A Treatment Co-ordinator (TCO) is a member of the team who looks after patients with regards to their treatment plans and the fees involved. Basically, a TCO relieves the Dentist of the duty of discussing treatment and the fees involved in order for the Dentist to focus solely on delivering dental treatment. TCO’s are only really necessary in private practices where money is more of a concern to patients.The job of a TCO involves a lot of responsibility and effort. It often takes a certain character to be a TCO, someone who is naturally good with people and can put them at ease. A TCO also needs to be patient, understanding and empathic as when dealing with patients, especially nervous patients; it is not uncommon for situations to become difficult. For example, a nervous patient comes for a consultation in order to be told that she needs all of her upper teeth taken out and a denture fitted and that if she came 10 years ago then this wouldn’t be necessary. In this sort of situation, the patient could become very upset, cry and need support. A TCO needs to be able to sympathise with the patient and offer them reassurance, whilst focussing on the goal of booking this patient in for the appointment and securing a payment.
Duties of a TCO:
• New patient journey
• Treatment presentation
• Discussing treatment plans with existing patients
• Recording daily diagnosed and accepted figures
• Following up outstanding treatment
• Conducting free smile consultations
•New patient journey:
The TCO should conduct the new patient journey from start to finish. This involves taking the initial phone call to booking appointments and securing payment. The first stage is taking the phone call. Excellent phone manner is essential. Once a patient has expressed interest in joining the practice, it is necessary to explain what kind of practice you are, e.g. denplan, practice plan etc., and the benefits of joining.
It is also a good idea to promote your practice and try and entice the potential patient along. If the patient is unsure as to whether they want to come for a consultation, take their name and address and offer to book them in for a free smile consultation (see section on free smile consultations) or send them an information pack. It is also important to find out about the patient and try to connect with them on a personal level. Ask what their concerns are and what it is they are looking for, be it general dentistry or a smile makeover so that you have a bit of information about them before they attend. Explain the consultation process and the fee. It is always a good idea to take a deposit over the phone or ask the patient to come into the practice with a deposit in order to encourage them to attend as you don’t want to risk the patient changing their mind and wasting an appointment. At the end of the phone call, explain that you will be sending them a welcome pack with their appointment card and receipt (if deposit was taken over the phone) and it is always a nice idea to ask them if they would like a drink on arrival. This makes the patient feel special and is all part of the first class service patients expect with private treatment.
What should I put in a welcome pack?
A welcome pack should include:
• Welcome letter.
• Information about the practice.
• If patient expressed interest in a particular treatment, e.g. Invisalign, put some information about it in the pack.
• Medical history form.
• Smile evaluation form.
• Appointment card.
• Receipt.
• Testimonials.
On arrival, the patient must be greeted warmly by the hand of the TCO or receptionist and either handed their choice of drink or offered a drink. Once the patient has had a few minutes to settle with their drink, the TCO will give them a guided tour of the practice and then escort them to the consultation room. For the first half hour or so, the TCO will discuss with the patient their medical history and smile evaluation forms, find out what the patient’s goals are for their mouth and what it is they would like from your practice. The TCO will make notes of this. At this first stage of the consultation, it is useful for the TCO to take some extra-oral photographs of the patient and their teeth in order to keep on their record. If the Dentist has a camera for cosmetic cases, it is worthwhile he/she training the TCO in photography, as this is yet another job the TCO can relieve the Dentist of. Once all information and photographs have been taken, the TCO can escort the patient into the reception area and ask them to take a seat while the treatment room is being prepared for them. At this stage, the TCO will explain to the Dentist the patient’s situation and dental background so the Dentist is prepared for the patient. It is necessary at a consultation to have the following:
• Mirror, probe, periodontal probe and tweezers.
• Bitewing sensor and holder.
• Intra-oral camera.
• Photographs on the screen that were taken earlier.
The TCO will then escort the patient to the treatment room and introduce them to the Dentist. If the TCO is a Dental Nurse then they can assist during the consultation to chart and assist with the x-rays, if not then another Dental Nurse can be doing this instead. Consultations can include an assessment with a Hygienist. If this is the case then the TCO will escort the patient up to the Hygienist after seeing the Dentist and then collect the patient at the end of the hygiene assessment.
Once the Dentist and Hygienist have both completed their assessments then they can put a treatment plan together for the patient. If the treatment plan is fairly simple and straightforward, then it is absolutely fine to discuss it with the patient there and then. If the patient accepts treatment, then appointments can be booked, payment can be arranged and membership discussed. However if the treatment plan is quite complex, then it is wise to invite the patient back for a treatment presentation.
•Treatment Presentation:
If a treatment plan is particularly complex or expensive then inviting the patient back for a presentation is a great idea because it adds value to the treatment. The patient is made aware that the Dentist has had to take time out of his/her diary to carefully study their x-rays and photographs in order to create a plan just for them.
Before the patient arrives, have their treatment plan(s) ready and any demonstration models, before and after pictures, testimonials etc. ready.
It is also a great idea to present the patient with a computerised presentation that can be burnt onto a CD for them to take away and view at home. Microsoft PowerPoint is a great program for this. You can create slides with descriptions of the treatment you are proposing for the patient and include images of their x-rays and photos highlighting areas of concern. You can also include at the end the stages of treatment and the fees involved.
It is really the TCO’s job to fully explain what the Dentist and Hygienist have recommended for them and the reasons why. Also to be discussed are the fees involved, any discounts that can be offered and payment options etc. If your practice offers finance, then the TCO can set this up at this appointment if the patient wanted finance as their payment method. If the patient accepts treatment then appointments can be made and payment can be arranged. Alternatively, if the patient wants to think about the treatment, then you can arrange a courtesy call a week later to see if they have made a decision. If the patient declines treatment then you can ask them why and see if there are any obstacles that can be overcome- e.g. “I can’t afford that, I can’t proceed with treatment” can sometimes be overcome with, “Well did you know that we can spread the cost over 12 months interest-free?.” If the patient still declines after you have tried to solve any issues they have then you can just update their record and explain that they are welcome to come again if they change their mind.
•Discussing treatment plans with existing patients:
If a regular patient requires treatment after an examination with the Dentist, it is a good idea for the Dentist to request that the TCO come and collect the patient from the treatment room and escort them to the consultation room to discuss the treatment plan in private. The Dentist will inform the TCO, in front of the patient, of the patient’s situation and ask the TCO to look after the patient from that point. The TCO will explain again to the patient the treatment needed (or requested if cosmetic) and the reasons for it. This gives the patient the opportunity to ask questions that may have forgot to ask the Dentist or may have felt too embarrassed to ask. The TCO can inform the patient of the cost of treatment, discuss which payment method would be best for the patient and book an appointment. Similarly with new patients, if the patient needs time to think about it then you can arrange a courtesy call and if they decline then you can try and clear any obstacles that they may have in order for them to book in for their treatment.
•Recording daily and monthly diagnosed and accepted figures:
It is important that as a TCO we keep track of the treatment that has been diagnosed each day and the acceptance rate. An excel spread sheet is the best way to do this and should have the following columns:
• Month treatment was diagnosed.
• Name of patient.
• Treatment provider, e.g. Dentist or Hygienist.
• Treatment diagnosed.
• Cost of treatment.
• Whether it was accepted, left outstanding or abandoned.
At the end of each day, all the treatment plans that were presented to patients (new and existing) should be collected and logged onto the spread sheet. Once this has been done, you can total up the amount diagnosed and come up with a percentage of the accepted treatment. E.g. Treatment diagnosed comes to £2000, £1650 was accepted- unfortunately Mr X declined a crown. To figure out the percentage of accepted treatment, just divide £1650 by £2000 and multiply by 100. This gives a total percentage of 82.5%. This figure should ideally be given in the following morning meeting. If your practice does not have morning meetings then you can give this figure to the Dentist or Practice Manager daily or weekly. In your monthly meeting, it is a good idea to provide monthly diagnosed and accepted figures.
Following up outstanding treatment:
It is important to keep a record of all patients that have been given a treatment plan and not booked an appointment due to wanting to think about it or not booking in straight away as they are going on holiday etc. This can easily be achieved by keeping an outstanding treatment file. This can be made using an excel spread sheet which should have the following columns:
• Date treatment was diagnosed.
• Name of patient.
• Treatment provider.
• Treatment diagnosed.
• Notes (so that you can make relevant notes such as “left voicemail, to call again next week” or “call patient when they get back from holiday next month.”
This file should be referred to regularly so that you know where each patient is up to with regards to their treatment. Ways of contacting patients are a courtesy phone call, letter to remind them of their treatment and reminder email or text. If patients have been on the file for a while, you could think of enticing them back for their treatment by sending them an offer such as “10% off cosmetic treatment only for this month” if the practice has an offer on.
Conducting free Smile Consultations:
A Smile Consultation with a TCO is a great way of allowing a potential patient to decide whether they would like to join the practice and find out whether the practice provides the treatments that they are interested in and whether they are affordable, without wasting theirs and the Dentist’s time. If the patient decides that they are serious about having treatment with you, then you can book an appointment for them with the Dentist, knowing that the chances of treatment acceptance are high. A Smile Consultation with a TCO should be about 30 minutes and involve a guided tour around the practice, a chance to meet the team and a discussion about the kind of treatments we offer and the fees involved with the TCO.
