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Would a Treatment Co-ordinator really benefit your practice?
In the latest segment of our podcast, we had the delightful Emma, an expert treatment coordinator, share her experiences and guidance on the evolving role of a treatment coordinator in a dental practice.
Would this TCO model work in your practice? What are the challenges in starting this? Are there any drawbacks? Emma spills all the beans!
Need to Read it? Check out the Full Episode Transcript below!
Highlights of the episode:
00:00 Introduction
02:21 Emma’s Journey to TCO
5:46 TCOโs role in various practices
10:00 Advantages of a TCO consultationย
14:13 Disadvantages of Treatment Co-Ordinators
18:20 Timings of Appointments
21:19 Patient consent processes
23:02 Profitability and practicality of TCOs
25:56 Introducing virtual treatment coordinators (VTC).
28:00 How to find a TCO
31:45 How to reach Emma
If youโre inspired to learn more, reaching out to Emma is a breeze. Connect with her through her Instagram page @em_thetco
If you liked this episode, you will also like Recommend Treatment Plans with Confidence โ IC038
Did you know? You can get CPD from the Web App or Phone App and watch premium clinical videos, for less than a tax deductible Nandoโs per month?
Click below for full episode transcript:
Episode Teaser: Mentally, why are you worried about a patient booking their next appointment? Why are you worried about how they're going to pay for their treatment? That's not your worry. That's for someone else to deal with.Jaz’s Introduction:
Hello, Protruserati. I’m Jaz Gulati and this Interference Cast, we’re going to cover the topic of treatment coordinators. Is it right for your practice? We hear from Emma Yates, who is a nurse turned into a treatment coordinator. And a treatment coordinator, if you haven’t heard of this term before, is someone who is kind of in between the reception team and the dentist, right?
They’ve got enough clinical knowledge to discuss the pros and cons of different treatment and help the patient in their journey to find out what’s the best treatment for them and also help them to pay for their treatment, how to finance it and answer those niggling queries they sometimes have and sometimes patients have to wait some time to hear from the dentist.
But that treatment coordinator is a friendly phrase, right? They’re not the scary dentist. They’re a friendly face. They’re an advocate for the patient. And I’ve seen over the past few years, lots of different practices adopt the treatment coordinator model. Now, I’m not sure if it’s just a UK thing or a worldwide thing, but this is definitely becoming more integrated in dental practices.
So if you’re a principal wondering if this is the right move for you, or if you’re maybe a nurse thinking, hey, you know, could I be a treatment coordinator? Or perhaps you’re an associate and you like the idea of your practice, having a treatment coordinator, and maybe you can send them this episode to weigh out the pros and cons of it as per the discussion that we have with Emma.
So let’s join Emma now. And at the end in my outro, I’ll let you know how you can claim CPD for this episode.
Main Episode:
Emma Yates, welcome to the Protrusive Dental Podcast. How are you?
[Emma]
I’m good. Thank you. How are you?
[Jaz]
Yes, absolutely brilliant. It’s a Saturday. I was working clinical this morning. I’ve had a couple hours of de stress, but now, I love, I’m doing the bit, which I love speaking to different people, learning, sharing.
And today’s topic is treatment coordinators of which you are for the past six years. As you told me before we hit the record button, I have so many questions for you, like so many practices could be employing this way of working. And they probably have so many questions. I’d be hesitant for some reason, so many concerns before doing such a big step.
So I think this episode today between you and I will go a long way in helping answering some burning questions that the community might have about having the TCO model. But just before we do kick off properly, just tell us a little about yourself, your journey. How’d you get into being a TCO, that kind of stuff.
[Emma]
Of course, yeah, so I started off as a trainee nurse when I was 18. BTEC Forensic Science in college, decided that uni was not for me. I wanted to go out into the working world, earn some money, but I wanted to stay with a medical background. So, went along to my dental practice had a checkup, and they said, oh, we’re looking for a trainee dental nurse, are you interested? I’m like, actually, yeah, I would be interested. Went along for the day really enjoyed it. I love dentistry, teeth. I love everything about it.
[Jaz]
Are you in the same practice now, by the way?
[Emma]
No, no, so I left there quite a while ago. I did stay there for nine years though.
[Jaz]
Wow.
[Emma]
I did all my post qualifications there, so my radiography, my fluoride application, impression taking, everything that basically got me to where I was today. I worked with a fantastic dentist, she taught me everything I needed to know.
And at the point of nine years, she said, I’m leaving, I’m going to go work in a private practice down the road, what are you going to do next? And I was like, I’m not sure, it’s all I know, like I was so comfortable there. And then she went, well why don’t you go and see Tipton training, they’re looking for a nurse.
Now the background of that was, the dentist that I worked with such a long time, Siobhan, she did the Tipton training courses and I learnt a lot about occlusion, facebow, impression taking from her that she loved from Paul. And it was a scary moment, but I took the jump and I applied for the job. I met Paul, Louise and the team and they liked me and I got the job.
So, I worked for Paul for three years. Traveling around, Ed was his dental nurse, his course coordinator, I helped girls out in the admin team, attended the courses as a sort of a course coordinator. And yeah, I absolutely loved it and I think I learnt the most of my dental knowledge from Paul and his team, which I think made me the person I am today as well.
[Jaz]
Amazing.
[Emma]
Traveling got a little bit too much. We traveled to Scotland, to London, we were traveling to Dubai. And it just got very much quite hectic within your own personal life. So I decided to take a break and go back into general dentistry. And I’ve been back in general for about six years now, which is when I started doing treatment coordinating. Wanted to come away from clinic for a little while.
[Jaz]
Okay, so when you were with Tipton team, with their training department and whatnot, and also in the clinic, you were doing general nursing, dental nursing, and not a TCO at that point.
[Emma]
No, I was-
[Jaz]
Okay. And so for the last six years. Okay, got it. Did the Tipton Clinic not consider keeping you on as a treatment coordinator? Did they have a treatment coordinator in their clinic?
[Emma]
So they didn’t at the time. Majority of the time, the nurses within the clinical team for the dentist that did the courses kind of managed it within the top business. I do know now that they do have a TCO at Tipton’s training that purely deals with balls patients. But at the time it was more dental nurse slash me. That just dealt with the day to day running of the surgeries, obviously on the courses we helped as well. So yeah, at that point we didn’t really have the TCO as such, but I do know now that they’ve introduced that over into their, sort of, business, bam.
[Jaz]
Do you think it’s grown in the last so many years? Do you know other colleagues? Who are also treatment coordinators. Do you have a community of treatment coordinators? And do you think that this is really accelerating or do you think it’s staying stagnant and perhaps practices have been resistant to adopt a treatment coordinator?
[Emma]
No, I think the complete opposite dental practices are really trying to get this TCO role into their businesses. I think the problem is with dentists now is they’re so busy. I mean, obviously you’ve got families. The admin time it takes for a dentist to look after one patient is just, it’s too much for one person to deal with and they have to have more discipline as a team to be able to do that for you.
I mean the whole idea of a TCO is it’s that middle person, so you’ve got your reception team, you’ve got your dentist, and you’ve got the middle person who’s got the clinical knowledge, who can take some of the heat off the dentist but can also support the front of house team as well and that’s how I fit into the team.
I mean, there’s a big, massive range of TCOs in the industry. There’s ones that are literally a bit more of a glorified receptionist who, well, they’ll deal with payments. Make appointments, and that’s really what their role is. We’ve got ones that are a little bit more clinical, which will take scans, talk through payment plans, and create treatment plan letters and get in touch with the patient and discuss that with them.
And then you’ve got probably more my sort of TCO where I do a lot within the business, as well as the treatment coordinator as well. So I would look at development, how we can introduce new things into their business, from what patients have told me about what they want from a dentist. There’s a lot of different elements of a TCO, it’s just finding the right one for you and what you want from a TCO.
Which I think why the pay scales for TCOs are so vast, from like a normal nurse fee all the way up to like a really high fee for a manager basically.
[Jaz]
It’s a very good point you make because there are different types of treatment coordinators, there are different roles that they’re assigned. And this obviously depends on what works best for the clinic, the kind of setup that a clinic has, what they’re trying to aim, what they’re trying to achieve.
What is, would you say, the standard model at the moment? And I want to know Emma is the patient journey, basically the standard you can talk about yours and how you’ve adapted it over time, how you might have improved it, for example, but how do you think most practices are using treatment coordinators where in the patient journey?
Because I know that some practices, what they have is that the treatment coordinator is the first person you meet. They get the history, they take the photos, they take the scans, and they’ll do a handover to a dentist, whereas others like they see a dentist first, and then in between they have a follow up chat, it’s the treatment coordinator who’s explaining most of the fees and stuff, and follow up a week later saying, you know, how’s it going, or how to chat again with dentists, this is what we think. What model do you use, and what are the most people using?
[Emma]
So I think a lot of people are using the model where they see the treatment coordinator post chat with the dentist. I personally don’t like that. I feel like don’t build that relationship up with a patient if you don’t meet them from this offset.
Most of my treatment coordinating knowledge came from when I worked in orthodontic practice. So I worked for one of the northwest largest orthodontic practice for about two and a half years. And they predominantly work with treatment coordinators. That’s the first person that you see, that you deal with.
They educate the patient on everything they need to know. And the orthodontist will actually pop in for five minutes and go, Yep, you’re suitable. No, you’re not suitable. Off they go. And then you back to the TCO and then they take over the selling role and making the appointment. So, I’ve been brought up with my TCO journey to be very much the main part of a new patient.
That is who you’re seeing. Yes, the dentist has a massive role in the clinical side, but you’re building that relationship so that the patient knows that you can be the person they go to and not have to wait till your dentist. When, when going into general practice where I am now, they didn’t have a treatment coordinator, so I kind of developed a role within what I’ve been taught and what I would have liked to have done as a treatment coordinator.
So I introduced the 10 minute chat pre new patient examinations so that they, I can get to know the patient. And I ask all the boring questions, not because I don’t want the dentist to do it. It just means that patient feels you’ve got a clinical background. So I’ll ask the things like, what toothbrush do you use?
Do you use a fluoride toothpaste? Do you clench and grind? Do you have sleep apnea? Do you snore at night? All these kind of things. They go, oh, actually, that’s very interesting. I’ve never asked that question before. And it means that that dentist is not spending the time on them icky questions, or so to speak.
The fluffy questions. That you need to know about, but really you want to get in the mouth and start looking and excited what’s going to happen and, and divide the treatment plan. So I kind of take that off the dentist and I do that and pass that over on my hand over to the dentist. That then means the patient feels that I understand what’s going on.
And then the dentist knows that I understand the patient’s background as well. Whether it was they’re nervous, they’ve got a health condition, they’re interested in a certain type of treatment they don’t offer, so then I have to refer them to another dentist. So it just means that I’m involved in that conversation and the patient understands who I am as a person as well.
Then I will chat to the dentist, tell them everything that I know about the patient, write it all up in the clinical note.
[Jaz]
This is in front of the patient? I’m just trying to get the details here. Like, are you going to walk with the patient to the dentist and do like a handover in front of the patient? Or is this like on a different day?
[Emma]
So I, there’s two different types I’ve done in the past. One practice I’ve worked at, we do it in front of the patient. Now at Parkfield, I do it, get the patient to sit back in the waiting room for a few moments and I’ll go and have a chat with the dentist before they get the patient in.
[Jaz]
What do you like?
[Emma]
I like that.
[Jaz]
You like it so the patient’s outside and you can really tell them what you think.
[Emma]
I mean, you’ve got, there’s some things that you don’t want to say in front of a patient because you don’t want to upset them. I mean, it could be anything from like, they’re very chatty. Oh my god, you know, be careful that we don’t have too much, like, questions about this, that and the other.
Get them in the chair, get back, get on with it. Or it could be the fact, they’ve opened up and said, oh, I’ve got an eating disorder, I’m worried about this, that and the other, because you’ve discussed a bit of diet. They might have really bad sugary habits, and they’re very nervous about telling the dentist that they’ve got a habit.
So that’s when quite nice them to tell me and I can just pass on that question and the answer to the dentist and they don’t have to talk about it until it comes to the end of the consultation and possibly some treatment might be needed to sort of hold that. And so that’s nice.
[Jaz]
What I like about that, Emma, is that, I can imagine if I’m a treating coordinator and I’m sort of going by my history and I’m trying to present all these photos and you’re doing it. And sometimes things in a random order and you need to collect your thoughts, but the patient’s watching you and you kind of get this stage fright, but it’s got a different tone to it. So I like the fact that the patient’s outside and you can just be like, okay, have a one to one and just have your time to sort through things. And, oh yeah, by the way, this, and, and so it’s less pressure. Did you feel that?
[Emma]
Yeah, exactly. And it means that you can kind of dip in and out of dental things. So I mix up my questions. I’ll start off with, last visits and what you do on a routine. They’ll ask them what they do for a living.
I’ll go, oh, by the way, what do you do for a living? Like, what’s yours, what do you do for a job? And then they will have a chat, maybe they’re a teacher, and they’re quite stressed because they’ve had the GCSE class just finished, or they’re just about to finish for half term, and they’re changing schools, and then you go back to them, they go back to another sort of questions to do with budget, and if they want any cosmetic treatment.
So I kind of break up the questions from clinical to personal to clinical and then explain what’s going to happen in that checkup so they’re not going to just get flung in the chair, sat back, and then all these numbers and letters are being read out, rabid x rays, next minute people leave in the room.
So it’s nice that they get sort of a pre chat to kind of know what to expect, especially because I find a lot of our patients come from NHS and private NHS examinations are worlds apart, especially the time that they spend in the chair. And I do feel like patients might get a little bit like, oh, I’ve been in this chair for a good half an hour now, and I’m like, what’s up?
What’s happened? Why am I in this chair for so long? So they’ve got someone to give them a heads up and say why we do things differently and what we’re going to do. I think that helps lap the patient. It makes ’em, again, feel comfortable within the team that they’re actually seeing.
[Jaz]
I mean, I think there are so many advantages to working with the treatment coordinator model. Like the patient feels like they’ve got someone on their side, they’re not the scary dentist, right? They’ve got someone on their side. The other benefit with the dentist is that, some dentists are terrible at it and they don’t like talking the money, right? They just hate it.
And I see you nodding now for those listening. And it’s great to have someone who just may be trained for that. And I think a lot of dentists might appreciate that. And that can work in different ways. I think it’s great to have so much information given to a patient before they actually go in. Just like you said, the advances are numerous.
I want to ask you a tricky one. What do you think? Are there disadvantages of having a treatment coordinator for a practice? Are there any times that you felt that you had to change what you’re doing to better suit a dentist or anything that practice need to consider before adopting this model?
[Emma]
Yeah, for sure. I mean, obviously everything comes with a couple of negatives. I mean, the big one is obviously a wage. Is obviously you’re employing a person to do that job. I mean a lot of dentists try and do get around it by having a multi skilled nurse. So they’ll do nursing some of the week and then they’ll do treatment coordinating some of the week. I personally don’t agree with it.
I think it’s too much for a nurse and a TCO role to be merged. Especially when they’re trying to do what they’re supposed to be doing. So yeah, a wage is a big factor. It’s an extra person in the building that you’re paying a daily wage. The second thing is they need their own space. They can’t do it at the front of reception.
They can’t do it in your surgery because you are in there. So most of the time they need a dedicated room or space to be able to have these conversations with patients. Prior to the refurb, the practice I work at the moment, I basically used to use a spare surgery if I needed to. So I’d do it at the beginning of the sessions, lunch times, end of day, pre consultations.
And luckily I had a small room with a desk in that we could have a chat in pre and post treatment about things like that. So yeah, space is one, wage is definitely one. And then finding the right person. I mean, a lot of people think every dental nurse could be a treatment coordinator, but that isn’t the key.
I think it’s really important that the dentist listens to what the treatment coordinator says, and that they’re happy with the values and the way they’re delivering the treatment plans. Because that’s the person who’s selling you. Like, you need that person to understand everything about you. I mean, I work with five dentists.
They’re all different. Everyone’s different. Jags likes consent. Mariam likes me to tell ask them loads of pre questions. I’ve been, like, to big treatment plans and then to be out on time. So you’ve got a lot of dentists that you’re looking after and you have to understand them, so you have to get the right person.
Someone who’s, obviously, a nurse is brilliant because they understand all the clinical, but administration, organisation as well, that is the key. So I’d say the three ones that do work against the most likely.
[Jaz]
I think it makes sense to have a GDC registered nurse to take on these duties because then they can do the scanning, they can do the photos, they can have that extra clinical input.
Whereas if you take someone who’s like a receptionist without a GDC registration, not being clinically trained, then they’re really then becoming a glorified receptionist. We’re just trained to talk more dental. Would you agree with that?
[Emma]
Yeah, completely. I feel like sometimes if you get non clinical, people will say all day. It’s kind of like going to buy a car at the end of your appointment. Which is not what you want to do. At the end of the day I always like to focus on a dental health point of view. So I’ll always sit down with the patient and say, how was your appointment? First thing I want to know. Good, bad, things you didn’t understand.
Then I’ll go through exactly what the dentist has just told me. So after the appointment, And they’ll pop the patient back in the waiting room and I’ll pop in and have a quick debrief with the dentist and they’ll let us just go this fill in, this fill is thin, this option, this many splints, blah, blah, blah, and then they’ll go, right, okay, back to you.
I’ll bring the patient in and go through the x rays again, through the cost, through why they need the treatment, the benefit, the optional treatment. And then ask them what they want to do. Like, what do you want to have booking today? Do you want to think about it? to book in for this? Should we prioritize this, this and this? So yeah, it’s, it’s got to be, you’ve got to have your systems in place for it to work. For sure.
[Jaz]
I love it. I’d love to have an Emma to go into and be like, okay, Emma, just yeah this is what I need to do. Can you spend some time to explain the x rays, photos and see what the patient wants? And obviously the dentist has sussed this out, but actually going back to the patient journey. So they see you first, then you do the handover. In confidence with the dentist, then the dentist would proceed to bring them in, I guess, to the examination, is that right?
[Emma]
Yeah, definitely. I mean, some of the dentists like me to bring the patient in and introduce them, like it’s Dr. Sambi and Tricia, they’ll be looking after you today, I’ll see you at the end of your appointment.
For instance, Nihal, he prefers to go and greet his patient from the waiting room and take them up to his surgery, have a little chat with him on the way. And then most of the time we’ll go, we’ve had a chat with Emma, she’s told me X, Y and Z, let’s sit you back and then we’ll have a chat at the end of your appointment. So, it’s a nice clean way of doing everything. Everyone knows who’s who and what’s happening.
[Jaz]
How long have you spent with the patient? Collecting the history, very, very vast and detailed history and having the chat and do photos as well.
[Emma]
If needed, yeah. If for any reason I feel like a patient needs the photographs and yes, if it’s like a cosmetic or an orthodontic appointment, if it’s just a, what I call an MOT, which makes the dentist laugh, I won’t bother because I can just have a say, give me a big cheesy smile and then I can see if there’s anything like a coloured crown that’s wrong, or margins, or lost filling. I can just make a quick note of that and does it need to be photographed.
[Jaz]
Okay, so how long does that all take you?
[Emma]
About 10 minutes.
[Jaz]
The whole, well, so all that history taking, and potentially photos, and just introducing yourself, telling the patient what to expect, that’s just 10 minutes?
[Emma]
Yeah, about 10 to 15 minutes. Obviously, it depends how chatty the patient is. If you get a chatty one, then it might be a little bit over. But normally, as soon as they try to get into the practice, I normally take them straight into my room and get going. And then I just let the, the dentists don’t normally lie about, they know the patients in the room with me, so they’ll just catch up as soon as they get into the clinical chair.
[Jaz]
And then obviously this depends dentist to dentist, but on average, how long are the dentists that you work with booking for the new patient examination?
[Emma]
So we allocate 40 minutes for the patient.
[Jaz]
And then once they’ve had that and maybe their dentists are starting to talk about the different options that are available, at that point do they hand over to you on the same day or a different day? Just tell us more about what happens afterwards.
[Emma]
Yeah, so normally the same day. Obviously, everyone’s entitled to annual leave, so sometimes it might be obviously when I come back from holiday, it’s expensive. But normally they’ll tell the patient, take a seat in the waiting room, I’ll pop in, we put it all on the computer together, go through times of treatment, anything that I need to know or need to know it’s optional or upsell, anything like that.
Once they’re all saved, I’ll bring the patient back into my room, and again, we’d spend 10 20 minutes just going through everything and sort of do it like a closed down.
[Jaz]
Good, and at that point, how much detail do you think the dentist is going into treatment? Like, the whole consent process, right? Like, if they’re saying, the whole root canal versus extraction debate.
Oh, plus also you got some decay on these molars. And also should we extract this wisdom tooth or not? They’ve had a bit of a chat there, but then it’s a bit difficult in terms of what they’re leaving for you to also discuss and what they’ve discussed already. Any sort of guidelines and hints to what do you think the dentist should be saying in their 40 minutes? Versus what you see that you excel at the most with the time that you have after the clinical exam.
[Emma]
Yeah, I mean, if it’s like a basic, this tooth is need removal versus root canal treatment, then obviously a TCO should be able to sort of discuss them sort of, to’s and from’s. If it’s more of an in depth thing like, I don’t know, a splint for instance, obviously that definitely needs to be just discussed in surgery.
So I think a lot of the dentists depend on what they’re like a lot of dentists like to speak, some dentists don’t speak at all. And again, it varies from dentist to dentist. So normally when they do a handover, they’ll tell me what they’ve already told the patient. So I don’t need to go back over that too much.
But we do have good consent processes within the practice. So what we normally do is a week before their due to come in for an appointment for RCT extraction implant, we will give them a post and pre op instruction via email and give them a week to at least read through everything and allowed to ask any questions just in case when on the case examination.
They didn’t understand everything or they misconstrued something. It means everything’s sort of cleared up before the actual appointment. And it’s not that down to that when you sit a patient in the chair, they go, oh no, I didn’t have the tooth out today. It’s like, that’s what you booked in for. It means that they’ve had that sort of week’s notice.
They know that they can’t go to the gym. They know they can’t drink alcohol for 24 hours. And it means that consent process is locked in. That you know exactly that patient knows what’s going on in that appointment.
[Jaz]
Have you ever had a miscommunication with a dentist? Has it ever happened? Or is it all human stuff? I’m just trying to draw some maybe some funny stories from you maybe as well. But you know, just humor me. Any sort of a funny time where you thought, okay, yeah, we need to change how we work with this particular dentist because there’s some miscommunication or confusions.
[Emma]
I wouldn’t say I’ve ever put the patient in for the wrong treatment, so to speak. But dentists can talk very backwards sometimes, and I sometimes have told a patient, Paul, with the wrong thing and then I’ve gone, I’m really sorry. I’ve told you completely the wrong thing, but a dentist has now explained this, this, and this, and you’re backtracking. But luckily, I mean, I don’t really mind being the person the wrong, but I’ll never make sure the dentist look better in the wrong.
It’s always, it takes a flat. But so he is a dentist. I will never allow it. I’ll always say it’s me. So yeah. Oh, it’s got the back.
[Jaz]
Wow. Well done. That is lovely to hear. So well done too. Emma, do you think TCOs, as far as any data, I mean, I’ve got my bias, I think I know the answer, but do you think they’re profitable?
A practice ultimately to have this spare room, another person to pay the wage. Do you think they do it because the practice turnover will increase or do you think they’ll do it because everyone just has more breathing space and everyone enjoy their quality of work more?
[Emma]
I think it works both ways. I think the first one with profit and obviously bringing more into the practice is yet. It’s got to. If you’ve got a TCO that is literally controlling all your treatment plans that are over a certain amount. So, normally anything over sort of 1, 500 is when I would track that patient and make sure that all their appointments are up to date and that I’m checking in every week to make sure that everything’s going smoothly.
Obviously, a lot of systems have things like Care Manager, which is SOE, and I’m guessing Dentaly and all the other ones have similar things. Another reason what a TCO needs to be doing is sitting there on a weekly basis and going through all these open plans. Giving the patient a call, making sure it’s not just because they don’t understand what the treatment’s for, that it’s from a health point of view.
Got decay, you’ve got a decay in his tooth. It’s really important that you have this filling done. If it’s at least six months, it could be bigger, it could go into a root canal treatment. And it’s another reason why it’s really important that a nurse or someone with a clinical background is having these conversations with a patient regarding open treatment.
So from that point of view, yeah, it’s got to. If someone’s monitoring your patients and the open course of treatment, Then, and recalls, and surely the practice should be making more money. A researcher’s can’t do it. It’s not viable for someone in front of house to be dealing with recalls, with a patient in front of them.
And then obviously taking payments as well and making a relaxed environment. One of the things that we’ve done at Parkville is take the phone lines off the main desk. So it’s purely just a podium with no phone lines. So it’s just that patient being dealt with at that time. And that’s helped massively with front of house and making sure that’s all under control.
From a patient sort of perspective, it means that they’ve got someone to always go to. So a lot of my patients are quite dependent on me now, which is nice because it means that they trust me and they understand that they can come to me and they’ve got-
[Jaz]
Are you Whatsapping? Are you like a business WhatsApp?
[Emma]
So we’ve got WhatsApp. I’ve actually just taken on a, because we’re so busy, and I’m so busy, we’ve just taken on a virtual treatment coordinator as well. So it’s called VTC and what they do is they help with all the new patient phone calls. So if a new patient calls, it will go to our VTC team, Ellie and Danny, and they will vet the calls for us and they will allocate the right appointment and put them in the diary and then they’ll still see me on the first appointment.
It just means that the front of house team are not having to worry about clinical questions or where they should be going in the diary because they’re already busy doing their own job, which is looking after the patients that are actually in the physical building. So that’s quite nice. If dentists haven’t got a TCO but they feel like they want that extra support when booking new patients in and they haven’t got a me to speak to beforehand, then VTC would do that for them and ask all them questions, build a relationship, paint a picture of the practice for them as well.
[Jaz]
Excellent. And I think the moment you mentioned about care manager and looking after patients with open plans at the moment, my nurse, Zoe is not only doing all the millions of things that nurses do. She’s also then getting tasks set to have a look at care manager, make sure she’s going through with a fine tooth comb.
It’s tough. It just makes sense to me to have a TCO. I’m going to be sending this episode to my principals and twisting their arms that, you know what, can we get TCO? We’ve got the spare surgery. Now and again, it would be good. And I’m sure lots of other clinicians are thinking the same thing.
[Emma]
Yeah, you don’t have to be there like seven days a week. And you could have someone who could do it from home. You could have someone who come in two days a week and did it. It just purely depends on how many patients you are dealing with on a day to day basis. Obviously the TCO role grows. I’ve gone from the practice having and not having a TCO to two and a half years being there.
Is that dentists that I worked with originally were a bit unsure what I was supposed to be doing. And they’re like, why aren’t you here again? Why can’t we just do that? And then now they’ve come to the point where they’re quite dependent on me and they like, when I’m on holidays, like, don’t want to be here.
Which is really, really nice. That means that they obviously have a lot of confidence in what I do. But it shows that the dentist does need support. Why are you, I know your nurses are brilliant. I’ve been in that clinical world before. In surgery, you need the best person next to you. But mentally, why are you worried about a patient booking their next appointment?
Why are you worried about how they’re going to pay for their treatment? That’s not your worry, that’s for someone else to deal with, sure.
[Jaz]
I love that so much. I’m going to make that my opening snippet on this podcast. That is brilliant. I love that so much. Emma, you’ve answered all my questions about TCOs that I had for you.
Is there any other messages you want to give? And I also want to learn, if a practice is thinking about doing it, how can they learn more about this? Where do you find the indeed of TCOs? How can you actually help and facilitate practices to find a TCO or build that into their infrastructure?
[Emma]
So the only thing I wanted to mention was obviously the free consultation site. Cause I feel like a lot of dental practices do still do free consultations, which is great for a patient, but we’re still finding that dentists still do their own free consultations, which I think is just crazy. I think if you’ve got a skilled nurse like your nurse who knows quite a lot about dentistry, about what you would do as a dentist then it’s good for them to be able to have that extra skill rather than looking for a care manager.
Also having that sort of base where a patient could just pop in the door and be seen straight away for a free consult rather than having to wait for a dentist to do so. So, I think definitely when you’re looking for a TCO, make sure they’re clinical. Make sure that they can do free consultations, make sure they’re spending time in the clinic, so they understand how you work and what treatments you offer.
I mean, all our dentists at Parkfield have different things they like to do. So, obviously, we have a jagged tendo, with our fixed implants, we’ve got Joe doing his sleep apnea, Marion, like, doing facial aesthetics. You’ve got to really key in and find what that patient wants. You might end up seeing a free consultation and have three types of treatments come out of it because they actually never knew what they, what you did as a practice.
So the TCO is there as sort of a brand person like you’re the walking brand of the practice, you’re the person who knows absolutely everything about the practice, what they do, how they can deliver it, how much it’s going to cost, how long it’s going to take. So yeah, you need to find someone that when you meet them, you think actually yeah, she could be the face of the practice.
He or she, I shouldn’t be there, say she, so we’re used to nurses being she’s, but the men are coming up with a dental nurse in the day.
[Jaz]
That’s true, that’s true.
[Emma]
Yeah, exactly, yeah. So please look for someone who is that person who you think, oh yeah, they could be the brand.
[Jaz]
It must have been so nerve wracking the first few times you did it, right? Just like, because you must have been so used to having a dentist there in the same room, and then it was just you. Did you feel like, really like, whoa, out of your depth, maybe?
[Emma]
Yeah, for sure. The first time, obviously when I was at Turret, the orthodontics practice, I was learning from a girl that I’d known for years and she was just, okay, you’ve done a couple now, I’m going to leave you to it.
And next minute I’m doing Itero scans and taking clinical photographs and taking x rays. I’m talking through positioning of teeth, occlusion. I’m just like, hang on, have I just gone to uni five years and just not realised? And you forget how clinical you actually are. For the dental nurse, you assist in someone, but you actually know a lot.
As a TCO, you get to have your time and say, actually, I know this stuff. Yeah, I’m okay. I get it wrong sometimes. I’m not perfect. And I’ll book the patient in for a Mary Lamb bridge, and I’ve not checked the slide. And to see if they’re going to hit it, they move tune forward. And it’s been times that, oh, and this plan’s not going to work for this patient, but we’re going to do this instead because you’re not a dentist.
Well, 90% percent of the time tend to get it right over just learning what their patients want. But the dentist knows the need. So yeah, it can be very nerve wracking. You’ve just got to persevere. It’s okay to be wrong. Don’t answer questions if you don’t know the answers. And if in doubt, you’ve got a dentist next door, just get them to pop in and have a little look. It’s not going to do any harm.
[Jaz]
If any practice principal out there has been trying to pep talk a nurse into developing their role into a treatment coordinator, please do send them this episode. I think Emma’s given us great insight and talked about real world feelings and emotions, but also how well the whole model.
The patient journey can be enhanced. I think that’s brilliant. Is there any way you recommend we go to learn more, Emma?
[Emma]
There’s a couple of places that you could look to. A lot of the good courses now are usually for free, which is great. So, you’ve got myself. I can come in and do some chats with you, one to one, Zooms, check what the practice wants, help put some systems in place.
[Jaz]
And how do we reach out to you? How does anyone reach out to you?
[Emma]
So I’ve got my own Instagram page, which is emma.tco, which you can tag if you happen to. Or an email address that I’m happy for you guys to post. Or you could just reach out to the practice and let them know that you want to speak to me.
Other options are through implant providers or Invisalign. So Invisalign have got the wonderful Laura Houghton who’s offering courses for their Invisalign providers. We’ve got Mia Den, who’s got the lovely Alison, I think her name is, who’s doing all the implant nursing coordinating. So reach out to your providers, TCO training.
Send the nurse on the course, see if they like the idea of it. Give them one patient to try and see how they get on. You might find not any of them need that much training. I personally have not done any training, so to speak. I’ve just self-taught, watched other people, watched dentists. Got on a few courses and kind of took everything that I like and made it into my own system.
My system won’t work for every practice, but a system will work somehow by changing a few things we can make it work.
[Jaz]
Well Emma, I think I can safely speak for all the Protruserati that you are very easy to talk to, you’re bubbly, you’re smiley, you’re honestly, I can see why you took to treatment coordinator like a duck to water.
So I think if you have, if you’re listening and you have an Emma in your practice, cherish them, but see if you can push them and develop them and let them blossom into something amazing. Like we’re in the 2023, I think this is going to grow year on year on year. So I think if this has pushed you over the edge to consider it, it’s definitely got me to kick my principles into like, hey, can we consider this?
You can have that conversation again, but I think it’s one to be had with your own teams and it’s got to be right for your practice and your business model. Emma, thank you so much for giving up your time to be on the podcast. I’ll make sure I’ll put in the show notes your Instagram handle and how they can get in touch with you as well as all the other people that you said.
[Emma]
Thank you so much for having me as well. It’s been lovely to speak to you.
Jaz’s Outro:
Thank you so much. Well, there we have it guys. Treatment coordinators. I think they’re brilliant. I’m definitely going to be twisting John and Chris’s arm to try and consider, can we employ this into practice? And it’s really got to be right for your business, right?
It’s got to be right for your practice, where you are in your journey of developing your dental practice. But I just think there’s so many advantages of having a treatment coordinator. So if you found this episode useful, please give it a thumbs up wherever you’re watching. If you’re on YouTube, like it.
If you’re on Spotify, Apple, please rate it. This is how the podcast grows. And of course, if you want to get CPD, if you’re a Protrusive Premium Member by visiting protrusive.app for less than the cost of a tax-deductible Nando’s per month, you get premium access to all the clinical videos and CPD for episodes just like this emailed to you by Mari, who is a CPD manager for Protrusive.
The website for that is protrusive.app. You can actually learn on your laptop and answer the questions. And it’s super easy to claim your CPD. Otherwise, I look forward to catching you same time, same place next week. Bye for now.
