Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Creating a Rewarding Dental Sleep Medicine

Practice!

“If you build it,!they will come.”!

Conflict of Interest Disclosures for Speakers 1. I do not have any potential conflicts to disclose.

2. I wish to disclose the following potential conflicts of interest:

Type of Potential Conflict Details of Potential Conflict

Grant/Research Support

Consultant

Speakers’ Bureaus

Financial support

Other

3. The material presented in this lecture has no relationship with any of these potential conflicts, OR

4. This talk presents material that is related to one or more of these potential conflicts, and the following objective references are provided as support for this lecture:

1.

2.

3.

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The Circle of Care!

“If you build it,! they will come”!

Field of Dreams!

My Dream!

My Strategy!•! FINDING PATIENTS TO TREAT!

–!Screen patients of record!–!Physician referrals!

Patient Centered Team!

How to Build It?!•! MY STRATEGY!

–!Screen patients of record!

–!Physician referrals!

Why Won’t The"Doctor Refer?!

1. Unknown Dentist!

Strategy: Refer!•! Refer, refer, refer!

Why Won’t The"Doctor Refer?!

1. Unknown Dentist!2. Unknown Expertise!

–!Experience?!–!Training?!–!Credentials?!

Strategy: Develop Skills!•! Develop Clinical Skills!

–!Annual Meetings!–!Comprehensive Series of Coursework!–!Trial and Error!–!Mentors!–!Accreditation!–!Eventual Board !

Certification!

Strategy: Credentials!•! Board Certification!

–! Attendance at Annual Meeting!

–! Time in Sleep Clinic!–! MD recommendations!–! Required # of cases (15)!–! Board examination!

Expertise?

Diplomate ABDSM

Strategy: Credentials!•! Board Certification!

–! Attendance at Annual Meeting!–! Time in Sleep Clinic!–! MD recommendations!–! Required # of cases (15)!–! Board examination!

•! Facility Accreditation!–! Required # of cases (5)!–! Practice Protocols!

Expertise?

Why Won’t The"Doctor Refer?!

1. Unknown Dentist!2. Unknown Expertise!3. Patient Disappears!

–!Physician unaware of treatment provided!

!

Strategy: Communication!•! Create Systems for Communication!•! Specialize My Team!•! Design Correspondence!!

In-House Team:!•! SM Correspondence

Coordinator

Strategy: Communication!•! Word Merge Document!!Dr. <Sleep_clinFname> <Sleep_clinLname>!<Sleep_clinName_name>!<Sleep_clinAdr1>!<Sleep_clinAdr2>!!Re: <PatinfoFname> <PatinfoLname>, dob: <Patinfo_dob>!

!

Dr. <Sleep_clinFname> <Sleep_clinLname>

Critical Components to Communication!

•! What it should say!•! Necessary details in concise and easy to

read format!–!Statement of intent!–!Significant Medical Hx!–!SOAP format!

Critical Components to Communication!

•! Statement of Intent!–! “I am referring my patient, <Pat_Name>, for an

evaluation of suspected Sleep Disordered Breathing.”!

•! Significant Medical History!–! “Significant medical history includes…!

•! SOAP !!–!S: “The patient presents with chief complaint of…!–!O: “Examination revealed…!

Critical Components to Communication!

•! A: Asks for Diagnosis!“Please evaluate and prescribe treatment!as you see appropriate.”!•! P: Requests a plan!“If you feel that a Mandibular Advancement Device (MAD) is recommended care I have included a referral form, a letter of medical necessity and prescription for treatment.”!

Critical Components to Communication!

•! Why collaborate with me?!–! I have Credentials!–! I follow AASM Practice Parameters!

“Cahill Dental Care is an Accredited Dental Sleep Center and all patients are managed in accordance with practice parameters established by the American Academy of Sleep Medicine.“ !

Critical Components to Communication!

•! Why collaborate with me?!–!Your patient won’t disappear!

!“If the patient is treated with a MAD I will keep you informed of our progress. When we feel the patient has attained Maximum Medical Improvement (MMI) with their device, they will be referred back to your office for medical evaluation.”!

Why Won’t The"Doctor Refer?!

1. Unknown Dentist!2. Unknown Expertise!3. Patients Disappear!4. Unknown Outcomes!

–!Physician unsure of efficacy and side effects of MAD therapy!!!

Developing the Team!

External Team Building!

Why Won’t The"Doctor Refer?!

•! Unknown Dentist!•! Unknown Expertise!•! Patients Disappear!•! Unknown Outcomes!•! Medical Reimbursement!

–!Physician concern that patient may incur large out of pocket costs!

Strategy: Insurance Expertise?!

“Your insurance only pays for 80% of my fee, ! so I only took 80% of your appendix”!

Crossroads!

The Power in Team!

Quality of Patient Experience!

•! Increased Delays!•! Disjointed Care!•! Conflicting Advise!•! Increased Anxiety!•! Patient experience?!!

Patient Self-Advocate

Team Medicine!

Quality of Patient Experience! Patient as Self-Advocate •! Increased Delays •! Disjointed Care •! Conflicting Advise •! Increased Anxiety •! Patient experience?

Patient with Team-Advocate •! Streamlined Dx and Tx •! Coordinated Care •! Consistent Advise •! Increased Comfort •! Patient experience?

EUREKA!

Virtual Team Building!

Virtual Team!

Virtual Team: Systems!•! Flow chart of patient care !

–!Framework of patient visits!–!Exact Medical Coding for each visit!–!MMB and Follow Up!

Flow Chart of Patient Care!

Virtual Team:"Essential Equipment!

•! Fillable PDFs!•! Electronic Health Record!•! Medical Dragon Dictation!•! Encrypted Email!!

Virtual Team:"Communication!

–! Patient presents for consultation!–! Patient cancels consultation!–! Patient starts treatment x3!–! Patient does NOT schedule treatment!–! Patient reaches MMI/MMB !

•! referred back to MD!–! Patient on long term follow up x3!–! Patient fails long term follow up x3!

•! Certified letter to patient!–! Patient discontinues use of MAD x3!

•! Certified letter to patient!

Data Collection!•! Identify all potential referral sources!

Data Collection!

Data Collection!•! Identify Your Peer Group!

Virtual Team Building!

My Strategy!•! FINDING PATIENTS TO TREAT!

–!Screen patients of record!–!Physician referrals!

Marketing Phone Call!

Marketing Doctor Visit!

Breaking Down The Barriers!•! Known Dentist!•! Known Expertise!•! Patients Don’t

Disappear!•! Predictable Outcomes!•! Insurance Management!

Success?!

“If you build it, they will come.”!

"Man, I did love this game. I'd have played for food money…. Shoot, I'd play for nothing."!

—Shoeless Joe Jackson!