The Dentist's Network #45


	Oral Cancer Detection Hygiene Department Upgrading Dental Software

Louis Malcmacher
DDS MAGD
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Be a Hero and Save Your Patient’s Life!

Oral cancer. These are two words that dentists hope they will never have to say to a patient throughout their entire career. Oral cancer kills one American every hour of every single day. A number of famous people have become victims of oral cancer, among them Babe Ruth, Sigmund Freud, Bill Blass and Jack Klugman. You and I both know that when a lesion is found in the mouth that may be squamous cell carcinoma, there is a 50% to 70% chance that the patient may not live past the next five years. They will also need radical surgery and major reconstruction that runs into the hundreds of thousands of dollars and causes immeasurable pain and suffering.

By the way, the number one finding of a recent dental patient survey done by the Crown Council was that patients want to hear more about oral cancer. CNN’s Dr. Sanjay Gupta recently did a story on oral cancer. Consumers are ready to get involved with learning more about their mouths and certainly want to be involved with oral cancer prevention.

I often wonder why we, as dental professionals, don’t take the detection of oral cancer seriously enough. Look carefully at my words: We do take it seriously, but we do not take it seriously enough. I would suggest that one of the reasons is because patients don’t take the detection of oral cancer very seriously either, just like many patients don’t take their oral health very seriously at all. I can tell you with certainty that if patients took oral cancer more seriously, then so would the entire dental profession.

When you look at other cancer awareness programs, some organizations have done an absolutely outstanding job at creating a very high awareness of certain types of cancer. Every woman knows how to do a breast cancer self-exam and routinely goes for mammograms, and everyone over the age of 50 knows that it is time to go for a colonoscopy. These types of self-examinations and screenings have helped to save many, many lives over the years and have reduced the mortality rate of these dreaded cancers very substantially.

An established self-examination for oral cancer would be a huge help in finding abnormalities or incipient oral cancer lesions early on. This kind of self-examination, much like a breast examination or a skin examination, is easy to do, does not require any special equipment and will help familiarize people with their own mouths. The primary benefit is early detection of any unusual lesions in the patients’ mouths and the secondary benefit would be consumers becoming much more familiar with their mouths, which would prompt them to seek treatment for oral health issues that they usually ignore.

My children, David Malcmacher and Shana Meystel, have heard me lecture about oral cancer a number of times and, being much more technologically advanced than I am, have developed a web site for consumers and dentists that show people how to do a self-examination for oral cancer. Because so many American consumers still do not have regular dentists, there is also a “find a dentist” section. Dentists who are committed to oral cancer examinations or the early detection of oral cancer via screenings can also sign up to be listed on the web site www.oralcancerselfexam.com.

This web site will be heavily marketed to consumers so that this oral cancer self-exam will become part and parcel of what people normally do to help find these lesions much sooner. The number of oral cancer cases per year has not gone down in the last 40 years, which should pretty much tell us that what we as dental professionals have been doing has not been working.

I strongly urge all of the attendees of my courses to use some type of oral cancer screening device, whether it is Vizilite Plus or a Velscope. Those who know me know that Vizilite Plus has been the choice in my office for a number of years because of its cost-effectiveness, ease of use and the Tblue stain that comes with the kit. The Tblue staining system that comes with Vizilite Plus is an essential part of screening, if anything is found, and no other system includes it. Vizilite Plus will help screen your patients and will help you find suspicious lesions much earlier than you normally would. After that, either a brush biopsy like Oral CDX or a traditional biopsy should be used on the lesion for either histological examination or total removal.

Getting the patients on board to fight this dreaded disease is crucial and overdue; institute early detection screening into your practice as soon as possible. Patients are looking for dentists who take oral cancer seriously. Let’s all work together because if dental professionals don’t take this lead, no one will. It is completely up to us. Go to www.oralcancerselfexam.com today and show your patients how committed you are to detecting and treating oral cancer.

Dr. Louis Malcmacher is a practicing general dentist in Bay Village, Ohio and an internationally known lecturer, dental consultant and author, and consultant to the Council on Dental Practice of the ADA. Interested in knowing more about how to truly enjoy dentistry? Click here.

Interested in having Dr. Malcmacher speak to your dental society or study club? Click here.

To reach Dr. Malcmacher, email him at DrMalcmacher@thedentistsnetwork.net or call 1.800.952.0521

Sally McKenzie, CEO
McKenzie Management
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Feeling the Economic Pinch? Uncover Your Profit Hub

I don’t need to tell you that our economy is experiencing some challenging times. Dental teams are wringing their hands and many dentists are wondering when it’s all going to end. I may not have a definite answer, but I can tell you that we’ve seen economic boom and economic bust in the past. What we do know is that it is cyclical and things will improve.

In the interim, this is an excellent opportunity to take a close look at one of your key production centers: hygiene. Hygiene departments, which could be the hub of huge profit, are yielding some pretty abysmal results more than most dental practices would care to admit.

It’s very likely that in your practice right now, hygiene is probably producing well below the standard of 33% of total practice production. If you step back and really look at what is happening, you’ll likely find that the hygienist has far more down time than you realize, patient retention is seriously lacking and periodontal treatment is minimal at best. No-shows and last-minute cancellations are taking a toll on many schedules these days. Throw in a weak recall system and you have some very real challenges. Take a couple of steps immediately and jumpstart your own economic recovery in hygiene, starting with the recall system.

In many practices, the recall “system” may be pre-printed postcards purchased en masse. Even if the patient overlooks the grammatical errors often found on these pieces, the mailers commonly reinforce what patients typically want to believe, that the hygiene appointment is just a “routine” appointment. Usually it says so right on the card.

During challenging economic times, if the patients are led to believe that oral health care appointments are simply “routine,” they are likely to interpret that as “not necessary.” For patients cutting back on seemingly unnecessary expenditures, a “routine” dental visit isn’t likely to rank high on the list of priorities. Look at your recall notices and evaluate whether they convey a message of urgency and importance or if they minimize the value of your dental care.

Next, take a look at who is responsible for your recall system. Oftentimes, there’s no real ownership of this vital practice because, well, everyone is just too busy. At least they used to be too busy until the bottom fell out of the schedule.

If you do nothing else to improve your hygiene department, at least shore up your recall and retention efforts. It is the number one strategy for boosting your practice revenues and, most important, it automatically improves service to patients.

Assign the job of Patient Coordinator to one person—NOT the hygienist. A coordinator is professionally trained to make calls. She/he is given uninterrupted time to carry out her/his responsibilities and has a defined mission:

Make a specific number of patient phone calls each day in a specific amount of time.
Schedule a definite number of appointments.
Ensure that a precise number of patients complete treatment.
Schedule to ensure the hygienist achieves a daily or monthly financial goal.
Manage a specific number of unscheduled time units in the hygiene schedule per day.

A good Patient Coordinator should be able to manage a patient base of 500 to 1,000 in an average of 15 hours per week. It doesn’t take much to figure out that reactivating a few inactive patients pays for the position quickly. Monitor patient retention. Each month, divide the number of patients due to be recalled for prophies that month by the number of recall patients treated. Your goal is 95% or higher.

In the vast majority of the practices we analyze, the hygiene department alone is losing $35,000–$150,000 annually. This says nothing of the thousands of dollars in additional dentistry that also disappears. However, a successful recall system helps patients to secure the dental care they need in a timely fashion. It also helps to ensure a healthy bottom line through rocky as well as robust economic times.

Sally McKenzie is CEO of McKenzie Management, a nationwide dental management, practice development and educational consulting firm. Working on-site with dentists since 1980, McKenzie Management provides knowledge, guidance and personalized systems that have propelled thousands of general and specialty practices to realize their potential. Sally can be reached directly at 1.877.777.6151.

Interested in speaking to Sally McKenzie about your management concerns? Email her at Sally@thedentistsnetwork.net.

Dr. Lorne Lavine
Dental Technology Consultants
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Upgrading Your Dental Software

Over the past few years, there have been a number of changes throughout the dental industry. Probably the biggest area of change is in the practice management software systems. Most of the companies will release updates or upgrades to their programs yearly, if not more often. In these cases, dentists need to consider changing or, at the very least, upgrading their current software. While it might seem like an easy process, there are many potential pitfalls. This article will explore a number of considerations to making the process a bit less painful.

1. Do you make the change?
Often this first decision is the most difficult. If you are using a program that is not being supported, my advice is that you make the switch now. You will have difficulty getting technical assistance if a problem develops and your software will not have updates, such as new CPT codes. The tough choice comes when your current software has simply released an update. In many cases, dentists pay for yearly support that includes any updates that are released. Dentists need to know exactly what this update provides and evaluate for themselves if the change is worthwhile. Keep in mind that PMS programs are complex, and new versions will almost always have bugs or other issues that need to be worked out. Sometimes, keeping with your current, stable version will make more sense.

2. The Importance of Backing Up
If you go ahead with the update or new software, there is nothing more important than backing up your data. It’s been my personal experience that more than 80% of all offices back up either too infrequently or their backups are corrupted and would not restore the data in the event of a catastrophic loss. The best way to test this is to install the program on a separate computer and import the backup data to test for integrity. Even when not considering a software upgrade or installation, offices need to develop systems of consistent, reliable backups that will involve having the data at another location. The backup won’t do you any good if it is in the office and the office is vandalized or affected by some disaster like flood or fire.

3. Avoiding a “Gotcha”
One problem that can often happen is when a program changes its main file name. In a networked office, the typical setup is to have a main server and the workstations “map,” or point to, the folder or filename on the server. In some cases, updating or installing new software changes the name of the file or folder. In this case, all the network mappings would be lost. Dentists should check with the software company before upgrading and work with a networking specialist if necessary to minimize their down time.

4. Pointers for a “Clean” Install
In order to try to get as clean an installation/upgrade as possible, you should close down any programs that might be running in the background. Many computers have anti-virus programs running (and if they don’t, they should!) and these are usually easy to close down. But what about programs that are running in the background that you might not see? Here’s how to find them: In most versions of Windows, go to the Start button, click Run, and then type in “msconfig” (without the quotation marks). In the window that opens up, select the “Startup” tab. Every item that starts when your computer boots up will have a check mark next to it. In many cases, these programs can and should be turned off. Some you cannot, so look up some of the programs online or work with a computer consultant before you start unchecking random boxes. As an added bonus, depending on how many programs you turn off, you should see that Windows boots up much faster. The other factor that will help this process is to defragment your hard drive (typically found under Programs/Accessories/System Tools/Disk Defragmenter. When you write data to hard drives, it often becomes fragmented as different parts of the same file are spread throughout the hard drive. Defragmenting will reconnect these files and speed up the system, and allow your installation to be written to one contiguous area of the drive.

5. When to Start
You’ve cleaned up the hard drive, made a backup and verified that the backup can be restored. Are you ready to proceed? My best recommendation is that this is not something that you want to attempt on Friday afternoon at 4:30 PM. Although most of the PMS programs have taken pains to develop installation routines that are easy to follow, they are hardly foolproof. Many doctors found out the hard way that software that was compatible with Windows 98 or 2000 didn’t work properly with XP. Keep in mind that you typically have many integrated programs trying to function together, such as PMS, image manipulation, databases, Microsoft Office, Internet browsers and many others. The point is, upgrades and installations are not always as smooth as they were designed to be. And when things go wrong, you need to have someone to call. Make sure that the software company is available to help in case of a problem. Make sure that your computer/networking consultant knows your plans and can offer assistance if necessary; you might even consider paying an expert to do the install and give yourself some peace of mind! I would certainly recommend that the install occur on your day off or a day that the practice is closed during the week.

6. Training the Staff
Your staff can be a great resource to assist in this process. Many doctors I’ve spoken to are surprised to see the level of knowledge that the staff has when it comes to computers and the software. If you haven’t done software training for your office, now is the time to consider this. These programs can be extremely complicated, and the more they know about the software and how to troubleshoot, the better off you will be. All of the major software companies offer various levels of training, from telephone and video/DVDs to on-site training. Find the method that will give you the best level of training; it’s one of the smartest investments you can make. And don’t limit the training to just one or a few staff members. Everyone in the office should become proficient in all aspects of the software, whether or not they have “clearance” to perform all the functions. You never know when a staff member might leave the office and their knowledge and training leave with them, so be prepared.

7. What can go wrong?
In a word, everything! Murphy’s Law was practically invented for computers and software! You could corrupt the data. You could make your operating system unstable and prone to frequent crashing, if it even boots up at all. Your digital cameras or radiography systems might no longer function, and if they do function, it won’t be with the same software that you’ve used for years. You could lose your ability to see other computers on the network, your ability to send e-claims and too many other problems to mention. Make sure that you have ALL the discs that came with your computer systems and the components handy: the operating system, driver files, installation discs and manuals. The better prepared you are, the easier it will be to recover from a problem.

8. Fixing It Right
Even with the best of efforts, some offices will get into trouble that they cannot fix on their own. Some good advice is to have phone numbers available for people that can help. The software company should have a toll-free support number. Some are better than others at having technical support reps accessible in a timely manner. If you worked with a computer company to build and install your hardware and software, make sure they are available. Keep manuals and software nearby for all the components in the systems. There are many online resources as well, such as the Dental Town message boards (my personal favorite!) at dentaltown.com or the Internet Dental Forum, internetdentalforum.org.

Software upgrades and installation shouldn’t be a difficult process, although it often turns out this way. The office that properly evaluates the reasons for upgrading and prepares for all eventualities will find the process to be smooth and rewarding. Software is constantly evolving, and dentists shouldn’t have reasons to hesitate with an upgrade if the newer version will increase their ability to run a better practice.

Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provide dentists a full range of services relating to the implementation of technology.

Dr. Lavine can be reached directly at 1.866.204.339 or drlavine@thedentistsnetwork.net.