Some patients wonder what added benefits they will receive from specialist referral. It is a good idea to make it clear to them that the treatment is exactly that – specialist – and therefore at a high standard. Being honest and upfront, while explaining why you are recommending this service, is crucial.
I, for instance, am a periodontist. I do not do endodontics. I can do it (and reasonably well), but I am nowhere near as good as my endodontic colleagues and don’t actually enjoy it. I tell my patients that I know somebody who can do it better than me.
For example, if patients need endodontic therapy they are referred to an endodontist. I have no ego about this. Accept that there are some things you are better at than the specialist but in this particular area of referral he has greater abilities (or so you hope). Explain it in that way to patients and your honesty will be respected.
Patients are also slowly coming to expect specialist referral and may well bring it up with you if they realise they were not given the option.
One of the problems that often stands in the way of specialist facilities on offer to patients is the question of who accepts ultimate responsibility on completion of the care.
This absolutely lies with the specialist in the area of the treatment he or she performs. With my periodontal patients, their periodontal health is my responsibility. With the implants I place, they remain my responsibility. The only condition is that the patient remains in my care on an ongoing basis for their periodontal or implant maintenance, and that the patients must attend their recall visits.
Some patients want to return to their own dentist or hygienist for ongoing maintenance. If this is the case, and I do not continue to see them, then the responsibility must pass back as I cannot be held to account. The patient must of course be informed appropriately.
My systems are not perfect, although I constantly try to improve and learn. It is simply not possible to be everything to everybody but I have attempted to set up systems that will work very well most of the time.
Where needed I will develop flexibility for specific situations. It is also important for referring dentists to speak directly with specialists, and vice versa, if there are specific issues or uncertainties to resolve.
Miscommunication can sometimes occur, particularly in written correspondence, so verbal clarification is often needed.
Communication between all parties involved in the conveyance will result in better care for patients and the release of pressure and responsibilities from the shoulders of referring practitioners. If this strategy is carried out properly, everyone wins.
• There is no place for ego. If a colleague is better at a certain specialist treatment than you then step aside and recommend them instead
• Be clear on where the responsibility lies between referring dentist and specialist. It should be the latter, providing the patient remains in their care and attends recall visits
• Formulate a system for your referrals that will work most of the time. Remember – no system can be perfect and please everyone
• It’s important to be flexible with your system for certain situations
• Quality communication between dentist, specialist and patient is vital. Verbal clarification is often the best way of clearing up any queries.