feeling for that. Tell me your thoughts on what you heard and what you felt,’ and they're already putting themselves into that co-discovery diagnosis process because they were a part of it from the beginning.” (30:02—30:47) -Miranda

“How often do you start [perio charting] and then not tell them, ‘This is what I'm doing’? So, three, two, three. Three, two, three. Seven. These are numbers, and if you don't tell them what they mean, they're not along for the ride. So, when you tell them why they have periodontal disease and what you can do to help them control it, it doesn't resound as well as it could have had you brought them along on the journey with you.” (30:59—31:24) -Courtney

“When you ask [patients], ‘What concerns you about what you heard or what you felt?’ they're going to say, ‘Well, it was definitely uncomfortable, mostly in the back. It didn't bother me so much in the front.’ ‘Okay. Well, remember we talked about if it's uncomfortable, there may be some infections? So, I'm going to take a look. Is it okay if I see that to share that with you? Let's look at it together with a mirror. Let's look at your image. What about those numbers?’ ‘Well, you said fours, fives, sixes, and I did hear that a couple of times. Am I losing my bone?’ Now, they're engaged. They're interested because they've been a part of that process, and we don't have to fight as hard or for as long to get them to come along on that journey with us.” (31:25—32:01) -Miranda

“[Use] imaging to speak for us. Intraoral photos are amazing. Really orienting your patient to their X-rays is great. Like, ‘Hey, I'm going to pull up your X-rays.’ And what does everybody say that X-rays look like? Toes! I think that I heard the chat just shout that out loud. So many patients just see toes, so they don't know what we're pointing at and what we're talking about. So, if we can orient them like, ‘I'm going to be taking a look at your X-rays. These white areas here are healthy. If there's a gray spot in this white area, that's something I'm going to stop and talk to you about. Here's your bone.’ Let them know what it is that you're looking at. They're not going to become a hygienist overnight because of your brief introduction, but they're going to be more engaged as you're looking through those X-rays.” (32:05—32:55) -Miranda

“Communicating in the patient's style is huge. If you're a C-style person and your general method of communication is to give a lot of detail and information because you need that to make a decision, not everyone does. So, you could be wasting tons of time during your appointment if you have maybe a D-style patient in the chair or an I-style patient in the chair. If you don't know what I'm talking about, look up DiSC. I'm sure we have it within the BPA on several videos. We talk about it all the time. It's four behavioral styles, communication styles. D-style people and I-style people tend to be a bit more urgent in their decision-making. They really don't need as much information. And so, if you're spending a ton of time going over statistical analysis and success rates and research papers and giving them literature, they could have already been on board like 15 minutes ago and didn't even need that information.” (33:54—34:49) -Miranda

“I love leaving X-rays on the screen. I love leaving a great intraoral photo like a ledge on the lower anterior of calculus, or a fractured tooth, or a broken old amalgam or something, and [patients] can see it for themselves after you've reviewed it with them in their style. Because I think across any style, you could just have the picture up and let the patient tell you what they see. And just by that dialogue — and again, if this is a patient you've seen for a long time, you know their preferences. You can feel them out pretty well. But you can have that conversation, let them drive it in their style while they are buying in because they're finding all of this information about themselves with you at the same time.” (35:10—35:55) -Courtney

“I love having an image up. When we do that chart prep, if I know that last time they were here we talked about a crown on number three because there was an older amalgam with fracture lines, I'm going to have that image up. As soon as they come in the operatory, it's already there, ready to go. I don't have to say a word. They're going to ask me, ‘Is that my tooth?’ And then, this last tip we have here about asking open-ended questions, then all you have to say is like, ‘That is your tooth. What concerns you about that?’ and let that open-ended question land and give them the space to tell you if they're concerned about it or not, and what questions they have. And now, you're not having to force that information upon them. They're asking for it and giving you their permission.” (35:58—36:36) -Miranda

“I always say patients are not information receptacles. And vulnerable moment — as a young hygienist, that was a mistake that I made. I came out of hygiene school like, ‘I'm top of my class. I know what I need to teach people. I've got all this education. Let's go!’ And people didn't want to hear it the way that I thought they would. And then, I felt like no one listens. You get a little beat down as a hygienist, and you start to feel like, ‘What am I even doing? No one even does what I asked them to do. I want it more than my patients.’ But if we stop for a minute and shift the way that we're presenting that information, not only does it make things more efficient within that 20-minute segment, it also does help to fulfill you as a provider because you start to see change in people and you start to see them owning their own disease, and it really does shift that mindset of beating your head against the wall day after day and not getting anywhere.” (38:12—39:07) -Miranda

“For me, I think 75% of the appointment should be health conversation, and 25% of the appointment is that personal connection and relationship building. What I have noticed in my own personal experience early on and working with other hygienists, and now as a coach, is a lot of the times when we're running behind, we're skewing this statistic a little bit and we're having a lot of personal conversation throughout the appointment that then makes us rush through having to get into the health-centered conversation. So, I like to say if you have it in your mindset about 75% clinical health-centered conversation, 25% personal relationship building, and if that swaps, that's when we start to lose some of our value as hygienists and we're not healthcare providers to those people so much anymore. It's more like that nail salon visit or that hair visit where you're chatting and getting a service done versus we really want them to see us as oral health therapists. We're healthcare providers, so we have to speak healthcare language the bulk of our appointment time.” (40:30—41:33) -Miranda

“[The therapeutic] segment of the appointment is where the therapeutic or the “cleaning” services happen. So, when we're looking at that, this is our working segment. I like to say this is minimal communication and conversation during this middle 20 minutes because we're getting down to business. It doesn't mean you're not going to speak at all during the middle 20 minutes of your appointment, but this is our working segment. We've done a lot of conversation, diagnostic co-discovery, and now we're going to get to business and we're going to take care of the pathogens that are present in this patient's mouth.” (41:37—42:07) -Miranda

“Are you giving away champagne but charging for water? So, how often are we providing services beyond the real diagnosis? So, making a proper diagnosis is going to help with time management. What does health truly look like? As a hygiene team or as a hygienist, if you're a solo hygiene practitioner in your practice, really define and document what health and maintenance looks like. And if there's something beyond that sitting in your chair, we might need to think about diagnosing and treatment planning an additional service, and maybe that's why this segment of our appointment is running long.” (42:44—43:24) -Miranda

“Isn't the most important thing that we can give [patients] the education and the tools to understand why the health of their mouth is so important and why we need to take a different course of action?” (44:17—44:26) -Courtney

“Sometimes people will say, ‘Okay. Well, what if I don't have time to start periodontal therapy today, but I know they need periodontal therapy? I need to get that prophy done. I need the production.’ We're going to be getting like four times the production next week and the week after when they're coming in for their periodontal therapy. So, that's going to come. And the other thing to think about is when we're providing those periodontal services and we've built that value and the patient is invested in their health, they're also going to be providing more restorative services for us long term because they're bought into wanting to be healthier and have a better oral health outcome. So, step number one is do away with the bloody prophies. We need to look at what's actually happening in our patient's mouth in our chair, define what's health, and then make the appropriate diagnosis. Is a prophy appropriate? If not, is it gingivitis therapy that this patient really needs?” (44:27—45:19) -Miranda

“One of the first assessments you can do is run a report on how many of these codes we're running. If our perio percentage is pretty low and we're mostly doing 1110s in our practice, maybe there's something else going on there and that's what's holding us back on time. If it's taking more than this 20-minute segment for your therapeutic services, the question you would ask yourself is, ‘Is there something more going on that I should be doing?’” (45:41—46:03) -Miranda

“Why [is] the 20-20-20 so great? Because it's a framework. It's saying you should be able to gather all your diagnostic in 20. You should be able to do your therapeutic in 20. So, if you're going over that 20, either there's too much chitchat, or you're giving away services and you're misdiagnosing. That's where the opportunity is.” (46:05—46:24) -Courtney

“Another way to make things more efficient is through our workflow. So, I would say consider biofilm removal first, polishing first. I was introduced to this concept early on in my career, which I'm super grateful for. The way I always explained it to patients was sweeping before you mop. And if it was a gentleman who says, ‘I don't mop,’ I'd say, ‘No problem. It's like washing your car before you wax it.’ What I often get pushback on with this is like, ‘Patients are used to having that at the end.’ No problem. If we can explain the methodology and why, ‘So that we can remove the loose debris and get that out of the way so we can really focus on those hard deposits, the things that are really causing your infection, we're going to go ahead and do this first. It's just like sweeping before you mop.’ And if you've never tried it, I say give it a try. Try something new. It can be a total game changer.” (46:29—47:21) -Miranda

“The other thing to think about is our mechanical instrumentation versus our hand instrumentation. Most of us in the hygiene world know Ms. Esther Wilkins and years ago recommended the 80-20 rule because research was starting to show us that mechanical instrumentation — your Cavitron, your Piezo — provides a more effective calculus removal and that water lavage, biofilm disruption. It also results in more efficient workflow. And so, if 80% of the time we're working with mechanical instrumentation and then 20% of the time hand instrumentation, we're going to have a more efficient therapeutic segment of our appointment.” (47:49—48:25) -Miranda

“Gone are the days of needing to create this glassy surface around every single tooth with our hand instruments. If we can provide that general hard deposit removal, calculus removal, biofilm disruption with our mechanical instrumentation for approximately 80% of the time that we're scaling and then provide some selective hand scaling, this flow is going to result in a more efficient workflow during this therapeutic segment.” (48:46—49:12) -Miranda

“[Polishing first] was not introduced to me when I first started. So, I was among the group that thought, ‘That's weird. I can't. That's the way we've always done it. I can't switch.’ And it was a total game changer to remove all the soft everything first and really home in on where you have to go. I love it. I understand the hesitation, but just do it. Just try. Just do it on one patient. You're going to love it.” (49:17—49:43) -Courtney

“The other piece of this is making sure that the instruments that you're using are effective. So, make sure that you're checking your mechanical instrumentation tips regularly. With our Cavitron, we get those little cards that have all the tips with the angles. How often do we actually stop and use that? Now, I know you're going to say, hygienists out there, like, ‘Yeah, but do you know how hard it is for me to get my doctor to buy me new Cavitron tips?’ Well, guess what? If you're running behind and creating production hiccups within the schedule on a regular basis and all it takes is an extra Cavitron tip to help get that back on track, this is the conversation that you can have with your provider, is making sure that those tips are assessed regularly and that we're getting the most out of their working action. Sharpening our hand instruments. We do have to take the time. We have to carve it intentionally . . . to make sure that we’re doing that. Otherwise, we are going to be less effective in our therapeutic segment. We’ll take more time.” (50:03—50:59) -Miranda

“Don't settle into, ‘That's the way we've always done it.’ I remember challenging a client and saying, ‘But why do you do that?’ And then, she would answer. And I said, ‘But why do you do that?’ And then, she would answer. ‘But why do you do that?’ ‘Well, because that's how I was trained to do it.’ And I'm like, ‘And when did you graduate?’ So, I graduated 20 years ago in 2003. I'm not practicing chairside anymore, but if I was doing things the same way as when I was in school — things change in 20 years. Things change in 10 years. Things change in five years. I like to always relate it to this. Think about having kids, for those of you who have kids. If you have a 10-year-old, and then you have a baby, that's a whole new experience of having a baby. Things change a lot in terms of what foods we're supposed to introduce, what products are appropriate, and what vaccination schedule is in place now. So, when we think about how much things change and how resistant we are in the dental community, we've got to sometimes switch and relate it to things that we're more familiar with to say like, ‘Maybe I do need to try something new.’” (51:16—52:15) -Miranda

“The last segment of the appointment, the last 20 minutes, [is] our logistics segment. So, this is the segment where the logistics are completed. We want to ensure that the appointment is concluded properly. We want to summarize and create clarity with our patient. We also want to make sure that the tangibles are done within our practice management software, and all of the communication amongst the team members is done well. So, this typically involves the doctor’s exam. Now, I don't have an asterisk here, but asterisk. We did mention this might have happened in that middle 20 minutes if your doctor came in and interrupted because you let him know that you were all set with diagnostics. And so, we just share that five minutes of the exam back with the other segment of time. But typically, it's going to fall within this last 20 minutes.” (52:18—53:02) -Miranda

“A lot of times, what ends up happening is we sit through our whole lunch break doing chart notes, and then we sit for 35 minutes at the end of the day doing chart notes. And our chart notes have to get done that day. Legally, we should have them done within the same day of treatment. And honestly, our brains, by the next day — we're already into the next working day, and now it's the next day's lunch before we're doing the chart notes from yesterday, and we forget things and we're not going to be as clear in our documentation. So, I challenge you to think of the 60-minute time is about 50 to 52 minutes of patient care. That's going to, more often, get you walking out the door by at least 52 after and headed up front so you have time to do your chart notes and your room turnover. I've done this, so I know it can work. I'm just going to throw that out there. Systems are the key, though. If we don't systemize things, then these last 20 minutes can get crazy out of hand, and then we're just rushing, rushing, rushing like crazy.” (54:29—55:25) -Miranda

“[It’s important to] have a handoff system or a PIT Stop for our admin team so that when we’re walking out, we’re sharing with them what procedures did we complete today, what are we scheduling next, and what's the financial investment for the procedure. The patient is going to want to know what that's all about, and also how much time is needed. So, we want to make sure we stop at the front and have a very systemized handoff as well, just like we do with our doctor. This isn't just for the efficiency of the office. It's also for the patient to be able to hear repetitively, what did we do today? What value did it add? What are we doing next time? How is that going to help them meet their goals? What are their objections? Are they concerned about time? Are they concerned about cost? And now, your admin team is set up for success to be able to take that patient off your hands and give you the opportunity to head back into your room and take care of business.” (57:36—58:22) -Miranda

“If you do find that you're unsure that you're following this 20-20-20 well or, ‘I do run behind pretty often,’ or, ‘I don't have time to do my chart notes and turn my room over on a regular basis,’ I would encourage you to do a time analysis. A really simple, not super-structured but easy way to do it tomorrow if you wanted to is have a Post-it note for each of your appointments. It says 20-20-20. You stop at the end of the diagnostics and make a check mark if you were done within 20 minutes. Write down the time if you weren't. And then, that second 20 minutes, was I done with my hygiene therapy segment by 40 minutes after the hour? Check if you did it. Write down the time if you didn't. Same thing with the last part. Do that for one day and look at your Post-it notes. That's a non-scientific and easy way to jump into trying a little bit of this and seeing, where do I maybe miss the mark throughout my appointment?” (59:31—1:00:29) -Miranda

“A lot of times, we put the pressure on ourselves that like, ‘I failed in some way if I didn't hit the mark.’ No. You have systems that either aren't established, or need to be revised, or the system itself is just failing you right now. It's not you. It always comes down to the systems. So, be honest with yourself because then you're not going to look at your own self and say, ‘What am I doing wrong?’ No, no, no, no. What systems could we do differently? What technology could we incorporate? It's not about you. You're doing the best you can. I know that. It's, how can we systemize things to make things more efficient?” (1:01:22—1:01:55) -Miranda

“Perform a time analysis. Determine which segments might offer the most opportunity for improvement for you. Try new things. Don't let the way that you've always done it hold you back from trying something new. And maybe you just try, ‘You know what? My last two appointments of the day on Tuesday, I'm going to try that new workflow and I'm going to polish first, and I'm going to leave my hand scaler sitting there until I'm done with 80% of my instrumentation mechanically,’ and just see what happens and how you feel about that flow. Just try something new.” (1:01:59—1:02:27) -Miranda

“Remember that systems are the key to success. When your timing is off, it's time to evaluate your systems . . . It's not about you as a human being or a hygienist. It's about these systems and how can we make them work for us and help our technology to work for us to make things flow a little bit smoother.” (1:02:28—1:02:45) -Miranda

Snippets:

0:00 Introduction.

2:18 ACT’s To The Top Study Club.

5:15 ACT’s Best Practices Association.

7:17 Katrina Sanders’s hygiene course.

8:23 Why this is an important topic.

12:11 The 20-20-20 concept: The diagnostic segment.

18:26 Prepare in advance.

22:46 Set clear “connection time” expectations with patients.

25:48 Utilize technology to your advantage.

29:18 Be intentional with how you communicate with patients.

33:54 Communicate in the patient’s style.

36:15 Ask open-ended questions.

36:36 Too much information can annoy certain patients.

39:20 Other co-discovery tools.

40:12 The 75-25 rule, explained.

41:34 The 20-20-20 concept: The therapeutic segment.

46:27 The 80-20 rule of mechanical and hand instrumentation.

50:03 Make sure your instruments are effective.

51:12 Maybe it’s time to try something new.

52:16 The 20-20-20 concept: The logistics segment.

53:30 How to spend the last five to ten minutes.

56:44 Tips for getting your notes done.

58:39 Other systems to consider.

1:01:56 Final takeaways.

1:03:29 Q&A: How do you stay profitable while offering high pay?

1:05:23 Q&A: How to manage patients who take the full 60 minutes without the exam.

1:06:19 Q&A: Software recommendations to record probing.

Miranda Beeson, MS, BSDH Bio:

Miranda Beeson, MS, BSDH, has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.

Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.

Courtney Dalton, BS, RDH Bio:

Courtney Dalton is a Lead Practice Coach who focuses on establishing a solid foundation in order for a practice to thrive. With over 15 years of experience in the dental industry, she is as passionate about patient care as she is about those who are providing it.

Courtney has an A.S. in Dental Hygiene from Manor College and a B.S. in Exercise Physiology from West Virginia University. Outside of coaching, she enjoys teaching group exercise classes and spending time with her husband, Dan, and children, Lola and Levi.