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Creating a Rewarding Dental Sleep Medicine Practice “If you build it, they will come.”

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

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Page 1: 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.”!

Page 2: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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.

XXX

Page 3: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

The Circle of Care!

“If you build it,! they will come”!

Page 4: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Field of Dreams!

Page 5: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

My Dream!

Page 6: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice
Page 7: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

My Strategy!•! FINDING PATIENTS TO TREAT!

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

Page 8: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Patient Centered Team!

Page 9: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

How to Build It?!•! MY STRATEGY!

–!Screen patients of record!

–!Physician referrals!

Page 10: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Why Won’t The"Doctor Refer?!

1. Unknown Dentist!

Page 11: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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

Page 12: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice
Page 13: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice
Page 14: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Why Won’t The"Doctor Refer?!

1. Unknown Dentist!2. Unknown Expertise!

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

Page 15: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Strategy: Develop Skills!•! Develop Clinical Skills!

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

Certification!

Page 16: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Strategy: Credentials!•! Board Certification!

–! Attendance at Annual Meeting!

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

Expertise?

Diplomate ABDSM

Page 17: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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?

Page 18: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Why Won’t The"Doctor Refer?!

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

–!Physician unaware of treatment provided!

!

Page 19: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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

In-House Team:!•! SM Correspondence

Coordinator

Page 20: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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>

Page 21: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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!

Page 22: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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…!

Page 23: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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.”!

Page 24: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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.“ !

Page 25: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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.”!

Page 26: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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!!!

Page 27: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Developing the Team!

Page 28: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

External Team Building!

Page 29: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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!

Page 30: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Strategy: Insurance Expertise?!

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

Page 31: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Crossroads!

Page 32: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

The Power in Team!

Page 33: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Quality of Patient Experience!

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

Patient Self-Advocate

Page 34: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Team Medicine!

Page 35: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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?

Page 36: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

EUREKA!

Page 37: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Virtual Team Building!

Page 38: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Virtual Team!

Page 39: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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

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

Page 40: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Flow Chart of Patient Care!

Page 41: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Virtual Team:"Essential Equipment!

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

Page 42: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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!

Page 43: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Data Collection!•! Identify all potential referral sources!

Page 44: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Data Collection!

Page 45: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Data Collection!•! Identify Your Peer Group!

Page 46: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Virtual Team Building!

Page 47: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

My Strategy!•! FINDING PATIENTS TO TREAT!

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

Page 48: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Marketing Phone Call!

Page 49: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Marketing Doctor Visit!

Page 50: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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

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

Page 51: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

Success?!

Page 52: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice
Page 53: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

“If you build it, they will come.”!

Page 54: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice
Page 55: Patricia braga 2015 AADSM Presentation-Building A Physician Referral Dental Sleep Medicine Practice

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

—Shoeless Joe Jackson!