Smart Systems Get The Patient To Yes

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Smart Systems Get The Patient To Yes

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State Task Force Dentist, Reopening Advice

State Task Force Dentist, Reopening Advice

Note: I was in the process of putting together re-opening tips and recommendations from dentists around  the country when I stumbled on this Facebook post from a dentist from Indiana. The post is full of excellent insights, knowledge and recommendations. 

First time poster, long time reader 😉 I am a dentist from around Fort Wayne, CHAIR of the IDA communications committee, member of the IDA Task Force for COVID-19 Response, and soon to be IKDDS Treasurer. I recently posted this on the Fort Wayne Dental Peeps page and was asked to share it here as well.

It is a long post so please bear with me. What follows is my professional opinion and should not be construed as the opinion of the CDC, ADA, IDA, IKDDS or any other person or professional entity. If you get through it all, I’m impressed 😊. 

First of all, this is a scary and challenging time for us all. I completely understand the fear and uncertainty that many of you are feeling since the recent announcement by the Governor earlier this week. There is an inherent risk that is present for all of us catching COVID-19. Unfortunately, there is nothing anyone can do to provide you with 100% certainty that you will not get sick. This is true in the dental office, grocery store, Starbucks, or even sitting at your home. All of the recommendations that have been presented by the CDC, OSHA, ADA, and even IDA are strategies to DECREASE risk, but NOTHING will eliminate the risk. That being said, each and every person has varying degrees of risk tolerance. If your individual risk tolerance is different from your dentist or anyone else in your office, it will create a significant strain in your offices’ work environment. Therefore, I strongly suggest you communicate this and see if a mutually acceptable plan can be created. If this isn’t possible perhaps the best move would be to separate yourself now. That means different things based on your situation, but it may mean you take an extended leave of absence and stay home, you retire, or you find a new place of employment.

Secondly, I wanted to address some of the misinformation I have been reading specifically related to Indiana’s return to work and the dental office recommendations. OSHA has released categories: very high risk, high risk, moderate risk, and low risk to describe patient encounters and susceptibility to transmitting COVID-19. Very high and high are procedures completed on suspected or known COVID-19 patients. Moderate and low categories are for patients that do not have COVID-19. Since we have no way of effectively discerning exactly who has it and who doesn’t then we must assume everyone is at minimum a carrier for the disease.

PPE - I want to make one thing clear regarding PPE. Most of us are all scientific minded that like to see things in black and white, right and wrong, YES and NO. Unfortunately, the topic of PPE involves 50,000 shades of grey. Everything provided by the CDC, ADA, and IDA in terms of “best practices” are currently recommendations, NOT mandates. Mandates are laws which are established by the state or federal government. And, up to this point, there are no specific mandates regarding appropriate PPE. N95 masks with face shields are considered “ideal”. However, wearing surgical masks with goggles is considered “acceptable”. Disposable gowns for each patient are “ideal”. However, wearing scrubs which are removed and laundered at the office is considered “acceptable”.

• Does a N95 provide better filtration/fit than a surgical mask? ---- Yes.
• Does better filtration and fit mean that you won’t get sick? ---- NO!

So, until we know more, PPE is a good-better-best debate. Each dental office and practitioner must determine what PPE is most appropriate for the procedures they will be completing. Higher risk procedures (ones which result in more aerosol and/or more time spent in front of the patient) should be appropriately treated using higher levels of PPE. Lower risk procedures (with less time in front of the patient and no aerosol) could be completed using our standard precautions.

CHAIRSIDE COVID-19 TESTING – In order for a chairside test to be appropriate for use in a dental office it must accomplish a few things.

• Rapid – it must provide results quickly –preferably under 10-minutes.
• Appropriate– it must answer the question - IS THIS PERSON CONTAGIOUS?
• Accurate – it must give us certainty that the results are true and consistent
• Inexpensive – it must be cheap enough that we can do it on every person, every day

Unfortunately, there are no tests available that check all of these boxes. Current viral-activity tests are taking 3-5 days to have results back, they are 70-85% accurate and dentists are not approved providers. Abbot Labs’ new rapid viral-activity test requires very expensive equipment which isn’t practical for most dental offices. Antibody testing evaluates the body’s immune response which may occur several days after a person catches the disease and becomes contagious. Hopefully this will change, and there will be a test developed that is as simple as chairside glucose screening. Unfortunately, we are not there yet.

Finally, I want you all to know the reason most of your bosses are wanting to get back to work. And, believe it or not, it has NOTHING to do with making money. We have all taken an ethical and moral obligation when we entered this profession to do no harm and to do what is in the best interest of the health and wellness of our patients. We have now gone a full month completely neglecting the dental health of our patients.

We are experts in the oral/systemic connection and educate patients every day on how the health of the mouth is connected to the health of the rest of the body. This viral outbreak has not eliminated the oral-systemic connection. We all have patients suffering from high blood pressure, diabetes, congestive heart failure, etc. which we know are tied to periodontal disease. These patients need to be on regular periodontal maintenance in order to stay healthy and keep their systemic inflammatory markers low. We also have patients with active tooth decay and oral infections which will only get worse with time. How would you feel as a patient if you had a deep cavity or restoration which needed completed right now? If these rather routine procedures are put off too long our patients will become dental cripples or worse yet, die. Now, I understand this is a bit of an exaggeration for most patients. However, if you don’t believe that maintaining dental health is important and that we have a role to play in ensuring the long-term systemic health of our patients then perhaps you are in the wrong profession.

My final question for everyone to ponder… If not now, then what time would be appropriate for you to return to work?

This virus is not going away. It will be here one week from now, one month from now, six months from now, and likely even a year from now. The risk of getting sick will be present from now until the time we have a reliable vaccine. So, if you are uncomfortable returning to work because you don’t want to be sick and/or don’t want to risk getting anyone else sick, then stay home (and know, it could be a long wait). If you are uncomfortable returning to work because you don’t feel like your boss is taking things seriously, then I suggest you have an open and honest conversation with them. If they are unwilling to listen, leave. It’s not worth the stress and risk to work for some one who won’t listen to you. However, most of you will find the exact opposite happens. They will listen to you! The truth is that, as business owners, we are just as scared. We have families and loved ones that are at risk. We are worried about making them sick. We are worried about making you (our team members) sick! We are doing the best we can to prevent this disease from spreading while at the same time fulfilling our professional obligations. Please help us, we can’t do it without you!!

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Shane Blake DDS Coudersport, PAMy name is Kevin Tighe. I am Cambridge's owner and senior consultant. Before joining the Cambridge team I was in charge of setting up workshops for large nonprofits throughout the United States and Canada. During that time, I was fortunate to receive mentoring from several world-class business consultants, including a dental practice management guru, which led to a position at Cambridge as their seminar organizer. In time, I began crisscrossing the country delivering seminars myself for the better part of a decade. Subsequently, I moved up to senior consultant and eventually owner.  Contributing writer to Dental Economics/DIQ, JADA, AGD Impact and Dental Town Magazine.


Client Reviews

Dr. Jacob Masters, DDS, Indianapolis, IN

CEO 1 Cambridge Dental ConsultantsI started with Cambridge in 2018 after 11 years in practice. My results have been great! I have been able to decrease the number of days I work per month and have finally improved my practice much more than I could do on my own! I highly recommend Kevin's on-target coaching! 

-Dr. Jacob Masters, DDS, Indianapolis, IN


Dr. Shane Blake, DDS, Coudersport, PA

Shane Blake DDS Coudersport, PAI have owned my dental practice since January 2005.  The practice is a rural solo provider practice.   The practice has always been successful but something was always lacking.   I did not manage the practice by the numbers and its shortfalls were overcome by sheer determination and hard work for both myself and the staff. 

My motivating factors to sign up with Cambridge in January of 2017 were that I had reached a point in my career where time with my family was worth more to me than the professional fulfillment that dentistry can provide.  The practice was so micromanaged that it required most of my time and I didn’t understand how to motivate both myself and my staff beyond the sheer nose to the grindstone path to success that had guided us the prior 12 years. 

Our consultant was instrumental in educating each staff member in what expectations are and how performance for each position is measured.   Staff members became more aware of their part in the overall success of the practice and doing their part.  Ultimately this led to a less stressful and more productive average day which decreased management stress and headaches and allowed life to be enjoyed just a little bit more with a little more time. 

We have had many changes in the practice after our initial integration over the last 1 ½ years.  Cambridge has been helpful in navigating those planned and unplanned changes.  My only regret is I had not called Cambridge sooner.


Dr. Kristin Rushing, DDS, Nashville, TN

Dental Consulting Client TennesseeI used Cambridge as well, it gave me a good foundation for employees to know what was expected of them as well as very detailed job descriptions that could be used to train new employees if I needed to replace a staff member. Mike also is good about coaching you so that you are knowledgeable about what your numbers and percentages should be but also things to look for when they are off.

Everyone is accountable for their numbers and communicate better as a team. We all want to be more productive and time was spent looking into my specific concerns as well as reviewing all facets of the business. Everything was reviewed including input from staff on ways to improve the office. I feel the morale in my office has changed and we are overall headed in a much better direction. As a side note, I've used a different consultants previously and their moto was simply to increase production. Patients felt pressured and we still had communication issues among the staff.


Dr. Jeremy Johnson, DDS, Monroe, WA

Dental Consulting Client WashingtonI'm extremely happy with my decision to utilize Cambridge’s services. My consultant, Mike, has been awesome! I love that I can call or email him whenever and always get a quick response. He even calls and checks in if he hasn't heard from me for a bit. My production increased immediately after the first in-office visit and has continued to climb. The initial investment was recouped in increased production about seven weeks after our first meeting.

My average per day production for the first four months I worked with Mike has been 20-25% higher than the prior two years. In fact, all of the four months have had higher average per day production than ANY month in the two years prior to working with Mike.

Last month I produced more than I ever have in one month since starting my practice in 2003. On top of that is the fact that my staff is driving all of this growth! They tell me which op to go to and when, then they get all excited when we exceed our goals! These four months have been the best months of my career!

That's a lot of exclamation points! This is all to suggest that you give Cambridge a call.


Dr. Andrea Mulholland, DDS, Columbus, OH

Dental Consulting Client OhioI have been the owner of a general dental practice for ten years now. I work four days a week and have an associate who is with me for three days.

The practice has always done well but I knew there were many aspects of it that needed improvement but I didn't know how to proceed. I researched several practice management companies but decided to go with Cambridge because of their good reputation and because I didn't feel pressured.

Mike is the consultant that I have worked with for the past year and a half and he has helped my practice tremendously. He really knows the ins and outs of a practice but I appreciated that he didn't use a cookie-cutter approach. He really treated my practice like the individual practice that it is and I didn't feel pressured to follow any suggestions that I wasn't comfortable with.

I know there are a lot of management companies out there. I just really feel like Cambridge is one of the best and was the best for me and my practice.


Dr. Jeffrey D. Weaver, DDS, Port Royal, SC

Dental Consulting Client South CarolinaWe have been using Cambridge since Dec 2013. We are really just getting started, but so far everything has been great. They really have given us the tools to quickly get our team focussed, and have created systems and measurable statistics for each area. YTD for 2014 compared to 2013, our production is up 12% (over $20,000).

Our office felt "stuck", like we simply did not know what we should be doing to get better. We knew the potential was there, but did not know the next steps to take. What we liked from the start is that Cambridge has been in every type of office and seen every type of problem/issue there is. Their ideas are proven and, so far, we have been very happy with the results. Our team is really pleased with the direction we are going.

We built our office in 2007 and, had we known, would have started with Cambridge much sooner. Good luck with your decision. I think you will be very pleased with Cambridge.


Dr. Ron McHargue, DDS, Moses Lake, WA

Dental Consulting Client WashingtonI was fresh out of school when I bought my practice in 2012. It came riddled with staff issues and I had no knowledge of business. I thought I could handle it and went for a year and a half before really coming to the realization that I was in over my head. I was stressed completely and needed help with staff issues and business advice.

I contacted Cambridge because of what I read on Dentaltown and because of their fair price and money back guarantee. Mike was very helpful in getting me over a couple of big hurdles dealing with staff. I now have a direction and a good plan for tracking numbers and keeping a pulse on my practice. I was hesitant to even hire a consultant, but I am very glad I did and wouldn't hesitate to get Mike back and work with him again.


Dr. Ed Warr, DMD, Ashland, OR

Dental Consulting Client OregonMy experience with Cambridge has been great. In June of 2014 I was very concerned as my year was down by about 6% from the previous year. I had used consultants before and hadn't liked any of them. But, I knew I needed help with what I did not know - I went to school to earn a DMD, not an MBA.

After researching several and having several phone conversations regarding their methods, I committed with Cambridge.

Their money back guarantee was a nice touch to lower the risk factor for me. So, I finished 2014 up 8% over 2013. In six months, Mike had helped me introduce practices that helped me have a 14% turn around in six months. I whole heartedly recommend Cambridge and their services.


Dr. Chris Burke, Pedodontist, Lexington, TN

Dental Consulting Client TennesseeI have used Mike Kittelson with Cambridge since I opened from scratch in 2009. Having no background in business, management or marketing he has helped us tremendously. Not only has he taught us which stats to track, he has coached us through employee issues, marketing programs, strategic planning for the future, and served as therapist and friend. He has also proved to be a wealth of information on helpful computing programs that have made certain tasks easier and improved employee productivity. I would recommend talking with Cambridge before making your final decision on which group to go with.


Dr. Dustin Snyder, DDS, Lewisburg PA

Dental Consulting Client PennsylvaniaWhen I initially contacted Cambridge, I was open for about a year and the production graphs were trending down, quickly. My Cambridge coach met with me, offered several ideas specific to my situation, and two years later, I'm having annual growth over 20% and we're already at record annual production with one and a half months left in the year.

I am now busier than ever, even under the previous owner! The best dental office manual I've ever used. I can't say enough positive things about what Cambridge has done for my practice!


Your Dental Practice Mangement Consultant and Coach

Shane Blake DDS Coudersport, PAMy name is Kevin Tighe. I am Cambridge's owner and senior consultant. Before joining the Cambridge team I was in charge of setting up workshops for large nonprofits throughout the United States and Canada. During that time, I was fortunate to receive mentoring from several world-class business consultants, including a dental practice management guru, which led to a position at Cambridge as their seminar organizer. In time, I began crisscrossing the country delivering seminars myself for the better part of a decade. Subsequently, I moved up to senior consultant and eventually owner.  Contributing writer to Dental Economics/DIQ, JADA, AGD Impact and Dental Town Magazine.


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