Beyond the Medical History: Questions You Must Ask.
September 20, 2017
During this month of September, I want to dedicate my blogs to my mother Pauline Seidel. In 2002, my mother came in for her hygiene appointment after having her mitral valve replaced.
During my periodontal evaluation I discovered a perio/endo abscess and she later had the tooth extracted and a bridge placed. She soon after completing the dental procedure had a stroke and died from endocarditis.
I really do not know for sure if when she had the extraction, that she took her pre-med. I don’t know if the dental office asked the important questions such as:
- Do you have any heart conditions?
- Did you take your pre-med today?
I know that we, as clinicians, and our patients, are in a hurry most days. That’s how life is in todays face-paced world!
Updating Your Medical History Process
The medical history is something I am very passionate about because I have reason to believe that my mother may have not taken her pre-medication which is imperative when you have your mitral-valve replaced. What I observe in offices is patients are seated and the assistants go to bring in doctor. Hygienist’s feel like there is not enough time to do it all so the review of medical history and even taking patients’ blood pressure are forgotten.
- Do you have a system in place about reviewing the patient medical history?
- How often to do you and your team members seat a patient in the chair and ask about the patients’ medical history?
- Do you ask more questions after the patient tells you, “No changes.” ?
- What is your office protocol for reviewing and updating the medical dental history?
Save a Life
Besides asking, “Do you have any changes in your medical history?” – Let’s create other questions to ask our patients. We are in the business of creating longer and healthier lives; right?!
Questions to Ask
The medical history you have may not be able to answer all the important questions you need to know for example:
- Do you have any heart problems?
- Do you take any blood thinners?
Even patients who do have heart problems, in my experience, have forgotten (I know…!) to write this in the medical history and they have even forgotten to let the clinician know about the change(s). Take a step forward in saving a life and ask more questions beyond what your patient has written on their medical history.
Some Examples of Questions You Must Ask (Even if the patient didn’t check these in their medical history):
- Have you had any recent surgeries?
- Again, I have had a patient forget to update their medical change and the man forgot, probably didn’t want me to know, he just had throat surgery (Hard to believe I know; but it’s a true story!)
- Do you have a dry mouth?
- Good to know when your patient takes a lot of medications.
- It’s the number one side-effect with medications
- Xylitol or Fluoride Varnish and 5% Fluoride Gel can prevent decay
- Good to know when your patient takes a lot of medications.
- Do you drive and text?
- Oh! You haven’t heard about this question? Refer to the above section “Save a Life” because this is our business
Today’s medical history forms can provide great information such as should you text, call or email your patient?
You can discover some great information that can help keep the perfect connection going beyond the patient in your dental chair.
Seating Your Patient
We recommend that you seat your patient and then just sit with your patient for few minutes to “connect.” Sit knee-to-knee and eye-to-eye with no patient bib. Use the next 2 minutes to connect, find something outside of dentistry to talk about. Create a human experience, not a dental experience at this point.
After you connect with that person in your chair, now ask the important questions and begin the review of their medical history.
This connection is a key secret to our clients who are highly profitable. Find out something personal or something that will make them light up and feel comfortable in the dental office (You do know most patients don’t want to be at the dentist. sad but it’s true.) Let your patients feel how much you care for them. They are more than a patient in your chair.
As fast as dentistry changes; so must your medical history.
Think about having online forms and accessible on a tablet or desktop in your front office. For new patients it can be an efficient and time-saving process to have your office forms online and accessible through a link you email or a place on your website.
When was the last time your updated your actual form to capture patient’s medical history?
How often does your office want a new medical history form completed?
These are important questions your entire team must know the answers to.
Make sure you have every person who seats the patient take a moment to “connect” with that person in the chair and then never forget to review the medical history before any dental treatment begins. And if you can implement a blood pressure screening annually, you will definitely hear from your patients that you have saved a life (or many for that matter!).
Together, as a team of healthcare professionals we can save many lives. That is what we are all about isn’t it?!
“Help Patients Keep teeth and Save Lives.”
ABOUT DEBBIE SEIDEL-BITTKE, RDH, BS
Debbie Seidel-Bittke, RDH, BS founded Dental Practice Solutions in 2000. She is considered a Leader in Dentistry by Dentistry Today. Debbie shares how to optimize your hygiene department with offices globally. The approach to optimize your dental hygiene department is an integrative approach as the entire team learns how to drive efficiencies and profitability in the practice. Teams that have worked with the team at Dental Practice Solutions have now doubled their practice production without working harder.
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