Times have definitely changed. The generation of patients that had full confidence and blind trust in their health care practitioners is dwindling and approaching their nineties. Long-gone are the days that a patient will initiate treatment because “the doctor said I have to do it.” We are in a modern era where the internet is ubiquitous and information is cheap. Patients can change their health care providers as often as they change their socks…
As Complete Dentists, we have been carefully and expertly trained by The Dawson Academy to see, diagnose and treat conditions of our patients that are quite often overlooked or neglected by our colleagues. When we see evidence of occlusal disease that we need to address, it is often easy to go straight to gathering records, developing a plan and presenting treatment options. Though this may seem efficient and can produce results, it often also can result in significant amounts of case presentations without scheduled treatment. Needless to say, it can also lead to a laboratory filled with unused mounted models.
The Concept of Co-Diagnosis
Co-diagnosis refers to the idea that the patient is involved in the entire process of developing their customized treatment plan. This significantly strays from the traditional doctor-patient relationship. We are no longer sitting across the desk from the patient, telling them what needs to be done – we are sitting side-by-side with them, showing their conditions and mutually formulating their options and ultimate treatment path.
The 7 Key Factors in Co-Diagnosis and Case Acceptance
1. Making the Connection
Make sure that you have established a solid personal connection with the patient. Let them know that you will be their advocate, advisor as well as clinician. Trust is crucial.
2. Recognizing the Disability
What is their driving factor? Is it fear of pain, inconvenience, embarrassment? Is it cost, or esthetics? Make sure you isolate which of these is most important to the patient. Then mention how their condition can affect that.
3. Comparing Their Condition to Normal
Start by briefly explaining to the patient what we consider to be healthy and stable before you begin the co-diagnostic exam. A good tool for effectively conveying conditions to patients is photography. Show them what is considered normal, then show how they stray from normal. A picture is worth a thousand words…
4. Find a Common Language
Don’t use dental terminology. Describe what you see in layman’s words and keep it simple. It can be helpful to find real-life analogies that they can relate to. I like relating occlusal issues to car problems: low-pressure or worn out tires, loose lug nuts or axles, tires that need balancing, an alignment that needs to be performed…
5. Owning the Condition
For any proposed treatment plan to be effectively implemented, the patient must truly own their condition. It can be easy for us to get emotional about a patient’s situation, and want them to correct their issues. However, they must understand that they have a condition that needs to be corrected, and they should want and ask for ways to resolve it.
6. Consequences and Benefits
During the co-diagnosis, discuss the potential benefits of having a condition repaired, and the consequences of leaving things untreated. Break down their issues into immediate, deferrable, eventual and elective. Explain your concerns, and predict how treatment or lack of treatment will affect their oral and overall health.
7. Tying it all Together
Briefly summarize all of what you have seen and discussed together. “After reviewing your situation, I feel that ____ is causing your current condition, and I feel confident that (occlusal treatment) will make you feel_____, and will minimize the risk of (their disability) happening.”
In this modern era, involving a patient in the process of their health care is absolutely essential. The real value of the truly co-diagnostic examination is that the patients get to see what we see, the way we see it, often in real-time. The advent of tools such as high-quality digital cameras as well as intraoral photo and video enable us to fully engage our patients during our Complete Examinations. Having the patient become an active participant in their exam and treatment plan through the co-diagnostic process will greatly increase the likelihood of their plan being accepted. The result? Both a happy patient and a happy doctor!!