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Working after lock down – Some practical advice – GET

Working after lock down – Some practical advice

We are living in strange and sad times. People are dying and most of us have been forced in lockdown, unable to work. The timelines are different from country to country, but we will all soon be going back to work in a world which is not the same we left it, with many new rules and regulations.

 

I am quite amused to see on social media many dentists and orthodontists suggesting protection protocols, I suppose based on their extensive know-how accumulated by one course of microbiology and hygiene attended during dental school. Fact is, rules will be given to us by governments (which employs real experts, hopefully) and we will have to abide by them. I don’t know where you live and when and under which rules you will be able to start working again but there is something which will be needed for sure: keeping your schedule and being on time.

 

This is simply because you won’t be allowed to have people filling up the waiting room.  All official guidelines published so far have one thing in common, your patients should not wait in the clinic. For example, here in Switzerland, patients should stay in the waiting room with at least two meters distance between them and for a maximum of 15 minutes.

 

Don’t get me wrong, keeping your schedule should be your mantra also in “normal” times. Just remember the last time you went for a doctor appointment and you were left waiting 20 minutes in the waiting room, how you went from upset to annoyed to offended to enraged…

 

So, being on time is a must!

 

I am aware that being an Italian you may consider me as genetically unfit to give advice on how to be on time, however here are my practical tips:

Implement appropriate scheduling:

Scheduling is a science by itself and I will need to write a whole separate entry about it. Just a couple of basic principles. One, you need to time different procedures and YOU need to know how long it takes to do what. Second, please, please avoid having 20 different kind of appointments, one for each clinical procedure. It is just confusing and you would need always experienced staff to manage them. You should have only five kinds of appointments: very short (five minutes), short (15 minutes), medium (30 minutes), long (45 minutes) and bonding (variable).

Do “like things at like times”:

There is an old wise concept in scheduling, try to group similar appointments in similar slots. You probably already adopt the most obvious and known principle, schedule bondings in the morning.​

Place unpredictable appointments at the end of the day:

Normally these appointments are the first consultations and following treatment plan presentations. Some people ask few question, some more and you need to have time to answer all of them.

Fixed loose brackets immediately, but only within the scheduled time slot:

Fixed loose brackets immediately, but only within the scheduled time slot: To rebond one or two brackets takes about five minutes which should not create havoc in your scheduling. On the other hand, for a patient who has eaten something wrong (which is never the case of course since, quite mysteriously, all brackets seem to come off while drinking water or sleeping…) and ten brackets are lose, you need to have a firm policy of rescheduling the patient.

Be firm in rescheduling patients who come late to their appointments:

In normal times, I would suggest to deal with patients coming too late by making them wait and see them at the first free slot available. In the post-coronavirus world, this will not be possible. So I advice you to try at least to take a look at them but to reschedule the appointment. We have to adopt new procedures and people understand this. It helps greatly if you are clear upfront about this policy.

Create a time buffer in your schedule:

In theory, you should have about ten minutes catch up time every hour. In the past I have used retention controls for this, since they have naturally a high no-show rate. Moving forward, the creation of catch-up time will happen by itself since most new rules prescribe a period of room ventilation in between patients.

Start the day with a briefing on the daily schedule:

Go through the appointment list together with your staff, trying to identify appointments in which a special set-up is needed (e.g. placement of palatal implants). This will ensure you have everything needed ready in advance. In addition make sure you have identified critical areas (crowded slots, potentially problematic patients, etc.) and procedures which are not know by the assistants.

Leave your personal telephone in your office:
If you analyze the reason for big delays during a day, you will find out that the bottleneck most of the time is yourself. There is a time for a Facebook entry, for an Instagram post, for a call to your new boyfriend or girlfriend, just that time is not during clinical hours.

 

So, wish you all a good restart and please, be worried only about what you can control.


I am an orthodontist with some special interest in business and management, plus a generic curiosity. A little disclaimer. I have a contract with an orthodontic material producer which sponsors my courses and which produces some brackets that I helped develop. I receive no royalties (yes, probably I am an idiot !) and I must say emphasise I was never told what to say or do.​
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