Date ArticleType
5/20/2015 Modern Dental Business

The 6 R’s of the Patient Service Cycle

The 6 R’s of the Patient Service Cycle
by Cindy Ishimoto

Goals for most practices include increased productivity, increased collections, improved scheduling, reduction of broken and changed appointments, improved case acceptance, reduction of stress and chaos, and, of course, improved accuracy in all patient service systems. 

Teams who work together to communicate effectively with patients and one another achieve their goals more consistently.  The communications system that can impact all of these goals is the patient service cycle: the method of transferring the patients smoothly from one team member to another.

Repetition is the key to learning, period!  Patients need to hear from multiple people on your team what was done today and why.  They also need to hear what is being recommended for their next visit, why it is needed, and how urgent it is to go forward with the recommendations. 

Practices grow with increased new patients, and the practices that ask the most, get the most.  Asking for referrals must be a part of the patient service cycle and everyone on the team must be expected to ask. 

Collections at the time of service are smoother when patients understand exactly what services were done and why they were needed, this prevents buyers’ remorse. 

Scheduling a productive day is easier when patients know how important their next visit is and why it needs to be done.  This value and urgency educational process is also a broken and changed appointments prevention model.

The 6 R’s of the patient dismissal process are: Recap, Recommend, Rationale, Readiness, Refer and Reserve.

Recap and Review:  Go over the services that were provided today, explain why they needed to be done, and what benefit the procedures provided.  Include before and after annotated photos; this will also provide visual representation of the education you are providing about why the treatment was needed.  If the patient speaks of any remorse for having done the procedure you have the documentation to show them what it was like before and how much better it is now.  Celebrate with the patient how well the procedure went and how pleased you (and the doctor) are with the results.

Recommend (the next appointment): Describe the service that is needed and the steps that will be involved, and the length of the appointment.

Rationale:  This is linked to Recommend. You must share with the patient WHY it is important to do these procedures or come back for their next hygiene visit.  This is the clinical diagnosis and must be documented in the recommended procedure and the clinical notes for the day. The second part is to share the urgency message with the patient, i.e. if it is decay, telling them that it is an aggressive infectious disease and that you do not want to see it get deeper or larger.  Or placing urgency by saying it is important to proceed sooner rather than later because the tooth may ___ (fill in the blank).  This is the critical link to helping patients value the appointment and the service. 

Readiness:  It is a clinical responsibility to find out if the patient is ready to go forward with the recommended treatment.  I recommend that you ask each patient, “is this the dentistry you want to proceed with?”  And if they agree, ask them, “are you ready to make a commitment with reserving an appointment?” When the clinical team links to the business team member, they can share with them that the patient committed to the recommendation, would like to reserve the appointment, and any questions they may have regarding the financial commitment.

Refer:  Internal marketing is the most successful marketing.  Patients that love a practice will sing their praises if you ask them too.  I recommend that each team member identify one patient each day in your morning huddle that they will be asking for a referral.  So Refer may come in the clinical zone or at the end of the appointment in the business office.

Reserve:  Once the business team receives the patient, the first step is to reserve the next visit.  Then review the financial options along with the insurance involvement and collect for today’s visit.

Sample: Clinical Assistant and linking to the business team: 

  1. Recap what treatment was provided today, why, and results obtained, ask for questions.
  2. If there is not a next visit with doctor then you will: review what will be done at the next appointment hygiene, including
    1. Benefits of the treatment
    2. Risks of not completing treatment
    3. Time interval needed and why the interval is important
  3. If there is a next visit with the doctor, review what will be done at the next appointment doctor care, include:
    1. Benefits of the treatment (why it needs to be done)
    2. Risks of not completing treatment (urgency statement)
  4. Give the patient two business cards and ask for a referral or give them permission to contact you with their questions.
  5. Provide post treatment care instructions as needed.
  6. Link with the business team:
    1. Review what was completed and how well the services went.
    2. If patient has not already reserved their next visit with the hygienist: Recommend reserving an oral health care / periodontal care visit in ____ and it is really important that (he/she) come for this care because _______. 
    3. Review doctor’s findings (diagnosis) and state the recommendations for services and length of time for the appointment, along with it is really important that (he/she) come for this care because _______.
  7. Thank the patient for coming in and state how it was a pleasure caring for them today and that you look forward to their next visit together for __(list the treatment).
  8.  Business Team reserves the appointments first (do not give the appointment card until after the financial commitments have been handled.
  9. Collect for today’s services, discuss the financial options for the next visit and have the patient sign the agreement
    1. Finish the appointment by thanking the patient for coming in today and that the entire team looks forward to seeing them on Day, Date, and time for (approximate length of appointment).  Share with them that it is really important that (he/she) come for this care because _______.

This entire sequence of patient education and patient transfer is a gentle way of asking for a commitment from the patient to go forward with their oral health care recommendations.

Repetition is the key to learning; the more the patient hears that it’s important from several different people, their belief that it needs to be done increases.  Consistency by the entire team in following the 6 R’s will help your practice achieve their goals and your patients will be healthier from having followed your recommendations.

  Cindy Ishimoto began her career in the dental profession over thirty years ago, first as an assistant, and business auxiliary and then progressing to a management position. Cindy's knowledge in all facets of dentistry, people skills, motivation and communication is reflected in her ability to teach and train. Cindy's love of people and dentistry enable her to share her enthusiasm to build successful-people oriented practices.

Cindy offers many services for dental practices as a speaker and a consultant: -for information you can contact her at 808-375-7344, or [email protected].