MANAGEMENT OF THE DENTAL OFFICE

Successful practice is a result of proper management of resources, professional skills, and relationships with other health care providers and public in general. In India, commoners are largely dependent mainly on government health care delivery systems in which dental services are integrated with medical services, while the affluent get private services for a fee. In recent years, policies of the government have allowed the participation of individual and multinational groups in private health care systems. Dental requirements of the public in India are vast, varying and largely unmet

  • FRONT OFFICE PERSONNEL:
    • The dentist may appoint a full time receptionist, a dental chair side assistant or a person who can do both the work and also part time personnel who will clean the floor, equipments etc.,
    • The front office staff plays a vital role in the success of the practice. The receptionist should be able to handle all kinds of patients
    • Receptionist should be the liaison between the dentist and patients. While giving appointments she should know the approximate time required for each treatment. She should be able to rearrange the appointments if such a situation emerges that the patient flow is regularly maintained without wasting any time
  • INTERIORS:
    • The furniture in the reception area must be durable, esthetic and comfortable. It should neither be too cheap nor be excessively lavish
    • It is better to have a sound proof operatory, atleast with the pediatric population in mind. A second waiting area between the reception and operatory may be incorporated
    • Electrical connection must be concealed and designed keeping in mind the lighting, fan, exhaust, compressor, x- ray unit, computer, dental chair and music system
    • The drainage connection must be designed to aid conduction of plumbing work with proper slopes for drainage etc., to avoid water stagnation in the pipelines and further inconvenience
    • The floor and walls should be designed considering the esthetics. Design should be such that there is minimum possibility of dust accumulation. Rubberized vinyl flooring is advised as it is easy to keep clean
    • A separate x- ray room with wall enclosed in a lead barrier will help to minimize x-ray hazards
    • Autoclaving and sterilization may be carried out in a separate chamber, close to the work area
  • APPOINTMENTS:
    • If a dental clinic is located close to government, commercial offices, corporate and business houses, the appointments are generally to be given in between 9.30 AM to 6 PM because most employees would like to avail treatment by taking permissible short break from their offices
    • If the clinic is in a residential area, the appointments are generally fixed between 8.30AM to 12. 30PM and 4.30PM to 8. 30PM, because in the morning office goers can visit the dentist before going to the office, while the house wife can avail treatment after 10 AM, retired and old people can visit the dentist by 11AM children will be brought from school by 4.30 PM and the office goers can also come for treatment after 6PM from office
    • Preferably, A diary has to be kept to note appointments so that there is no confusion over the appointments
    • Patients should be scheduled to arrive atleast 15minutes before the scheduled appointment
    • If possible the front office assistant should be trained to call each patient atleast half an hour before the appointment and confirm the appointment. This also could act as a reminder for the patient regarding his/ her appointment
  • STOCK AND MATERIALS:
    • For the smooth functioning of the clinic, the assistant or the receptionist should have good knowledge about the materials used in the clinic
    • The staff working in the clinic should know the amount of material required for a particular period, amount of material in the stock, quantity to order, from where to purchase, the mode of payment etc.,
    • Care should be taken to have sufficient material in the stock, so that the routine work doesn’t get disturbed. Material should never be bought in excess than required for a particular period as most of them have a short shelf life
    • The dental office should know how to make economical use of the materials
  • RECORDS AND ACCOUNTING:
    • Maintanance of clinical records is a must and should be kept confidential. They not only serve as a basis for future treatment, but also as evidence in case of legal claims or when summoned by law
    • Accounting includes:
      • Income generated
      • Expenses met
      • Tax paid
      • Interest on loans
      • Membership fee for associations
      • Professional indemnity etc.,
    • The dentist himself or his/ her assistant can do accounting, but by preference should be done by a qualified auditor
  • MEASURE OF SUCCESS IN PRACTICE:
    • ‘Success’ is a relative term
    • A dentist who is well known and respected by his/ her fraternity for his/ her professionalism, loved by his/ her patients for his/ her concern, kindness and devoted work, when his/ her absence is felt- are some of the indicators of success
  • WASTE MANAGEMENT AND INFECTION CONTROL:
    • Wastes have to be segregated before disposal
    • Wastes that are hazardous may be disposed through companies that collect biomedical wastes and process them
    • A tie up may be made with the nearest hospital to dispose wastes that are to be incinerated
    • It is important to follow suitable infection control measures to prevent cross infection
    • The dental assistant may be taught the use of an autoclave so that he/ she sterilizes instruments on time
    • Hand washing between patients not only protects the clinician from cross infection but also gives the patient a sense of comfort and increases the confidence of the patient on the dentist
    • The parts of the chair that are generally contacted like the light handle etc., may be wrapped with a polythene sheet or aluminum foil, which may be replaced between patients
    • Use of a head cap, face mask and gloves help prevent contracting infection from the patient
  • GROWTH AND EXPANSION:
    • Related directly to the ability of the dentist to deliver thorough performance
    • It is the measure of popularity achieved and monetary status achieved over a period of time
    • Expansion is the extension of the operatory and inclusion of qualified associates into practice
  • MISCELLANEOUS:
    • Dentist should have good communication skills.
    • In the first visit itself, a detailed history must be obtained and the condition explained along with the approximate cost and mode of payment for the treatment
    • It is a good practice to open the clinic atleast half an hour before the first appointment. The assistant must arrange instruments for each appointment at the right time
    • Preferably, written instructions have to be given- it saves time
    • It is better to have a link with credit card managers
    • If possible an attachment to an insurance company or joining the medical panel of the company may be tried for
    • The dentist should have an association with a good laboratory which promptly delivers the work on time
    • Arrangement for proper waste disposal must be made
    • All the professionals also need an occasional rest from work. A dental practitioner must take one day off from work every week, should have atleast 2 vacations every year to spend time with the family
    • Whenever the dentist plans such holidays, alternative arrangements may be made to reduce inconvenience to the patients.

REFERENCES:

  • Essentials of Preventive and Community Dentistry- Soben Peter- 3rd Edition
  • Textbook of Preventive and Community Dentistry- S S Hiremath- 1st Edition
  • Essentials of Preventive and Community Dentistry- Soben Peter- 4th Edition

 

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