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946: Metric Mondays: Perio Diagnostic Percentage and Perio Acceptance Percentage – Miranda Beeson

How do you know if you're serving your patients well? In this episode, Kirk Behrendt brings back Miranda Beeson, ACT’s director of education, to share two metrics that will help both your patients and your practice get healthy. To learn more about perio diagnostic percentage, perio acceptance percentage, and how to improve these numbers, listen to Episode 946 of The Best Practices Show!

 

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Episode Resources:

Main Takeaways:

  • Align your team on what healthy looks like.
  • Clearly define your optimal standards of care.
  • Calibrate on what to do when patients aren't healthy.
  • Be aligned on how you present information to patients.
  • Build trust and value for your patients to increase acceptance.
  • Patients invested in periodontal health will explore restorative health.

Quotes:

“With these particular metrics, the most important thing to remember is that we're trying to make sure that we're serving our patients well. Ultimately, the revenue, the productivity, the profitability will come when we're taking really good care of people. So, this is a really important thing to remember when we talk about these numbers because it can get really personal for hygienists.” (3:06—3:25) -Miranda

“When we think about these particular metrics, we're realizing and recognizing that we're serving our patient population and we have to look at, what does the general population look like when it comes to periodontal disease or people having active infection? What we know is that in the general population, people that are 30 and over, somewhere between 40% and 50% of the population have some form of gingivitis or periodontitis, active disease. Also, when we're looking at patients over 65, that [percentage] goes up even higher, sometimes into the 60s. So, if in our practice we're primarily doing preventative care, we likely are missing the mark on helping some of our patients who may have some early signs of disease that we need to help manage. In turn, when we're doing that and we see these numbers improve, our revenue is going to improve, our profitability is going to improve, and our schedule maintenance improves.” (3:26—4:26) -Miranda

“Everything gets better when we're taking better care of people. So, that's where this really stems from, is making sure that you understand, as the doctor or the practice owner, how hygiene can contribute to the profitability of the practice in a positive way. It's important for hygienists to understand how hygiene and our perio protocols can contribute to the revenue of the practice because you're also looking to add that value and be compensated in return. Also, it's really important because we always want to make sure that we're giving that optimal standard of care to the patients that choose to come and see us every day.” (4:27—5:04) -Miranda

“Perio diagnostic percentage, or if you have Dental Intel, it might say perio presented percentage — same difference. So, in Dental Intelligence, who we primarily use, it's going to be people over 30. If you're tracking this in your practice management software, you may not have that age parameter. But it's measuring how many adult hygiene patients that you've seen were diagnosed with periodontal disease relative to the number of patients seen. So, for example, if you saw ten patients as a hygienist today and three were presented with 4000 codes, such as 4355 full-mouth debridement, or 4346 gingivitis therapy, or perhaps scaling and root planing codes, the 4341, 4342, you can even include 6081 for implantitis. How many of those were presented with new treatment around those 4000 or perio codes? So, say three of them were out of the ten. Then, for that day, my perio diagnostic percentage would be 30%. We’re usually looking at a week or a months’ time and we’re saying, out of the number of hygiene visits performed, what percentage did we identify, diagnose, and treatment plan some form of periodontal help or therapy for our patients?” (5:11—6:37) -Miranda

“Perio acceptance percentage takes it to the next level and lets us know, it's great if we diagnose it, but how do we know if we're building value? Are people moving forward? So, that's going to help us measure the percentage of patients that were diagnosed or presented with that treatment who actually accepted the treatment. In that same example, if we had seen the ten patients, three were presented with treatment, we were at 30% diagnostic percentage. If all three say yes and schedule even just their first quadrant of therapy before they leave the practice, then we're at 100% acceptance. So, we're looking at, number one, how much are we diagnosing? Then, from that, how much value are we building and people are saying yes and moving forward with that treatment?” (6:42—7:27) -Miranda

“When you have high diagnostic rates, it's showing that you're identifying and documenting disease rather than defaulting to the routine prophy concept. A lot of times, it comes down to time. I know you say all the time we're serving champagne but charging for water. In most cases, we're busy, we're on the hamster wheel, we're going through the motions, and we don't have time to go through all of this. So, we're just like, ‘I'm going to clean you up. Work harder next time. Floss a little better. Maybe we'll see you in three months.’ But instead, if we stop and if we have these high rates, we know we're looking and aligning around what is healthy in our practice. If it's not healthy, what is it? What are we doing about it?” (7:34—8:14) -Miranda

“If our acceptance rates are high, then we know that we're building trust with our patients. We're doing a really good job of creating value, probably a little bit of co-discovery, helping them to own a bit of that disease for themselves versus us wanting it more than they do, helping them to understand the importance of this therapy. So, strong performance here is going to lead to healthier patients. It's going to lead to improved long-term retention, increased hygiene revenue, and then, ultimately, practice revenue because what we know is that when patients take care of their periodontal health and they're really invested in the outcomes around their periodontal health, they start to think about and explore restorative health as well. So, over time, that revenue continues to build.” (8:15—9:03) -Miranda

“Low numbers might point to underdiagnosis, incomplete exams, or gaps between education and patient communication. The biggest factor around that tends to stem from, how are we setting ourselves up for success when we're doing the evaluation? If we are leaning our patient back, we're probing, we're recording, and we're muttering to ourselves and typing things in the computer but we're not really having a full conversation to bring our patient in as an active participant in that exam, and then afterwards we're just telling them our findings and what we think they should do, there's going to be a whole lot different level of patient acceptance than if we are explaining to the patient, ‘Here's what's about to happen. Here's what I'd love for you to do while I'm completing this exam. Listen for these things. Feel for these things,’ and then giving them the opportunity when that exam is over to share what they heard, share what they felt, and be an active participant in the conversation around identifying and diagnosing the disease. You're going to have more people say yes. Then, we're going to have these acceptance rates and diagnostic rates going up over time.” (9:04—10:12) -Miranda

“Case acceptance starts chairside in the back. So, as a team, there are some things you can do to make sure that that's more likely to occur. Number one is defining your optimal standards of care. You have to align as a team. Doctors and hygienists have to align around what we consider to be the optimal standard of care, how often we're recording their periodontal health and evaluating it, and what we are recording and evaluating. I cannot tell you the number of times I look at perio charts, and it's pocket depths, bleeding points, and that's it. So, we need to be looking at the whole picture: pocket depths, recession, furcation, mobility, bleeding points recorded at least annually in the practice, and then honestly spot-checking visit by visit just to make sure that there are no changes.” (11:49—12:37) -Miranda

“You have to make sure everyone is aligned on, how do we present this information? How do we use patient-friendly language and visuals? How are we building value throughout that conversation so that we're actively participating in a conversation with them and not just talking at our patients? A real simple go-to question is, ‘What is your understanding of periodontal disease?’ and giving the patient the ability to share with you what they know or don't know versus you making any assumptions about where you need to start this education process with your patient.” (12:56—13:29) -Miranda

“Let's all calibrate and align and standardize on one super, super simple thing, which is, what does healthy look like? If we can all agree that somebody with a healthy periodontium looks like this: it's usually pink, tight tissue, less than ten bleeding points, minimal attachment loss, if any. Every practice has some slight variable, but it's very common that it ends up — because there are AAP classifications for what healthy is. So, we need to reference the evidence and then align as a team on, ‘When we see a patient in our chair that looks like this, it means they're healthy,’ because the next step is, if that's not what it is, it's something else, and what do we do about it?” (14:48—15:31) -Miranda

Snippets:

0:00 Introduction.

2:46 Why this is an important topic.

5:04 Perio diagnostic percentage and perio acceptance percentage, explained.

7:28 How these percentages impact the practice.

10:13 Healthy ranges and how to impact this metric.

13:30 Align on what healthy looks like.

15:52 ACT’s BPA.

Miranda Beeson, MS, BSDH Bio:

Miranda Beeson 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.
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