A New paradigm in Doctor/Technician Communication
A New paradigm in Doctor/Technician Communication
I recently wrote an article for the Journal of the American Dental Association that will appear soon titled A New Paradigm in Doctor Lab Communications; Collaborative Agreements. Dentists who embrace a dialogue that is in their patientís best interest have a higher preponderance of restorative predictability and success. As laboratory technicians, we are encouraged and motivated by those who seek our consultative and professional skills. Being able to sit down with restorative dentists and work through a multitude of issues PRIOR to fabricating restorations yields a more fulfilling and rewarding partnership. The one page, checked box prescription form can still be a viable communication tool if it has been preceded by collaboration on appropriate fronts.
Like taxes, taking the time to understand the rules of engagement, channels of communication and goals and objectives takes more time than the simplified form above indicates. This oversimplification of taxes, doctor-technician relationships or other potentially collaborative processes risks compromising the results.
The Old Paradigm
The doctor has historically proffered a prescription that tells the laboratory what they are to do. We may have had a brief discussion regarding preferences of materials, procedures and defined how many layers of foil relief, but usually have not really engaged them in defining what is required of each to perform at their optimal levels. Often the resultant treatment that ensues has a myriad of exchanged sound bites that strive to alter the landscape and climb towards success. What I have proposed in describing a new paradigm for this is what we routinely observe in excellent doctor-technician relationships. To succeed, seek out what the most successful are doing and copy it.
A New Paradigm
The premise for this collaborative agreement is really quite simple. It requires both doctor and laboratory technician to ask of each other a fundamental question. What is it that you need from me to do you very best materially and procedurally on behalf of the patient? Or, in the context of the IRS joke above, ìwhat do you need from me to do your best stuffî? The challenge is more on who blinks first and opens a safe, facilitative, non-judgmental dialogue rather than the scripting itself. We could wait a long time in hope of hearing those words from some of our clients. At the Pankey Institute, we facilitate a formal exercise for developing these collaborative dialogues with specialists and laboratories. In the real, everyday world these conversations are less likely to occur. I suggest that we, as technicians, take the chance and step out of the box and initiate the discourse. If we sat down with our doctors who are trying hard to do their best stuff (in a profession with changes occurring at the speed of thought) and asked the question from a sincere best practices standpoint, we just might end up having a real conversation.
This dialogue is predicated on our ability to stimulate a curiosity in the dentist to ask back the question to us. What does the lab need from me to do their best stuff? Hopefully, it will be like asking ìhow you doingî? or ìwhatís newî? These are the types of questions that you almost automatically ask the same back in response without even thinking. I am not suggesting that starting this discussion is that easy, only that someone must blink first and take the chance.
What To Discuss
Without claiming absolute domain (like our IRS) here is a starting list of topics you could go over. Develop you own with your best clients and personalize it. Risk a little and take the road less traveled, it just might make all the difference.
Pre-treatment Considerations and Collaborative Agreements
- Collaborative agreements
- Mounted study casts
- Imaging
- Case consultation
- Treatment planning
- Diagnostic workup
- Material evaluation
Treatment Considerations
- Physical indices
- Incisal/Occlusal matrix
- Reduction guides
- Mounted models
- Provisional matrix
- Observed indices
- Imaging
- Shade
- Translucency
- Surface texture
- Characteristics
- Instructions
- Written notes
- Material choices
- Timelines
Post Treatment Considerations
- Celebration
- Imaging
- Mounted finished casts
Do you have a question for Mark Murphy? E-mail jdt@nadl.org
