For those offices that closed the second or third week of March due to COVID-19, thinking they would be staying home for 14 days, we are now entering weeks 5/6 and the world of orthodontics as we knew it has forever changed.  There is not yet a firm date for the country to reopen, however some are saying that even May 1 will be too soon.  Can you go eight or more weeks with your office closed without seeing your active orthodontic patients in the office?  How long can you go without seeing New Patient Exams and Observation Recall patients?  Will you have production lined up the first day you reopen?

I have been overhearing Betty on calls with her clients these past weeks and the message that she is repeating on every single call is:

• Keep in contact with your patients now
• Do virtual appointments, including virtual exams in select cases
• Be very prepared now for the moment you can reopen in the future

I thought I would share many of the items I have heard her talking about because Betty is correct!  Every doctor and every member of the practice team needs to think outside the box and prepare now as the future will look different.

When you reopen, will your state government limit your patient volume?

You may need to have Plexiglas partitions between chairs like the grocery stores have installed.

You might need to schedule patients in every other chair – do you have a schedule prepared?

You may need to request parents wait in their cars in the parking lot and communicate with them by phone when the appointment is over – do you have time and staff for this?

Will you be taking the temperature for every patient upon arrival going forward?

What message will you communicate to patients/parents about the extra sanitation steps you have taken?

Will your staff be available to work extended hours when you do reopen?

Do you have an adequate supply of masks, gloves, face shields, and thermometers now?

What about the community pens you all share in the office – how will you protect your staff?

Could your records assistant and/or financial coordinator act as a temp TC to assist with the demand to get new patients and recall ready patients seen quickly?

New Patients – many clients are still getting a few NP calls a week and they are stacking up.  The profession may not have been ready for virtual New Patient Exams before COVID-19, but what a difference a few weeks has made.

What would you say to an existing family wanting their third child seen now?  Is a virtual exam an option for you?  Could you offer 7 year old siblings a virtual New Patient Exam and leave the 60 minute exam slot open for age ready patients?  Selfie photos and FaceTime video chats are an easy answer for specific instances; however the personal relationship and level of trust and value must be strengthened.  The need for treatment must be fully explained and the message about what you would worry about if this mouth does not get correction must still be your defining moments of persuasion.

Observation Recall and Between Phase Recall patients can still be seen today, virtually, with the same level of relationship and discussion you historically have put forth in person.  Virtual visits will not replace in-office personalized supervision visits; however you must expand your thoughts for specific instances going forward.  A tremendous amount of production comes from these children who become ready for treatment and they must be held close.

Are you still paying attention to your Birthday Club patients while your office is closed?  Do you have patients of this status who have had their 7^th birthday but have yet to schedule an exam?  You could offer virtual New Patient Exams to these families.

TC’s should be calling every NP, Start, Recall Ready, and Consult that had to be cancelled to keep them close with details about your practice.

Status clean-up, Unscheduled Recalls, Pending calls – are these tasks still on the to-do list for your TC?  Are patients floating in the Records Taken, Consultation Scheduled, or Specialist work needed statuses?  Now is the time to get caught-up and organized.

Patients who had their braces removed days before you closed – have you checked on them to see if they are wearing their retainers and asked if they are showing off their smile?

Patients who planned to have their braces/appliances removed in March/April – will they still be ready?  They are perfect candidates for virtual appointments now.

Retainer check patients – let’s see them virtually now so there is more room in your schedule when you reopen.

Many college age kids are back home now, but have you considered virtual retainer checks for your out of state college patients for the future, freeing up your future schedule?

Aligner Starts – do you have their aligners on the shelf because their start visit was cancelled?  Is their signed paperwork waiting on the desk of your TC?  Can they pick up their aligners in a nice presentation package passed to them in your parking lot and then have a FaceTime Video call as they insert the aligners at home?  This could be April production!

Existing Aligner patients – are you delivering their next sets of trays and seeing them virtually?

Active patients with braces and/or cemented appliances – by now, you or someone from your team should have spoken to each one of them.  Yes treatment is about great results, but it is also about the relationship so make those calls!

Every practice has pokey wire or loose bracket patients from time to time.  Given the current practice closure, you should be seeing these patients virtually to determine if they need to be seen in the office today.  Consider how you might add this feature to your practice after you reopen.

The doctor should review the treatment card for every patient and categorize them by priority to be seen.  Name them level 1-2-3-4-5-6 so you know who needs to be seen the first week you return based on where they are in treatment, their clinical situation, their hygiene, etc.  Who should you speak with now, who needs a virtual appointment, who needs a FaceTime video chat?  Who on your team will make the calls?

Chart documentation – please date and document every call/contact.  Can your computer store the selfie photos?

Each doctor must decide for themselves what constitutes an “essential” visit.  This is not an emergency visit, but since you cemented appliances in their mouth, how long are you comfortable going without seeing them?

Have you personally spoken to each of your top professional referral sources?  Keep them close, are they well, what are they doing, do they remember you…?

Patient games, Facebook, Instagram – are you continuing to help your patients feel valued?  Do they know you miss them?  How are you communicating during this time of closure?

As you consider your future, you must think about the big stuff like Exams, Starts and Recalls, but do not forget all of the small things that make day to day operation of the practice run smoothly.  The genie is out of the bottle and virtual appointments, as well as virtual New Patient Exams, should be part of your world today.  Add value to everything you do by how you interact with your patients and how you talk about the quality results you provide.  Differentiate yourself and help prospective patients trust you.  So, use every minute of your 8-hour day of social distancing now to get your head in the game for the new version of normal we must live going forward.