“My patients have vanished without a trace; what happened?”

Why the referral process is broken.

For there to be a solution, there must be a perceived problem.  When it comes to General Dentistry, situations develop where it is necessary to refer a patient, whether a new patient or an established patient, out of the office to a specialist for consultation and care.  Many of these patients don’t make an appointment for the specialist, and some are never seen again at the general dentist’s office either.  What happened, and why did they “fall into the cracks?

Referrals are a routine system in all general dentistry offices but they should never stop at handing the patient a paper referral slip or an email. The specialist is emailed a copy of the referral slip, the x-rays, and the periodontal chart while the patient will hand carry the paper referral and the directions to the office.  Therein lies the problem, “out of sight, out of mind.”

The system has remained the same in most dental practices for years, and some practices send hard copies or photocopies of films with the patient or by snail mail and not use email technology at all.

An old worn-out saying, “old habits die hard,” that loosely translated means habits are hard to break.  The tragedy is that some patterns that are standard protocol are costly and dangerous.  The old practice of referring patients to specialists by paper and unsecured email is such a bad and broken habit.

The current referral process can break the link between the General Dentist and the patient.

Whether the patient books the appointment through your business coordinator or is left to call on their own, there is a high probability that the appointment is canceled, broken, or never made. 

 A survey completed by Dr. Sam Ahani of refera.com points out that 30- to 40% of his referred patients did not create or keep their appointment.  Some patients felt that they would not be welcomed back to his practice because they did not visit the specialist. So they are in dental limbo. Patients fear change and the unknown; it is essential to monitor their progress and be available for questions.

Sending paper dental referrals can result in the following problems:

  1. It can take too long to reach the receiving dental facility if it is an urgent referral. Email is fast but not HIPAA compliant. Some emails go to Spam, and others are accidentally deleted.
  2. Paper form referrals can get lost in the mail and never realized by the sender, or even forgotten by the patient.
  3. Referrals can often be hard to read, illegible, and be missing essential facts. The staff must spend additional time completing the form, taking valuable time away from other management duties. Miscommunication can happen, which can affect the patient’s care and experience.
  4. The average processing time is three days or longer with paper referrals vs. less than 4 minutes with an electronic system.  

It is vitally important that the general Dentist have a close working relationship with the specialist(s).  The referring Dentist should visit the specialist’s facility, observe treatment, and be free to ask how his/her patient will be received and treated.  Become familiar with the specialists’ communication skills, clinical judgment, and competence.

Teleconference and video virtual tours should be available in these uncertain pandemic times.  In-person visits are rare but should not derail good professional communication.

Patients like to know they are being sent to someone their dentist trusts.  Once the patient has seen the specialist, the general practice must be informed immediately of the patient’s status.   Sending reports via snail mail is slow, and when they reach the General Dentist, they often sit in a pile on the desk awaiting review.

If the treatment will be phased, and there will be more than one General Dentist or specialist involved in the care, all providers must be in the communication loop. 

Referral.com is working to unite the general dentist with the specialist and to include the patient with a video chat feature.  Fixing the broken referral system takes this team of people and technology united on one platform.

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