Improving Communication between the Dental Team and Patients
Dr. Joel L. Rosenlicht is a Board Certified Oral Surgeon with a private practice in Manchester, CT. He is currently the Vice President of the American College of Oral and Maxillofacial Surgeons and is also the Treasurer for the American Academy of Implant Dentistry. Dr. Rosenlicht has lectured nationally on implant dentistry and has authored or co-authored numerous articles that have appeared in peer-reviewed dental journals and chapters in four textbooks. Dr. Rosenlicht has taken time out of his busy schedule to discuss how the XCPT software can be used to improve communications between the dental team and patients.
Osseonews: Dr. Rosenlicht, the XCPT software program has been developed to improve communications with patients. With this program you can display a patient’s panoramic radiograph or pictures of their oral cavity on the computer monitor. Could you describe how the XCPT software program can be used to educate patients about their implant treatment plan.
Dr. Rosenlicht: The XCPT software program is a very versatile and useful program that enables the dental team to effectively communicate with patients. Treatment plans involving dental implants can often be complex and difficult for patients to understand. It is our responsibility to communicate the information to the patient. The better we are at communicating, the better the patients are at understanding their treatment plans.
Osseonews: Overall would you say that since you started using the XCPT program, case acceptance has increased.
Dr. Rosenlicht: There is no question that case acceptance has increased since we started using the XCPT program. But even more important than that is the fact that it is far easier for us now to gain case acceptance because the patients understand the treatment plan so much better than before. I think this is a very important point. We do not have to spend as much time or work as hard as we have in the past to gain case acceptance. We have found that once the patient truly understands what his needs are and what we intend to do to resolve those needs, case acceptance follows logically and easily.
Osseonews: Can you describe how this works with the typical patient.
Dr. Rosenlicht: One of the great virtues of the XCPT program is that the center of our discussion focuses on the patient’s own radiographs and own presentation of teeth, edentulous ridges and soft and hard tissues. We are not drawing diagrams on the bracket table. We take the patient’s radiographs and illustrations of their oral cavity and demonstrate on them where the problematic areas are and how we will correct or improve them. We can demonstrate exactly where we intend to place implants using their true diameter and length. We can also demonstrate exactly how we intend to restore the implants. This is all done pictorially for the patient.
Osseonews: How many times do you have to go over the treatment plan with the patient?
Dr. Rosenlicht: In the overwhelming majority of cases, we only have to go over the treatment plan once. The XCPT program is that effective. At the end of the session we print out hard copies for the patient. They take these hard copies of the treatment plan displayed on their radiographs or oral cavity imaging home with them. If they have any questions they can call us and they can refer to their hard copies and we can pull them up on the screen. This kind of discussion works very well because we both have something concrete before us and we can refer to specific areas with ease. Many patients do have questions later and this is a great way to discuss them.
Osseonews: How often do patients go home with their hard copies and discuss the treatment plan with their spouse or significant other?
Dr. Rosenlicht: In our experience, this happens quite often. These treatment plans may be expensive or complex and patients often want to discuss them with their spouse or significant other before making a commitment. Having the hard copies greatly facilitates the patient explaining the needs they have and how these will be addressed in the treatment plan.
Osseonews: The XCPT software creates a vivid and explicit set of visual illustrations for the patient. About 65% of the adult patients in the United States are visually dominant. So this kind of educational program should be very effective for most of the patient population.
Dr. Rosenlicht: That is certainly true but it is even better than that. For patients who are visually dominant we can manipulate the visual illustrations and focus in on certain areas or show other views. We have great latitude to modify the visual imaging. And again, this is all on the patient’s own radiographs and views of their oral cavity. This makes this a very personal experience.
For those patients who are auditory dominant, which is about 25% of the adult patient population, we can use the radiographs and views of the oral cavity as cues for spending some more time actually discussing the treatment plan. These patients require more discussion and more verbal dissemination of information. Again, we find the XCPT a very useful too for dealing with these patients.
Osseonews: The XCPT program enables the dental team to tailor the presentation or the information to suit the particular needs of each patient.
Dr. Rosenlicht: Some patients require a lot of information and others do not. Some just want to know something about the basics. The dental team has to make an assessment and then decide how much information to present and in what format.
Osseonews: Compared to other forms of communicating with patients, the XCPT seems to be so much more sophisticated.
Dr. Rosenlicht: That is absolutely true. And many patients expect this kind of a ‘high tech’ presentation. Today patients are far more knowledgeable than ever. With the internet and search engines, so much more information is easily available. Patients come in knowing more and expecting more. If you are proposing what most patients would consider a ‘high tech’ form of dentistry then they also expect a ‘high tech’ presentation. Drawing pictures on the bracket table just doesn’t cut it anymore.
I like to think of this as sort of a ‘wow’ effect. You want the patient to be wowed with your presentation, especially the high tech part of it. If you are proposing high tech dentistry, don’t even think of drawing pictures on the bracket table, or worse, holding up the patient’s radiographs and pointing at sites.
If I could just add one other dimension here to the discussion. The XCPT takes the stress out of communicating with patients. You do not have to search for pictures or illustrations. You do not have to relate generic examples to the patient’s own situation. You have a very neatly packaged system that does it all for you.
Osseonews: Do you feel that XCPT type presentations are going to become the standard operating procedure in most practices?
Dr. Rosenlicht: Put it this way. If you are not using the XCPT or a program like it now, you will be in the future. This is the way information transfer has been developing in dentistry. If you are going to do sophisticated, high tech dentistry, this is the kind of the communication tool that you need. I would put this in the ‘must have’ category of dental assets.
Osseonews: How can the XCPT be used to communicate with other dental specialists and general practitioners?
Dr. Rosenclicht: This is a very important point. The XCPT makes it so much easier for members of the dental team to communicate with each other. You can e-mail back and forth radiographs, imaging and variations or questions on the treatment plan. You can manipulate your copies of radiographs or oral cavity imaging. This becomes an essential tool, especially in complex cases.
Osseonews: What is your advice for the beginner with the XCPT?
Dr. Rosenlicht: For the computer literate dental team member, the transition is an easy one. But even for people like me who are not computer literate, there are excellent directions. The ‘Help Menu’ is excellent and very easy to use and extremely helpful. Just start at the beginning and gradually build up your skills. You do not have to be a geek to figure out how to use the program.
There is a learning curve. Start with the basic skill sets and practice them. You will find that you can master the program in a short time.
Osseonews: Do you use XCPT in the operatory?
Dr. Rosenlicht: We have installed fixed computer monitors in the operatories. This makes it easier to display the information to the patient. We are comfortable presenting simple treatment plans in the operatories. For more complex treatment plans, we prefer a private office setting.
Osseonews: Who presents the treatment plans to the patients?
Dr. Rosenlicht: I firmly believe that it is the doctor’s responsibility to do this. The implant coordinator can be present to help with questions on financial arrangements or logistics. But the doctor should present the treatment plan and should answer any questions the patient might have.
Osseonews: Can these custom treatment plans be entered into the patient’s record?
Dr. Rosenlicht: You can make an entry either in an electronic or paper dental record. In any case, this constitutes a very important piece of information. You can establish that you spent a significant amount of time and effort describing the treatment plan to the patient. You can have entries for alternate treatment plans, potential for complications, and so on. This creates a strong argument for your diligence in educating the patient and obtaining a true informed consent to the treatment plan. As we move into an ever more litigious society, the virtue of maintaining complete dental records assumes great significance.
Osseonews: On behalf of Osseonews.com I would like to thank you for discussing this subject with us. For further information on the XCPT software, please go to www.XCPT.com.
Interview conducted by Gary J. Kaplowitz, DDS, MA, M Ed, ABGD
Editor, Osseonews.com
