Specialist referral is a well-established procedure in many countries and is becoming more common in the UK.
However, a number of problems still persist that limit the specialist facilities that are on offer to patients and these include:
• Lack of referral facilities across much of the country
• Perceptions on behalf of both dentists and patients that specialist care is expensive.
• Lack of communication between referring dentists and specialists
• Lack of understanding on what added benefits specialist services can offer
• Who accepts ultimate responsibility on completion of the specialist care
Over the next two articles I will consider ways that each of these can be overcome.
The first issue is a major problem and is related to a lack of long-term foresight and planning. I am not sure there is an easy solution to this although, as usual, sticking plaster solutions are being sought by the bodies that be.
Patients having to travel some distance may be the only current option in some areas. Those of you who regularly read my articles will understand my views on ethical selling. Part of this is the importance of selling the idea to patients that they need to receive a particular specialist treatment for their own benefit.
For patients with advanced periodontal disease, the sales process or educational process starts with the referring dentist and their practice team. Failure to educate the patient at this early stage that they have the disease and will suffer if it is not treated will deny patients the care they require.
Telling patients that the specialist treatment is expensive, before explaining the benefits, will turn many patients off. I know this is a major block on the route to referral so be careful of the words and phrases you use. It is often related to lack of time for the referring dentist and I have attempted to create an easy referral route for my referring dentists. An additional problem I find is that sometimes patients don’t know why they are being referred – they need to be clearly informed at the outset.
Communication is paramount. Simple standard referral forms (hopefully supplied to you by the specialist) are very useful. These should not be over complicated as an onerous form will be a barrier to referral – after all, who likes filling in forms? They should, however, offer sufficient information to allow smooth conveyance. Let the specialist know what you want – and don’t want – him or her to do.
Additionally, if you are not sure about something, speak directly to the specialist. Don’t be afraid to pick up the phone. I am more than happy to speak to a colleague to resolve any issues.
One of the challenges I face is the massive amount of paperwork and written correspondence I have to send to the referring dentists and patients. If I am not careful I will find that I have no time to care for patients. On completion of care, I inform my referring dentists that they can assume everything is fine unless I write to them on a specific matter. This results in the referring dentists trusting me and realising that I know what I am doing.