I had a patient who was fearful of dental procedures and the related financial implications. She is employed full time with dental benefits and is married, but her husband is now underemployed and more at home taking care of the children.
My patient had some emergent dental issues that we resolved, but she had other issues that also needed attention. (I am sure that sounds familiar!)
Her appearance at scheduled appointment times was less than stellar. With the advent of text messaging, we can now text our patients to confirm their appointment (at their request -- we offer a choice), in addition to sending reminder postcards. Even so, this patient failed to appear for two Saturday appointments. Our policy is to allow no more than two no-shows on a Saturday, then you are not able to preschedule a Saturday appointment again. So she rescheduled, of her own accord, for a Monday she had off of work.
That Monday came, and despite the text reminders she again was a no-show. We attempted to phone her, but there was no response, and we had to charge her for a failed appointment. We were almost certain she was not planning to return to our office.
At this point we had not seen her in the office for more than a year. She subsequently missed a routine preventive care appointment and also a restorative one.
Lo and behold, on a recent Monday I received a text from her: "What is the number 4 the root canal dude. It is killing me." (Please take no offense, my dear endodontist friends. Her words, not mine!)
I texted her back with the endodontist's phone number, then waited a few days before sending her another text (obviously the only way to reach her). She responded that she hadn't made an appointment with the endodontist yet.
Yesterday, I received another text, saying that she had finally had the procedure completed. I reminded her that she will need to schedule a follow-up, and attempted, in 140 characters or less, to explain what the next steps should be.
I am not saying this is the best, most appropriate way to communicate with patients, but for this particular patient it worked (for the moment!). Will she continue to restore the tooth? Only time will tell. It will be an expensive extraction if she waits, as we all know. But we are only able to talk about the potential outcomes of dental issues. After that, it is up to our patients to take the next steps.
Maybe she will text that she is ready for an appointment next week. Who knows? The ball is, as always, in the patient's court.
Sheri Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal andWoman Dentist eJournal. You can reach her at firstname.lastname@example.org.
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