An average day at the practice starts at 8am, and on three days a week it ends at 8pm. The five dentists stagger their hours throughout the day, with different start times to cover the long working hours. The reason we begin our day early and offer extended opening hours is because many of our patients commute each day into Manhattan for work; we stay open later three days per week, and open on Saturdays, to accommodate these people.
The team gathers for a ‘morning huddle’ each day, where we discuss the details of every patient due in. Each clinician has a scheduling sheet, containing all the information they need to help the dental team to deliver high quality care, including patients’ medical history, current medication, treatment plan and any possible future treatment. We review the details together and make reminder notes. The ‘morning huddle’ ensures everyone knows what they and their colleagues are doing, helping the practice operate smoothly and efficiently every day.
Scheduling
We use a computerised system to schedule our appointments and an internet-based system to confirm bookings. Each day we assign time for a variety of cases including routine appointments and longer slots for more complex procedures, and time is set aside for emergency patients. If at the ‘morning huddle’ it is decided that more or less time is required according to previous experiences, we can at times adjust the computerised schedule to accommodate this. This method of scheduling works very well for us – despite being such a large practice, we are rarely off schedule and patients appreciate this punctuality.
Patients
Unlike the UK with the NHS, all dental treatment in the US is private and can be funded in part by the patient’s insurance. In the main, patient needs may be covered by their insurance policy, so once the practice submits the paperwork and receives an estimate of the benefits covered, we can provide the on-going treatment and care needed. Whatever isn’t covered by the patients’ insurance becomes their responsibility. Patients then make a choice about whether to pay out of their own pockets.
With regards to the most common treatments, these vary greatly within our practice because we provide such a huge range of services. While implants have been popular in the US for a long time now, I think that the trend is currently shifting more towards tooth whitening and cosmetic orthodontics, and we have seen the demand for such
procedures rise.
Infection control
I have previously worked in three different offices and although there are some variations in procedures, effective sterilisation and infection control remains a priority in the US. Dental regulations are not in the public eye and if the premises look clean, patients are happy. However, within the profession regulations are taken very seriously and we follow all protocols to the letter (recommended by the American Dental Association, the Occupational Safety and Health Administration and the Centre for Disease Control).
Each dentist has an assistant to help them in their daily practice, but in addition we have another assistant who we call a ‘rover’. This person is responsible for the autoclave sterilisation and ultrasonic area, infection control and decontamination tasks for that day, throughout the practice. The ‘rover’ organises the instrument trays for each treatment room and restocks them when operatories are turned over and prepared for the next patient. Each day
the ‘rover’ is changed so a different assistant becomes the ‘rover’ and as a result, they all have very thorough knowledge and practical abilities to ensure efficient and outstanding infection control procedures. While this is not a mandatory requirement for all practices, for one as large as ours, it is necessary to ensure all instruments and equipment are ready for each patient, helping the dentists to remain onschedule.
We have a separate sterilisation area with a dirty tray cabinet and a sterile tray cabinet, following the dirty to clean workflow, and the autoclave and ultrasonic machine are located here. The ‘rover’ double-gloves, with heavy duty gloves on the outside when sterilising instruments. These are rinsed, placed in the ultrasonic baskets, then in the ultrasonic machine, before being rinsed again, dried, bagged and dated. Each bag is then put into the autoclave for about 30 minutes, after which the bagged instruments are removed, dried and placed in a sterile tray.
All sundries we use for infection control processes throughout the practice are chosen for quality, and we tend to source them all through a dental dealer so as to benefit from a good price. Our practice and operatories are kept absolutely immaculate – when temporary staff visit to cover someone out sick or on leave, they are always impressed by our sterilisation system and the impeccable standards of every surgery.
Staying up-to-date
We constantly receive newsletters and emails from different organisations; the American Dental Association (ADA) and the Academy of General Dentistry (AGD) to ensure that we are aware of any new protocols. Dr Kelly continually updates our working practices to comply with all the regulations, and is often prepared for new regulations before they are brought into effect.
Marketing
During the summer, May to September, we run special programmes for teeth whitening because it is so popular. We offer a special rate, which includes the consultation and in-office whitening as well as a whitening tray for the patient to continue the treatment at home. The patients love this and know that we run it in the summer so come May they all start asking when it is due to start again and want to book an appointment. I think special offers definitely increase business and help to bring in new patients.
Part of the community
Our practice is pretty unique because both owner doctors, Dr Gregg and Dr Kelly, are long-time residents of Huntington so everyone in town knows them.
They participate in many events within the community and belong to an organisation called ‘Dentists for a Better Huntington’. This group participates in charity work and it also enables the dentists to network too. Referral business comes to the practice and they refer out to other professionals as well. Dr Gregg and Dr Kelly are all about giving back to the community that supports Kalmar Family Dentistry.