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Continuing Education

When interacting with challenging patients, behavior awareness can help

As my patient pool grows, the dentistry doesn’t change much, but the person in my chair changes every day. I connect with most patients pretty well, but every now and then I am presented with a challenge. What I would call a difficult patient has nothing to do with the dentistry required in their mouth. The difficulty comes from the patient interaction. I know myself, I know the dentistry, but there is something missing in my understanding of the patient.

Dr. Carolyn Norton

Dr. Carolyn Norton

I received some insight from one of my attendings at my GPR program, who is also an L.D. Pankey Institute faculty member. He introduced me to the Social Styles Model, which is taught at the Pankey Institute along with the concept of relationship based dentistry. Our discussion led me to the TRAMCOM Group website. Here they elaborate on the specifics of the Social Styles Model.

In the 1960s Roger Reid and John Merrill created the Social Styles Model to help predict human interactions in business relationships. They identified three variables that determine a person’s social style: assertiveness, responsiveness, and versatility. Within these behavioral dimensions four social styles emerged: analytical, amiable, driving, and expressive.

Responsiveness is determined by how much you control or reveal your emotions. Assertiveness is based on where you fall in the spectrum of ask versus tell, or lead versus follow.

No one social style is better than the others, and each style has its own pros and cons. Once you get familiar with each social style, you will begin to pick up on clues that tell you which style your patient uses. Here are four unique behavioral patterns recognized in the Social Style Model, according to The TRACOM Group:

ADA New Dentist guest blogDriving style patients control their emotions and speak assertively. These people want to know the facts about their treatment. Be direct and practical regarding their problems and treatment options. They are focused on the end result and want to know you have a plan.

Amiable style patients show their emotions and prefer to ask questions than give orders. These patients are friendly and ask questions because it makes them feel more comfortable. Take the time to talk with them and get personal. It will definitely pay off.

Analytical style patients control their emotions and prefer to ask questions than give orders. They ask questions because they want to know all of the details. They want to understand each step, the cost, and maybe even the number of appointments. They appreciate precision and accuracy. Take time to develop their treatment plan to show that you care about these things too.

Expressive patients show their emotions and speak assertively. These patients will share their thoughts and feelings regarding their dental problems, but may need your direction. Let them speak, you listen, and then help them focus on their needs.

The next time you have a challenging or difficult patient, look at this social style chart and see where they belong. If you understand why a patient is behaving a certain way, then this may help you alter your social style to make the interaction successful and prevent frustration. This is where versatility comes in. Versatility is primarily the responsibility of the dentist in the patient-doctor relationship. A versatile dentist can alter their social style to make the patient more comfortable. This requires a certain level of awareness and compassion for the patients social needs, not just their dental needs.

I can easily recall patients that fit each social style. Seeing them through this lens makes me like them better as people, and I will definitely change how I interact with them at our next appointment.

 

Dr. Carolyn Norton is a New Dentist Now guest blogger and a 2014 graduate of the University of Florida College of Dentistry. She is in a 12-month general practice residency at the North Shore University Hospital in Evanston, Ill., affiliated with the University of Chicago. Dr. Norton was a contributing editor for the American Student Dental Association from 2012-14.

Are you interested in learning about the different types of group practices?

Learn more about the different types of group practices in videos posted on the ADA Center for Professional Success website.

Center for Professional SuccessDentists from three different practice group models spoke at ADA 2014 — America’s Dental Meeting in San Antonio about their organization’s structure, management, patient care and more. In 2014, the ADA Health Policy Institute proposed a classification system for group practices and a nomenclature that would more specifically describe them.

The videos include presentations on group practices that are dentist-owned and operated; affiliated with a dental management organization affiliated; insurer-provider; not-for-profit; and government agencies.

The presentations are available here.

Learn how to identify drug-seeking patients in upcoming webinar

An upcoming webinar aims to educate dentists on how to interview patients with addiction problems and identify those who are just seeking drugs.

prescription drugsInterviewing and Counseling Patients with Substance Use Disorders and Drug-Seeking Patients is scheduled for Feb. 18 from 2-3 p.m. Central time. Michael O’Neil, Pharm.D., professor of pharmacy practice at South College in Knoxville, Tennessee, will lead the webinar and review basic interview and counseling skills that help optimize patient care and protect dentists from patients who may have criminal intent.

Dentists may find themselves the targets of prescription drug diversion scams and schemes and the webinar will provide tips on how to talk to patients about their intentions and counseling that will help minimize risks to the patient and dentist.

To register, contact Alison Siwek at siweka@ada.org. Registration closes Feb. 16.

Know the difference between accidents and signs of domestic violence?

In a year where high-profile accusations of family violence have rocked the National Football League, the ADA House of Delegates streamlined Association policy on family violence during its meetings at ADA 2014 — America’s Dental Meeting in San Antonio, according to ADA News.

An employee crying

Resolution 89H-2014, Educating Dental Professionals in Recognizing and Reporting Abuse, states that “the ADA supports educating dental professionals to recognize abuse and neglect across all age groups and reporting such incidences to the proper authorities as required by state law.” The House rescinded policies from 1993 and 1996.

“Family violence has been a hot topic in the news media as high-profile players in the NFL have been accused of violence against children or partners,” said Dr. Lynn Douglas Mouden, chief dental officer for the Centers for Medicare & Medicaid Services. “There is a universal mandate for U. S. dentists to report suspected cases of abuse or neglect of children, but dentists should also be aware that some states also mandate reporting cases that deal with adults and elders as well.”

Are you able to discern the difference between accidents and intentional injuries or signs of violence? Do you know what your state’s law in regards to reporting family violence?

If your answer is “no,” Dr. Mouden suggests attending the 7th Biennial National Conference on Health and Domestic Violence, set for March 19-21, at the Renaissance Washington, D.C. Downtown Hotel.

“With training, dentists are better able to discern the difference between accidents and intentional injuries, or between otherwise normal conditions and the signs of violence,” Dr. Mouden said. “Because laws vary from state to state, dentists should work with their state dental association to learn more about the laws regarding reporting of family violence and about opportunities to learn more about preventing family violence.”

For more details on the conference, hotel accommodations or to register, click here.

10 steps to increase provider participation in Medicaid/streamline administration

Here are 10 steps to increase provider participation in Medicaid and to streamline the administrative process from Action for Dental Health, a nationwide, community-based movement aimed at ending the dental health crisis facing America today.

Action for Dental Health

  • Step 1: Talk with the manager of Provider Enrollment for your state and review the process for enrolling in the Medicaid program. Confirm basic information such as documentation expectations, electronic filing and ability to participate on a limited basis.
  • Step 2: Identify populations of interest that your practice will serve. Determine how those patients will access your practice, whether via local community outreach or referrals from the local community health center after being triaged.
  • Step 3: Discuss with your state dental association the current baseline of provider participation and the data that will be coordinated as reported by your state to the Centers for Medicare and Medicaid Services in its CMS 416 report. This information is the basis for determining what positive results are being seen due to increased provider participation.
  • Step 4: Participate in a state Dental Medicaid Advisory Committee or form a committee if one does not exist in your state. Invite other Medicaid providers, both private practice dentists and those working within community health centers, to participate.
  • Step 5: Review Medicaid rates, prior authorization and enrollment processes for your state. Are adult Medicaid benefits available? Was there an increase in providers if rates were increased? Learn what negotiation and compromise efforts were performed.
  • Step 6: To streamline your credentialing and provider eligibility process, review those states making a positive difference (Oklahoma, California, Maryland and Kentucky). Invite the people who perform the enrolling process to your Medicaid advisory committee to investigate what might be done in your state to expedite credentialing.
  • Step 7: Meet with the manager of your state Medicaid Integrity Program to learn of the processes they follow for chart audits and review. Explain the need for uniform compliance training for auditors for reviews. Discuss with your Medicaid Advisory Committee.
  • Step 8: Maintain strong lines of communication with the state Medicaid program, the state oral health program, the ADA and Medicaid-CHIP Dental Association who can be resources for you.
  • Step 9: Share program successes and failures with your local dental society.
  • Step 10: Write an article for your state dental association journal about your Dental Medicaid Advisory Committee, your experiences in treating the underserved and the value that dentistry can provide in communicating with the local medical community about the importance of integrating oral health for patient overall health.

To view the full 10-step process, click here. For more information about the ADA’s Action for Dental Health, visit ADA.org/action.

Research: Number of dentists will continue to grow in U.S.

A new research brief published by the ADA Health Policy Institute show the number of dentists in the U.S. will continue to grow over the next generation.

Under the most likely scenarios, the ADA’s model predicts that dental school graduations will exceed dentist retirements. The net increase of practicing dentists will exceed the corresponding growth of the U.S. population.

Health Policy InstituteThe new report, available at ADA.org/researchbriefs, shows the number of dentists practicing per 100,000 people today has climbed more than 4 percent from 2003 to 2013 and is projected to climb 1.5 percent from 2013 to 2018 and 2.6 percent by 2033.

Another HPI analysis found that the percentage of the U.S. population reporting that they were unable to access needed dental care declined between 2003 and 2012. These declines occurred across all age groups.

Additional ADA research suggests that the most effective policy changes to address access to dental care would focus on more prominent barriers to care such as cost, geography and education. Barriers related to the availability of a dentist were reported much less often by a very small percentage of the population and declined in all areas.

New research from HPI includes:

• “Dental Care Utilization Rate Highest Ever Among Children, Continues to Decline Among Working-Age Adults.” HPI found that from 2011 to 2012, dental care utilization increased among children and decreased among working-age adults.

• “Dental Benefits Expanded for Children, Young Adults in 2012.” More children had dental benefits in 2012 than in the previous year, representing a continuation of more than a decade-long trend. The percentage of children without dental benefits is at its lowest rate since the Medical Expenditure Panel Survey, the source of HPI’s data for this brief, began tracking dental insurance coverage in 1999.

• “Fewer Americans Forgoing Dental Care Due to Cost.” The percentage of the population reporting cost as a barrier to receiving necessary dental care fell in 2013. This is the third year of this decline, reversing the increase that occurred from 2000 to 2010. Despite improvements in affordability over the last few years, cost still remains the most critical barrier to obtaining needed dental care.

• “Supply of Dentists in the United States is Likely to Grow.” Under what HPI considers the most probable scenario, the per capita supply of dentists in the United States is projected to increase through 2033.

• “Most Important Barriers to Dental Care are Financial, Not Supply Related.” Between 2004 and 2012, fewer Americans reported needing dental care but not getting it. In both periods, among a group of 11 types of barriers to receiving needed dental care, financial barriers were mentioned most often. The level of financial barriers was highest among low-income, nonelderly adults.

• “A Ten-Year, State-by-State Analysis of Medicaid Fee-for-Service Reimbursement Rates for Dental Care Services.” HPI found that the average Medicaid fee-for-service reimbursement rate was 48.8 percent of commercial dental insurance charges for pediatric dental care services and 40.7 percent for adult dental care services. Over the past decade, Medicaid reimbursement for pediatric dental care services relative to market rates fell in 39 states. The available evidence strongly suggests that enhanced Medicaid reimbursement, in conjunction with other reforms, increases provider participation and access to dental care for Medicaid enrollees.

All of these briefs are available at ADA.org/researchbriefs.

Pick up practice management skills from the comfort of your own office

The ADA Center for Professional Success recommended some ways for new dentists to pick up practice management skills from the comfort of their own office or home, and earn continuing education credits at the same time.

Center for Professional Success

  • Improve your own organization: Use the SMART goal process to learn to set organizational objectives to help improve the efficiency of your office. Evaluate your external and internal strengths and obstacles that factor in your goal attainment. Develop new habits and processes that will result in a smoother, more efficient work environment each and every day. It’s free for ADA members. To learn more, click here.
  • Interested in peer review? Peer review is a way to address the issues of quality oral health care for our patients in a self-regulating manner. It is a dispute resolution program that is based on our ethical obligations as dentists to provide our patients with the best care possible in each situation. This course outlines the administrative aspects, the differences among different systems and an overall look at how to best structure a system that is confidential, consistent and easily accessible. It is free for ADA members. To learn more, click here.
  • Other courses available: ADA CE online offers a number of courses for member dentists. Take time to browse through the selection, and find the perfect class to suit your needs. To learn more, click here.

ADA launches new dental student Web portal

The ADA launched this month a new Web portal designed to provide a one-stop shop for dental students seeking information, ranging from financial resources to finding a job.

ADA for Dental StudentsThe portal ADA for Dental Students can be found at ADA.org/student or can be accessed via the Member Center on ADA.org.

The portal provides dental students easy access to a variety of ADA resources and benefits, including information on dental careers and finding a job, financial planning and student loan debt, dental licensure and examinations, professional ethics, and more!

The portal will be regularly updated with new and noteworthy information and resources. For more information, contact the ADA Office of Student Affairs at studentaffairs@ada.org.

Want to know more about treating patients in long-term care facilities?

With a goal to reduce barriers to dental care for some 1.3 million nursing home residents in the U.S., the ADA has launched a Long-term Care Dental Campaign that includes an online continuing education course.

Dentistry in Long-term Care: Pathways to Success, is an eight-module course designed to help oral health professionals become more comfortable providing care in long-term care settings and to create successful and sustainable oral health delivery programs that serve nursing home residents.

Participants will receive 10 CE credits when they complete the course. The modules cover topics that include the structure and organization of long-term care facilities; choosing an appropriate delivery model; regulatory and legal compliance; creating and organizing an oral health program; working with complex patients; treatment planning; financial considerations in long-term care; establishing an environment for effective daily mouth care; and accessing the scientific literature.

For more details on the course or to register, visit success.ada.org/en/dentistry-in-long-term-care-course. Cost for ADA members is $475 and $650 for nonmembers. Up to three additional staff members can register for $150 per person. (Team members must register at the same time as the dentist for this reduced rate.)

The campaign is an initiative of the ADA’s Action for Dental Health, a nationwide, community-based movement aimed at ending the dental health crisis facing America today. Read more about the Long-term Care Dental Campaign here.

Do you treat nursing home patients in your practice? How can dentists help to reach this population?

Ready for ADA 2014 in San Antonio?

While you’re packing and planning your itinerary, here is some information that will help make your trip to ADA2014 smooth sailing:

ADA 2014 logoCheck the mail … every individual registered for the meeting will receive a separate mailing packet with their badge and tickets, even if several individuals from the same office or household registered. Packets may not arrive at the same time.

Sample badge

Sample badge

Check your badge for admittance code … everyone attending the Opening General Session and Distinguished Speaker Series featuring President George W. Bush Oct. 9, 9-10:30 a.m. at the Alamodome, must be pre-registered and have a bar code, like the one shown at right, on their badge for entry. (If your badge does not have a bar code, you must log back in to your registration, add the event, then reprint your badge on-site.) The bar code allows admittance for a one-time entry and is nontransferable.

Tickets for the Welcome Celebration, Oct. 9, 6:30-9:30 p.m. at Historic Sunset Station, and the New Dentist Reception, Oct. 10, 5:30-7 p.m. at the convention center, Lonesome Dove Room, are still available. Purchase online, on-site at the registration area in the convention center or at the door.

Use your smart phone: the ADA 2014 mobile app will be available Oct. 1. Users will be able to sync their course schedule to the mobile app and get updated course information, exhibitor listings, show specials and more.

For more details on what you need to know before you go, click here.