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The Dental Assistant As Patient Care Coordinator

Posted Apr 09 2009 7:14pm


The following is an article that I had published in the now closed Contemporary Dental Assisting magazine.  I've had a few e-mails lately asking about the PCC position.  I thought I'd run it here in case any of you are looking at this position for your practice.  I will be speaking on this subject at the Florida National Dental Convention in Orlando in June.

The Dental Assistant As Patient Care Coordinator

Clinical dental assisting has been around a long time and is gradually evolving into a profession that is dynamic and multifaceted. When I started assisting in 1976, there was little for the assistant to do except set up and clean rooms, take radiographs, and provide suction. Dentists that I worked with did not generally ask my opinion, expect me to understand the procedures I was assisting with, or think that there was an opportunity for growth within the profession. As a matter of fact, I don't know if I or they considered dental assisting a profession.

Fast-forward to today and dental assistants know and understand a wide variety of procedures and materials, and must be able to discuss those procedures with patients and help them understand how the proposed treatment can benefit them. We are human behavior specialists who need to be able to read the dentist's mood on any given day and respond accordingly. We have to understand that patients act in certain, sometimes unusual, ways when they are stressed and fearful, as they often are in the dental office. We must be able to reassure the patient and help turn their fear into confidence in our skills and care for their well-being. Behind the scenes we keep the equipment maintained, the supplies stocked, and the office immaculate. What else could there be?

A new and exciting step for an experienced, well-trained, enthusiastic dental assistant is to become a patient care coordinator (PCC). This position offers the practice the ability to extend even greater services to their patients. The PCC escorts the new patient into the practice and is their advocate thereafter. The position can be infinitely satisfying for a person who can get genuine gratification from having a positive impact on the patient. The PCC lets patients know that they are viewed as unique individuals and will be cared for as such. The PCC is also available to patients whenever they have questions or concerns about the proposed treatment or even about financial considerations. Finally, the PCC dedicates his or her time and resources to working with patients to help alleviate any fears, concerns, or misconceptions they have about their treatment. The PCC is the icing on the cake and let's face it—what's a cake without the icing?

The PCC is also a great adjunct to the dentist. He or she is able to step in and take over with sensitivity at a certain point in the dental process, allowing the dentist to go on practicing dentistry.

Which scenario sounds better? A dentist is stretched for time. He or she has to check up on hygiene, inject the patient in room one, and finish the composite in room two. Now the dentist has to explain a complicated, lengthy treatment plan as quickly as possible. Enter the PCC whose time is dedicated to helping the patient understand the treatment that is recommended and why it is needed. The PCC can do what the dentist might wish he or she had the time to do.

Progressive dentists are identifying people they know and trust to handle this important aspect of patient care.

PCC and Patient Interaction
What a PCC does exactly will probably vary according to the practice. The following is an example of how things work in our office. When the new patient arrives in the office he or she is immediately greeted by name by the receptionist, who then brings the patient's file to me. After reviewing the file, I greet the patient in the reception area and invite him or her into my office for a preclinical visit. In my opinion, this is one of the most important steps. It gives me a chance to get to know the patient and the patient to get to know and trust me and the practice team.

I begin by asking open-ended questions about the patient. I also tell him or her about myself, the dentist, the staff, and the practice. I ask about any good and bad experiences the patient has had in dentistry and what we can do to help. We spend anywhere from 15 to 20 minutes on this part of the visit.

A few times it became apparent during this step that our practice was not the right choice for a particular patient. Using the right questions and giving the pertinent information about the way we care for our patients, I can help the patient come to the understanding that he or she might want to continue searching to find a practice that fits his or her particular needs. For example, our practice is prevention oriented with an emphasis on restorative dentistry. If during the preclinical phase of the initial visit it becomes clear that the patient is really only interested in being seen on an emergency basis and has no interest in being active in our recall system, then we are probably not the right practice. When I see this, I will explain to the patient that we do expect our patients to come in for regular prophies and exams. We will usually agree that it would be better for the patient to find dental care that better suits his or her individual desires. This saves the patient, the dentist, and the staff a lot of frustration.

It is important to understand that you are not just giving the patient the impression that you care about him or her, you must truly care or the impression won't last long.

Once we have completed the preclinical interview, I accompany the patient to the operatory. I then proceed to chart existing conditions. This provides a great opportunity to educate the patient about his or her present oral health. By explaining what I am seeing and how it can affect him or her and explaining the treatment options available, the patient is better able to understand the dentist's diagnosis and treatment recommendations.

Once I have finished charting existing conditions and have made notes about what I see, I will talk to the dentist for a few minutes and relate the patient's goals for his or her oral health, fears and anxieties if any, and past dental experiences, good and bad. I also will be sure to let the dentist know what conditions I have mentioned to the patient while charting. The dentist then goes in, spends some time getting to know the patient, and proceeds with the exam.

This is where the importance of a well-trained PCC is evident. While carrying out the exam, the dentist will be bringing up areas of concern that have already been introduced by the PCC. This reinforces the patient's confidence in the practice and the diagnosis. The patient has already had time to absorb some of the information and has started the process of accepting that treatment is needed. Now the patient is more receptive to the dentist's recommendations because time has been spent carefully and thoroughly explaining the conditions and options.

Next, I will take the necessary radiographs, study models, and diagnostic photos as prescribed by the dentist. If the treatment plan is limited, I can go over fees with the patient at that time. If the treatment plan is lengthier, the patient will be recalled for a consultation.

After I complete the comprehensive exam, the dentist and I review the findings together and organize a treatment plan. I will then prepare a review of the findings and print out x-rays and information sheets pertinent to the treatment being proposed. I also will be ready to suggest a few payment options. By the time the patient returns for the consultation, I am prepared to discuss and explain the needed treatment. I have time to answer questions patiently and continue to educate the patient about his or her oral health.

There are many creative options that I can suggest to help the patient find a way to afford the necessary treatment. Once the patient decides to begin treatment, I help schedule a series of appointments, help track everything, and remain available at any time.

Making a Difference
There is great satisfaction in being a PCC. You have a major impact on the patients you serve, the dentist, and the practice. You are not only a caregiver, you become an educator. Most patients tell me that they have never had such a thorough exam. I get to know the patients and understand them. Then I can share what I learn with the rest of the team. I am using all the skill and knowledge I have developed over years of assisting in a new and interesting way that benefits our practice and patients. I still assist clinically, too, so I truly believe I have the best of both worlds. There is definitely a place for a PCC in any practice that wants to provide excellent service and satisfaction to their patients. It requires an educated, experienced, caring, and dedicated person who is confident in his or her abilities and wants to take a new professional direction. You can have a new opportunity to make a difference.


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