In my office, the oral surgeon is with me one day a month. This means that I need to handle all of the postoperative complications; in the past, when a patient was referred to the specialist's office, he or she would handle the complications. I only saw the patient several months later, after all had healed. Now I am handling prolonged swelling after third molar extractions, missing healing implant caps with overgrown tissue, etc. I am learning more about oral surgery than I ever thought I would. Since my in-house specialist and I enjoy great communication, he is only a text or phone call away, and he advises me on how to handle things.
Upon hiring a specialist, you will find that your treatment planning will improve. You'll start asking questions such as: “Does this case require a sinus lift?” You'll need to know this since you are scheduling the patient and handling the finances. “Are these wisdom teeth full bony impactions, partial bony, etc.?” You'll become confident in deciding since each one has different fees that you need to explain to the patient. Everyday practice was a lot simpler when all you did was sign a referral slip and advise the patient to go see the oral surgeon.
My staff and I have also become a lot more oral-surgery aware. As such, you are able to quickly determine when oral surgery is necessary. The staff walks around in their specialty goggles now. And since they have a front row seat during these oral surgeries, they've become knowledgeable about the possibilities and difficulties a case can present.
After you've added a specialist to your staff, word will get out about the new addition, and there’s a possibility that you will get a phone call from your local specialist — who may not be happy about it. How do you handle this uncomfortable situation? Well, with the truth, of course.
In my office, our in-house oral surgeon cannot possibly treat every single case — he's already booked out two to three months. The result is that we still refer cases to our local specialists. Additionally, we have patients who love seeing our local specialists. They've developed a relationship with them, and we never try to sever that relationship. Sometimes patients tell us how a certain specialist extracted the wisdom teeth of their first three kids. Our response is to assure them that he'll be seeing child number four as well.
There also are those cases that absolutely cannot wait for your specialist's scheduled day. The patient may be swollen or in extreme pain. That patient is referred out immediately, and your local specialists treat them. So, if you get that angry phone call — and I think you will — keep all these factors in mind.
Another factor you have to consider when hiring a specialist is whether you — the dentist — should also work when the specialist is working. Depending on the specialty and the physical size of your office, my general advice is that you do not perform dentistry during the time the specialist is providing services. Your staff will need to be focused on assisting him or her, especially at the beginning of the relationship since they will be getting to know each other. Having your staff totally focused on working with the specialist will work wonders for making this new adventure run smoothly.
Finally, remember that patience is a virtue. If you have a specialist in your office once a month, then it will be five months before they've worked a full five days in your office, so it will take longer for everyone to get properly acquainted. Turning this new endeavor into a well-oiled machine takes longer; however, it will happen.
I encourage you to add specialty services to your practice. You will find that both you and your patients will be glad you did.
Andy Alas, DDS
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