‘Dentistry will clearly never be the same again’
Richard Scarborough asks principal dentist Martina Hodgson about her approach to running a private dental practice in the weeks since COVID-19 broke out.
Martina, who runs The Dental Studio in Wakefield, discusses her current approach to patient recruitment and managing patients who are part-way through treatment such as Invisalign. She also shares why she thinks dentistry will never return to the way it was. And why her initial focus for reopening will be on staff training.
Tell us about your practice?
My practice is three terrace houses knocked together in an old coal mining village in Yorkshire. An unlikely place for a fully private general practice with a heavy emphasis on aesthetic dentistry. But we have won multiple awards and have the loveliest patients.
Can you tell us about how life has changed in your practice since COVID-19 hit?
Like everyone else we have ceased face-to-face dentistry altogether. My whole team has been furloughed with the exception of my treatment coordinator (TCO).
On a personal level it has been very challenging trying to balance home schooling two kids under 10 with the demands of keeping the practice going and planning for the future. Whilst also keeping in constant communication with my team and patients.
In terms of the practice, all of the dentists have been telephone triaging patients and trying to deal with the unacceptable lack of dental emergency provision out there.
I’ve been spending a lot of time keeping in touch with my team too. Such as via one-to-one Facetimes, Zoom meetings and Whatsapp groups and emails. It’s so important to keep them in the loop as it is a very unsettling time for us all. I like them to know what I am thinking (and help them stay positive).
How do you normally recruit new patients, and how have you changed this approach now?
We get a lot of new patients through word of mouth and social media. However, personally I spend about 80% of my time providing Invisalign. So we do run some Google and Facebook ads to recruit new Invisalign patients.
Initially we stopped all paid marketing, but upped the social media presence. I think it is really important to keep in touch with your patients via every means. So I make sure to post regularly to keep patients updated and well informed, as well as communicate our practice culture and how our team are spending this time.
Recently I have noticed a general increase in organic enquiries and so have just started Facebook ads again. It is important to be sensitive to the times and to what is going on out there. So the message is different to what it may have been in the past.
How have you managed to maintain relationships with patients during this time?
All of our dentists have been personally rearranging patient appointments. That way they can stay in touch with their patients and discuss over the phone any concerns they may have. Patients really appreciate that personal touch, it goes a long way. It’s also a great opportunity to check in on more vulnerable groups or shielded patients.
We have also sent regular emails and newsletters to keep them in the loop, as well as regular updates on social media.
People will remember the way businesses behaved during this crisis. I have seen several examples of businesses that have dropped all communication with their clients. Now those very clients are questioning their relationship with those businesses.
How are you managing patients who are part way through treatments?
It is time-consuming to keep in contact with those patients, but also critical. I have contacted them all personally to give bespoke advice and given them a mobile number they can directly contact me on if they have any queries.
Where possible, we monitor patients remotely. For example, this is possible with Dental Monitoring for Invisalign cases. In some instances, this is enabling the treatment to progress to the next aligner. In others, we pause the treatment; it is possible to order three replacement aligners from Invisalign, which they can ship direct to the patient.
Contact with patients is time-consuming but it is the right thing to do. It shows them that we are willing to go over and above to look after our patients and I have had a lot of positive feedback.
What has been your approach for patients who had been on the cusp of starting treatment?
Starting treatment right before lockdown would obviously not have been the right thing to do. But we have contacted them all individually and ensured that all those patients have an appointment booked in July to start their treatment. Obviously if we are able to open earlier, we can bring forward their appointments. But this keeps them in the books and ready to go.
What is your patient contact strategy?
Our TCO has been answering the phone and dealing with general patient enquiries. When people call the practice there are also options for patients to contact their own individual dentist directly if they have any dental problems.
We got a new phone system through Yotel recently and it’s been invaluable during this time. It has enabled us to automatically redirect calls to my TCO’s mobile. She can work from home and also patients can directly contact their own dentist. Hopefully that way people feel when they ring that there is a human still there to speak to!
Patients can also contact us via email and a contact form on the website.
How are patients responding in the current time?
I think our patients have generally been brilliant. They have been so understanding and really appreciative of the personal contact we are all making with them. They understand that we can’t see them face-to-face right now and are just glad that they can get some advice and speak to someone.
What are the major things that patients are contacting you for?
The most common calls are in relation to their payment plans. My TCO is great at dealing with those and also reassuring people. We get one or two calls a day for dental problems and that’s about it.
The last week or so I have also noticed an increase in enquiries for cosmetic dentistry and Invisalign, so this is reassuring to see.
How are you responding to these?
My TCO is on hand every day to deal with general enquiries – most people just need a bit of reassurance. The dentists are telephone triaging as best they can and getting prescriptions to the patients where relevant. Making sure that queries are dealt with quickly and efficiently is really important. Patients are so grateful just to have someone to help them.
We have been offering video consultations via Zoom for prospective Invisalign patients and this has been really successful! We send them a link to Smilemate first so they can upload their photos prior to the consultation for me to review. It’s pretty cool AI technology and gives us a good idea of whether they are suitable for treatment, how much and how long it will take (subject to full assessment in person, obviously), which we can then communicate to them at the virtual consultation.
We will definitely keep these initial virtual consultations up when we reopen. It is very convenient for patients and also reduces the footfall through our practice right now whilst we are social distancing.
How have you been planning for a return to normal dental practice and resuming treatment with patients?
The next few weeks will be key in deciding when we reopen. It is important that we are ready to hit the ground running. But also that we don’t rush into treating patients without the whole team being ready and prepared.
I don’t think there will ever be a return to ‘normal’ dentistry the way it was before coronavirus.
We have a unique opportunity at this time to implement new practices and patient journeys into our businesses. And also to move forwards and stay ahead of the curve.
So, as well as overcoming the challenges of obtaining PPE, producing new protocols and systems, it is important to make sure the team are prepared.
Once we have organised and zoned our appointment diary safely, we will then prioritise people with dental problems and plan patients who are overdue their exams and treatment.
On a business level it is important that we get up and running and making a profit again ASAP to get the practice back to a healthy position. We will be making sure there is time in our diary for higher income, lower risk procedures such as Invisalign.
What will be the priorities once practices are back up and running?
Once we get the go-ahead to open our doors, the first thing I have planned is a week of team training prior to re-opening. This is a great opportunity to do lots of training with the team on things that we never normally have time to do.
Also, there will be a huge amount of changes to the way we work, new protocols and systems. It is important the team have time to digest these and refine them as necessary.
Getting back to work in a calm, measured and organised way is important so everyone is clear about their role and can work safely to protect themselves and our patients.
We need to rethink not only our cross-infection measures but also the way our diaries run and the way we provide care. We also need to consider reducing the number of visits to the practice a patient has.
This may mean carrying out more treatment in one visit, consultations and consent via video and remote motoring using tools such as Smilemate and Dental Monitoring for Invisalign. I am also considering implementing hygiene exams to minimise the movement of patients around the practice, as well as the many other benefits of this way of working.
How different do you think dentistry will be in the post-COVID-19 world?
Dentistry will clearly never be the same again. But it has always been an evolving profession so that’s nothing new. We’ll have new ways of working to get used to. It will take a long time to get our practices back to financial health.
I hope the NHS will see this as an opportunity to overhaul the current UDA system, which is not fit for purpose.
The cost of running a practice will increase and our revenue will go down as we need longer appointments for patients and have to defer some treatments. Not only that, but we will have a global recession to wrestle with. So all these things will challenge our businesses and ways of working.
We will see more and more dentists adopting digital dentistry. I see the digital revolution accelerating.
The only way to survive is to adapt and lead the way for change. Now is the time to decide what you want your practice to look like, how you want to work and how you want your life to look.
We will never get this opportunity again to press pause and reset. It’s time to grasp the new opportunities that are coming our way and embrace the brave new world we are entering.
We have seen an amazing coming together of our profession, who have achieved amazing things by collaborating during lockdown. By being strong, compassionate leaders and supporting one another, we can guide our teams through this period of change and come out the other side stronger and braver than ever before. Hopefully we can all look back and be proud of how we acted and what we achieved.
Martina is the owner of The Dental Studio and has been at the practice since 2005. She qualified from Leeds University in 2001 and has a particular interest in orthodontics and Invisalign.