Life after Covid 19 Scheduling Strategies

All right, should I get started, Jean?

Yeah, let's make this happen. It's 101.

All right. My name is Taylor Callender and I am the founder of Minty Content. I'm actually your speaker for Friday's webinar. So I hope to see you all there. But Jean asked me to hop on and introduce her webinar today. I help Jean with her marketing and social media and a lot of other things. A little it, a little graphic design.

And I am really excited about her session. I always learned so much. If you haven't heard her speak before, get your pen and paper out because you will be writing furiously with all of the information that she has to share. She is a very talented dental consultant who helps people whether they are looking to open a startup practice or purchase another practice or just improve systems within their practice. No matter where you are in the process, she has something wonderful to offer. She's also lost your audio. What's that?

We lost your audio for some reason.

Oh, no.

Is it back on?

Now it's back on. Yep.

Okay.

Offering five complimentary consults for your reopening. So if you'd like to take advantage of that, visit her website, go to the Contact Us form and just mention the COVID 19 consult or that you are on this webinar in either the subject line or the body of the submission form. It's going to be on a first come, first served basis, so don't delay with that.

So I thought, I haven't asked Jean this, but I actually visited my dentist on Thursday and I thought that I would share some of my observations about visiting the office.

And you visited as a patient. So, yeah, I'd love for you to share.

I did. I visited as a patient. I recently moved to Utah from Southern California. And so our governor allowed dental practices to open last Monday. So I was their third or fourth day of seeing patients. And of course, there were little mishaps and things that I was being hypercritical of because I've been sitting in on these webinars. Like someone touched the front desk, touched my phone. I felt like they should have put more stuff away in the waiting area. They did a great job having a Covid concierge taking my temperature. Everybody was masked up. But I think the biggest takeaway was just to relax and be confident. It was like everything that they were asking me to do, like rinse my mouth out with hydrogen peroxide or that they were so covered up, they were being very apologetic and nervous about it. And I feel like to Put your patients at ease. Just act like this is totally normal, because it is the new normal. So that was my one big takeaway, is just relax. So without further ado, here is Jean with her presentation on After Covid scheduling strategies.

Thank you. That was great. Thanks for sharing that. I'm sure other people enjoyed it just like I did.

My pleasure.

Okay, so today we're going to talk about After Covid strategies of how do we schedule. So the objective of the strategy that I want to introduce is, first of all, understanding the link between your schedule and. And the value of your time. So that's an intricate part. The other thing is that we're going to discuss some longer, more comprehensive visits. And what does that look like? I'll be going over some scripts as well as some actual templates for you. And then increasing the value of Doctor and Hygiene's time while providing consistent flow to the day and providing sustained productivity patterns for the doctor and hygienist. So it's almost like people are feeling, like, taboo, like, should they even talk about productivity now? Because, oh, my gosh, there's this crisis and we have this issue going on, but we don't need to be obsessed with productivity. But the reality of it is there's a direct link between what we produce and what we collect and how we pay the bills. So I think we have to touch on that today. And then ongoing support needed to for timely recall exams. So making sure that if we were a practice where the doctor had a hard time getting into that hygiene room, we have to kind of discuss and we'll go over a template of how that looks. I felt it was important. Many of you had been on my presentation, some of you had not been on my presentation that I did early on on COVID 19 and kind of what to expect. And then I also did1 on COVID 19 and sterilization processes. And those will be posted on our YouTube channel. Most of our webinars are on there right now. We had an issue with those too. But I felt it was important to show this slide again about grief because I think many of us really didn't correlate the idea that we could be going through grief and this is a process, and that our patients and our staff are going through grief in different stages. Right. And so when we all kind of. If you look on the far left side of this, you'll see shock, surprise, shock. At the event, we were all in almost disbelief, like, denial. How could this be? What. What the heck is this? And we were looking for Evidence that it wasn't true. And then we hit, you know, frustration or you know, feeling of anger or frustration. I know the first week that this came down almost eight weeks ago now, I was just talking doctors off the ledge, just like, let's go through this, it's going to be ok. Let's apply for this, this and this. Get your cash flow in order, get things in order. And then by the second week I myself hit some low mood energy where I am very energetic, I have a lot of energy. I can honestly say I don't suffer from depression. By the grace of God. That's great. Many people do, many of my family members do. But for me I hit probably three or four days where I had to literally do some really good self centering and meditation and getting myself back into like I need to pick myself up on my bootstraps. And so that lasted and then I got into really the initial engagement of the new situation. Here is our new reality, you know, what are we going to do? And so early on I formed, in the end of week one, formed a mastermind group where we had an attorney that was an HR specialist, a accountant, an insurance credentialing specialist, a consultant, a dentist, a hygienist, a marketing company, and really just from that point forward we made decisions as a group. What could we be doing to help people in the community, dentists, staff. There was a lot of information early on that was getting disseminated out there that was just hyping people up and freaking people out and not accurate. And I felt really strongly that I had to start these webinar series and begin to start disseminating information that I could first control what was being disseminated, secondarily use it with evidence based data as best as I could by the cdc, the ada, the cda, any other state dental societies. And then secondarily also being able to really express hope to people because I think negativity just breeds negativity. It's not a good thing. So the next stage that I think all of us are in right now and have been, I want to think for the last few weeks, is this integration, you know, the changes, what are we going to do? What is the renewed person or us as individuals or staff? What does it look like? And so the far right side of your slide you'll see like creative alignment, like okay, let's get on some webinars, let's have our own private meetings, let's do what we can do to learn and to be able to master what this new world is going to look like. And then secondarily, I think, you know, maximizing the communication, we're going to talk a little bit about that today and that hopefully helps to spark some of our motivation of what we can do to move forward, to develop the capability to be able to deliver the dentistry that we all know and love and then to be able to share our knowledge with our team, with our staff, with our families and so on. So I thought this was interesting. This was Donata, which was a survey that was put out this weekend and I wanted to post it because I found it extremely interesting in that when we asked the question of Americans, the worst is behind us. In week one, 7% felt yes, that was true. In week four, 11% felt that. And in week seven, 29% felt that second question was very concerned about families financial situation. In week one, 37% of the people that were surveyed, 34% in week four and 27% in week six, 7 were concerned. So that has gone down then. Pandemic will last six months or more. In the first week, 25% said, yeah, I agree, 36% by week four and by week seven, 56% of us have said yeah. And I think that's based on the knowledge that has been shared by the scientists out there. And then lastly, will, you know, will you return to air travel? At least 60% said at least four months and seven months for 42%. So it's just an interesting stat. And the reason I share that is because so many of us right now and some of our staff and some of our patients, when we think of that scale of that stress stages or grief stages, everyone is at a different stage. And I think we have to be mindful of that and respectful of that. But I also think this is an important factor and that is that there's uncertainty and when there's uncertainty, people have self doubt and fear. And so that paralyzes us, it causes us to be blind. I mean, I've talked to several hygienists and quite a few dentists and I can tell you that there are some really interesting blogs and Facebook posts and Facebook groups and social media channels that people are just spewing non factual bits of information and other people are believing it. And so I'm not here to say, hey, I'm the excellent be all end all expert of all experts, but I live life a long time. I've been in dentistry 38 years and I think I have a really good feel and a pulse. I Talked to probably 100 dentists a week, no lie. And I'm getting a real good feel for what's out there. And so what I would like to present to you today is let's start looking at some good options that are available to us. And I believe, and I've always been a big proponent of this in the practices I go in, I always give them the Charles Swindoll attitude, saying. And I think it is all about the attitude. So a professional attitude can really make a vision real. And what does that mean? It means that an attitude has to evolve around a lot of things. It has to evolve around our great systems, the nice facility, the clinical expertise. And each day, if we approach it with, how can we make a difference, what can we do that's going to make the interaction with our patients easier? And I didn't know that Taylor was going to share her story today about going to the dentist. But I can tell you that I could see that staff would be apologetic, like, oh, sorry, we're all, you know, we have all this garb now that instead of just being a professional and saying like, hey, how are you? It's great to see you. Wonderful to have our patients back. We're so excited. Don't make excuses for it. And being prepared for their visit. I think, you know, I have always been touting that you have to be prepared for patients when they come in. And. And that doesn't mean just, hey, let's just do our morning meeting and chat about, okay, we got eight hygiene patients and eight dentist patients. Okay, great. No, it's really being prepared for their visit. Looking at their health history and really analyzing what's in their charts and what have they been diagnosed with that maybe they didn't have done? And how is their hygiene and what are they doing at home? And then communications, obviously, with the team. And first, you know, last is like the respect respecting your team.

So great leaders really begin this process with communicating with their staffs effectively. And I've had many conversations, as I mentioned, throughout the weeks, and I have had everything from Dennis saying to me, nope, I closed the doors and I haven't done any emergencies. And I've referred all emergencies to an endodontist. And I haven't sent a letter to my patients and I haven't called any of my team, what should I do? Okay, to the other extreme, doctors are meeting by zoom once a week. They're filling the team in on all the details that they're doing. So I'm not here to say.

You'Re wrong or you're right, whatever you chose.

Excuse me, but I am here to say that you absolutely now is the time. No matter where you're at on the spectrum to now is the time that you need to kind of kick into some changes. You need to first and foremost talk to your team. If you've been texting in the past or emailing, now is the time I want you to pick up the phone, have a one on one with each team member, let them know you care. Caring. You know, I was talking with a dentist earlier today and Elizabeth Sanchez, who's on the line as well, who's a consultant with us, we were talking and I said to the dentist, you know, in many ways, as tragic as this has been for the world with this pandemic, in some ways I feel it has been somewhat good for the world. And I'm not a California pie in the sky, floating on air kind of person. I'm very strategic and realistic. But when I say care, I believe that humans, as humans, we have had a chance to hit the pulp, stop the brakes and say, what can we do different? How can we treat other people differently? And I think it starts with your staff. You've got to let them know you care. And part of what letting them know you care is, is sharing with them. I know. And you know, as dentists, you've been out there and you've been searching for PPE and you're trying to get it in the right, you know, the. You want to get N95s and you don't really want KN95. I mean, I understand all of that, but you need to share that with them. When is it coming? Where is it coming from? How are you getting it? How many do you have? How long will it last? Do you have any idea? What's the process? The other thing is internal training and the timing of that. I mean, I've heard doctors say, well, we're going to come in an hour before our first patient. We're going to kind of discuss what we need to do different. We're going to go over in a little bit. I think that needs to be a little bit more than an hour for sure. But you also need to communicate with your staff, their roles in achieving your vision and what are your expectations. How do you feel that the new normal is going to be? So first, I think you should be asking them some questions. Are they concerned about coming to work, treating patients? If they say yes, I want you to go back to that scale in the beginning and, you know, where are they at on that grief, where are they at on that worry? I can tell you in week one and probably into week two, I was watching way too much tv, reading way too many newspapers and that got my anxiety up way high. I had to just kind of trust the scientist, ride it out and base everything on evidence based. So when you're talking with your team, you want to ask them.

Do they have any concerns? Yes, I have concerns. What are your concerns? The staff is saying they have concerns. What are their concerns? Are they going to come back full time or part time? Is that even an option in your practice? It may not be. If I have staff on the line, I want you to know it doesn't mean the doctor's being mean that they're not allowing you to come back part time. And it may mean that the practice simply cannot survive without you being there full time. In the sense that it's a full time practice and you have a part time person. How do we help treat the patients? The other thing is, if there's any limitations, listen to them. Listen. Document. Make sure you document everything, the conversations. And then also regarding our changes, do we used to be 4 days, 32 hours and our. Are we going to have to go to four or five days, 40 hours? How does that look for that employee? You don't know yet. But you do know one thing. You're not going to let the practice go down the tubes because your patients are needing times that you're not available. That's not going to be an option. I'm assuming with most of you this is your dream, this is your business. Of course you're going to do what it takes. I have shared with many of my colleagues that since this crisis has happened, I have worked more days, more hours, weekends. I mean, I'm not opposed to working weekends. I take calls on the weekends. But I mean, my hours have, you know, really filled. Am I whining and moaning about it? No, I'm not bellyaching about it because I know that I can help people and if I can help people get through it, then that's great. And you as clinicians and as staff, you're there to help patients. So sometimes we have to compromise. We have to make some concessions that we don't want to. Does it mean we're always going to be open 40 hours or 20 hours? We don't know. Identify the needed changes. Are there team members willing to do what it takes to kind of get back to normal? That's a big part, right? We need to know. And lastly, don't judge, don't judge people. I think it's really, it doesn't serve you well. It doesn't serve them well. Always realize that they are just at a different stage of this process with this, with this crisis. So let's talk about some seamless reopenings, some steps. First and foremost, I would recommend that you have one to two days of training with your team. And what would you do during that? Well, we'll kind of go through that. But before you actually, once you're finished with the one to two days, one and a half days, two days of training in house, I would encourage you that before you kind of open the doors, you know, hallelujah, we can see patients, do a soft opening, meet with the staff kind of plan that you're doing. Just several patients coming in, you're going to space them out. You're going to see how it goes. Everyone's going to get their wiggles out. You know, you just kind of like Taylor had said, people she could tell, they were a little uptight and stuff. Everyone's going to get their wiggles out. And then the next thing is that make sure you're looking at the CDC infection prevention documents they are in. I've offered everyone, them meeting after meeting, and I will offer them again today. They are on my Covid19 website and I have that slide coming up later at the end of the presentation. But the toolkit's yours. It's organized in documents and letters and scripts and whatnot. The other thing is, many of you have said, hey, we're OSHA and HIPAA compliant. We get it. We've been trained, we're current with that. I would urge you to start looking at your health history forms and your OSHA and your hipaa. Make sure that all your documentations are there, that they're in a binder, that they're, that they're really properly in order. Obviously, you probably have heard this before with me and maybe on other webinars. I don't know. But you want to begin to stagger your patients and suggest that they have and come with masks. In most states, not all. It's a law. I mean, May 1, California passed a law that you must wear a mask when in public. I can't tell you. I have been out, not out and about, but in my car. And I can't tell you how many people don't wear masks and aren't practicing social distancing. The other thing is letting the patients know that when they arrive, they can stay in their car because Again, everyone's at a different spectrum. You have some people that are saying, well, why would I stay in my car? And then you have other people saying, oh, that's great, so you'll text me when you're ready for me. Oh, wonderful, great. Even though we know we're not filling our reception room with patients, we're not having it be a waiting room. And then also just basic explanation about what is the safety of the practice and the appointments. There's also an ADA patient check in process form. The ADA has, I feel, has really kind of risen just within the last several weeks to kind of finally start putting some documents out that I think are beneficial for you to follow and use. And then also I think it's important that you communicate with your patients about the restrictions without having anyone other than the patients be in the practice.

So the first thing, if many of you are not aware, there is an employee screening daily log that the ADA has put out. Again, that's in my COVID 19 toolkit. It's free for anyone that wants it. But in that log you are to keep a binder. This is my recommendation. I would keep a binder with months. January through December, when you go back, your first day is on the bottom of that particular month. And then you add the days going forward. The question would be, why would I want to take my staff's temperature? I've had doctors ask me that. Why would I want to ask them if they have a cough or their shortness of breath or if I have to dismiss them, what happens? Let's go through this. First of all, we need to be keeping a log of our staff and our temperatures for a couple of reasons. If it were my practice, I'd also be having an oximeter and I'd be taking their oxygen levels. It's a very three second thing. You slip it on your finger and you get it. But if by chance a staff member gets Covid for whatever reason, you have to report that to the county health department. They will then, if you've heard about the tracing, they are going to want to know who that employee came in contact with. They may require you to close the office down for 14 days. So I'm not the county and every county is different throughout the country. But I do know that if by chance an employee files workman's comp and you do not have your log, your workman's comp may say, I'm sorry, you were supposed to, based on the ada, you were supposed to keep a log of your patients and Your staff and we're not covering the workman's comp, so I don't know that to be fact. I'm just surmising, as we all know, insurance companies always find ways to not pay claims. This would be a great way. Well, your ADA told you to do this and you're not doing it, so I would urge you to do that. The other thing is remove non essential items. Samples, brochures, magazines, anything in your reception room or your operatories. Take those out. Dentatus models, anything like that. Pens, keep it clean. Dental supply deliveries. If those come in, do what you do at home. You know, you should be sanitizing those boxes and letting them, you know, take effect and then opening them up and putting them away. In regards to aerosol sprays, I've gotten many, many, many questions on this. As you all are aware, many of you are aware there are no guidelines right now in regards to what you definitely should do. However, the ADA does recommend, as I did in week two, just put on it, use a rubber dam and in the hygiene area, do not do cavitrons, use hand scaling until we can use Isolite and things like that. Do the best you can to control the aerosols. There are some I wanted to get into it, but I thought no, I just not going to. I'll do it next time on another webinar. But there are some new things out in the industry. Hypochlorous acid is one used with a fogger that kills Covid on contact. But again that's for another day. So taking steps to better organize your practice. Why is that important? Well, because you may have some staff that are not gonna come back for whatever reason. And so doesn't it make sense that now before you reopen you get those storage areas labeled and things where they need to go and the lab area and the sterilization area. It's important because if you have someone new coming in, you don't want to look like your house isn't in order and it's messy. So this is a busy slide. I apologize, but it was the best way I could kind of show you without opening the whole COVID 19 toolkit that I have. So there is within the COVID 19 toolkit and under the ADA it's separated by what you need to do before you open for getting ready for patients and then when you're open with getting ready chairside. So some of the areas I already mentioned, but some I did not. So preparing the entrance and the exit of the building or office with A hand sanitation station. So ideally touchless type of thing. And also that if they are waiting in the waiting room or bathrooms or patient consult rooms, that there's tissues and hand rub and soap at sinks and trash cans. Obviously, if you can space chairs six feet apart or what I have seen is an actual sign on the chair that, that it says, do not sit in this chair with a line and a circle through it so that you're visually showing people if they are going to sit there. If your office has toys, readings, junk it. Okay, then the next thing is the chair side checklist. So dentist and staff can use this checklist to prepare for procedures. So informed consents. I've had quite a few doctors say to me, do you have informed consents? I do have a lot of informed consents. They're not with HIPAA informed. I'm sorry, they're not with COVID informed consents, which you probably should have. You know them revised.

Limit paperwork in the operatories as much as possible. For those of you that are my clients, you're going to probably say, great, we don't have to use those darn appointment trackers. And the answer is yes you do. You'll put them into a plastic sleeve and use them that way. Place new chart notes in documents away from patient contact. When possible, cover the keyboard with either disposable, flexible or clear barrier plastic wrap. ADA is a saying and change in between patients. Obviously limit the operatories to one patient at a time, not more. So there is this hierarchy of safety for health controls. One of the things that we're recommending this is not necessarily on the recommended by the ada, but we are recommending it and have always. And that is the autoclave identifier. Log sheet, log report. Again, I would put that into a binder and you just keep that sheet in there and you identify the autoclave if you have more than one. The date, the time that it was loaded, the initials of the person that loaded it and and then when it was unloaded, the date and the time and the initials. Why is that important? Well, if a patient calls up and says, hey, I was in two days ago, I checked positive. Yes, we know the sterilizer is going to take care of those COVID virus germs. But it's just nice to have everything organized the way you should. If someone were to come and ask you, you say, well, here, here's the report on that day and this is what we did. She came in at this time and da, da, da, da, da. You have proof training and administrative controls. One of the things that the CDC Infection Prevention Guide Handbook is we go into each of those areas, training and administrative engineering, work practice protocols, as well as your ppe. So if you haven't instituted an ICC job role yet, that's Infection Control Coordinator, I would urge you to do that. Typically it's an existing patients. What I'm finding is either it is a lead assistant or a lead hygienist, someone that's there all the time that really is kind of, you know, is going to be that person that's just meticulous with this and that's a job list of what their kind of responsibilities could be. The other thing that again, I know this is on scheduling, but I felt it was important to touch on this because this is linking to the scheduling. Right. It does have some overlap. So just understanding what you're using, how much time you need to be disinfecting your surfaces, is it a one step or a two step process? It is the spray or a wipe. So I've included that for that purpose. And then also if you're using bags versus caddies for your instruments or cassettes, you know, do a test on those. Check it. If you making sure that you guys are sealing it at the exact dotted area to seal it, test it, put a little bit of water in one of them, do it the correct way during your training with your staff and do one the incorrect way. Turn them upside down and see which one leaks out water, the one that's not sealed correctly. That tells you that if we're rushing and running and gunning and we're doing things half, you know what, then we're potentially not really getting a sterile instrument the way that we need to. So also make sure that you're doing your sterilizing steam indicators, your chem indicators and keeping logs of that as well. Okay, so now we talked about great communication with the staff, what you need to do in regards to the training and things of that nature. Now let's talk about great communications with your patients. I think for those of you that were on my webinars last week, I had, I think it was on Tuesday. Dr. Nancy Haller spoke about are we leading? You know, are we good leaders right now? This is the time that it's kind of called the task. So I loved this picture on the bottom. It's a little grainy, but I thought it was awesome because here they are. They're all, you know, kind of garbed up like we know we're going to be. And they Just each help signs. We are here for the community or we're here for our patients. And I think that's a great fun thing to do. So I think if you're communicating with your patients, you should be if you haven't been already. And part of that communication. There absolutely are some great guidelines again in the toolkit. But I think it's important that you verbalize to your patients that you are and always have been using hospital standards regarding sterilization. Now, you and I know none of our patients are on the webinar today, so I'm just going to talk very frank with you. I have been in hundreds if not thousands of practices in my career and by profession I'm a certified dental assistant. So I know the clinical areas. Well, I can tell you that there are many of you that are not really doing the standards of sterilization as you should. You're cross contaminating, you're sloppy, you're not understanding the process. And so that's kind of why I said do a day and a half, two days. We may know what we're supposed to do, but we're not doing it regularly. And no offense, I'm not trying to, but if we're really being truthful with ourselves and the four walls, we're going to admit that. The other thing is always remember to express hope and excitement to see the patients. Now, once you open, you are going to get an influx of phone calls. I have a practice in Kansas that they got, they were going to be open May 4th. They sent out a blast text through revenue. Well, and within 30 minutes they had 50 phone calls and they were, they were for hygiene. So they said, our hygienist is back, we're opening May 4th, blah, blah. They had in 30 minutes 50 phone calls. So that's going to be hard to answer and it's going to be very tempting to let it ring through the voicemail. I would urge you as best as you can, if you need to, you know, double up on the phones because they're ringing a lot. Try to not let it go to voicemail. I think it's impersonal. I think it at this point in time, you know, everyone's been getting voicemails for every business just about and it's frustrating. They just want a human. Now we can be a human. Let them hear you and see. Understand that. So the other thing is there's great leaders communicate with their patients on a couple of other fronts. One is there is a patient screening form that you need to let Your patients know that they are going to be asked to complete according to the ada, they're recommending that it be done pre appointment. So over the phone you ask these questions and, and that same form be asked of the patient again when they come into the office. Same exact form. So the other thing that the ADA is recommending is that we obviously have a hand sanitizer available for use, that we check the patient's temperature. Touchless forehead scan is convenient and produces less waste, though any thermometer is appropriate as long as it is cleaned appropriately between uses. Be sure to follow the manufacturers. If the temperature is elevated, supply the patient with a mask and instruct them how to don it. Follow through in asking screening questions and alert the dentist. So what does that mean? It means that if they have a temperature that is above 100.4, we want to make sure that we are not maybe dentist call, of course, but we may not see them that day. Complete the screening form, which you'll have a sample of. And then obviously each state there's a whole guideline by state and territory for the health department websites. So you have to check your own health department as well of what they're recommending. The other thing is make sure, and I had said this before, so forgive me if I said it on a previous webinar. Order some cheap pens with your name on them and your phone number. Give the patient the pen, do not take the pen back. We don't want to be exchanging pens. Don't have a cup of pens where they reach in for it. Or you can ask them to bring their own pen. In regards to those of you that are using iPads, some patients are really hesitant. They don't want to have the iPad. That's okay. That's why it's important to really send them something. This is, this is from my dentist, Dr. Paul Daughtery. And I can tell you he just sent out the letter, which is, I believe it's the ADA letter, that it looks a little tweaked, but I liked what he tweaked about it. And one thing he did was he highlighted in yellow your information online prior to coming to our office. Click for your online forms. When you click for the online forms, you see over where it says welcome Jean St. Louis. Your forms, 2020 medical history, HIPAA insurance information, patient registration, photo release form. What a great idea. It's a great idea because guess what? This is a perfect time to update all your medical records, all your registrations, you know, in the past. What do we do? Oh, we only do it once a year. Patients don't like to do that. We know we should. We just don't do it. Well, guess what? Now's the time. You've got a perfect excuse. Just do it. The other thing that I thought was great about what he added and tweaked was we're offering virtual consults via teledentistry. Visit our virtual consultations. There's a small fee to be attached to the service. It's a great thing to do, so hats off to my dentist. The other thing is, this is the guideline for the infection prevention and it's by the cdc. So if you are a client on the line, you already have this and I've customized it for you with your logo. So I will give this to all that are on the line. It's in my Covid toolkit. How it is about 23 pages long. How I have chosen to teach people how to use it is I've taken the first section and I've called it internal training. And it's a checklist. And you go through with your staff, that's an internal document. The next part of the document is what it's about nine pages, if you don't count the title page and the back page. But it is a checklist that you go through and you actually check yes or no, did you do it? And you. You will add notes. Now, in both of those documents, I have given it to you with examples. So if you get the training for the staff and you're saying, well, I don't understand what this is. I've given you an example of what I mean, or what CDC means in that area concurrently in the patient, one that you can send out to patients that are apprehensive or nervous or post it online. I have doctors that have taken this screenshot of the infection prevention checklist enacted by your office name. They posted it on their website with a link. When they click the link, they get the one that I'm referring to that you will do with your team. And at the last page, it has a spot for your team signatures. So for those patients that are really nervous and apprehensive, yeah, they might read all of it. For some patients, they could care less. They're not going to care great. They don't have to click on the link. So the other thing is, it's able to be emailed to patients so that you can say if you have Mrs. St. Louis on the phone who's really nervous about coming in. Oh, we have followed. Let Me send you our checklist. It's so comprehensive. And. And did I mention all the staff we've been through training for a day and a half or two days. I mean, we've all signed it. We have been through it. You're going to see everything that we've done now on the patient one, it says.

CDC recommends you remove your lab coat or your jacket before you leave the operatory. Well, we've added a little blurb. Doctor has installed hooks in every room for us to hang our lab jacket before we leave. So you don't want to send it to the patient with all. Yes, yes, yes, yes, yes. You want them to know that it's a real document. You did actually do the training. The CDC has not changed their infection prevention in its entirety since 2003. Kind of hard to believe, but they've updated it in 2016. In addition, there's a CDC checklist app for your phones. I am a proponent of no phones in the dental office. By staff, by doctor. They get locked in the purse, locked in the key, and the storage, wherever you keep them, you can use them when it's on your break. But absolutely. Especially now. Now's a great time. If your staff has been on their phones or it's in their lab jacket, no more. End of discussion. We are not using phones, period. Okay, so the most important thing is our patient. Far none. We know that that person is the most important. They're the patient center of the practice. If you focus your practice on this, I believe if you establish the blt, believable, likable, trustworthy, that patients will absolutely come back to your practice, will support you will absolutely be the best patients that they've always been. But we have to make sure we're offering the best dentistry that we can, that we create an environment that is trusting and that enables the patient to believe us, like us, trust us, blt, believe, Likable, trusting changes. And that we are having changes. But they're good changes. They're going to help sustain our relationship with the patients. So when we talk about Ideal Day Schedule, the key to Ideal Day Schedule is to improve patient care and to improve the doctor and team satisfaction with the patient. So to launch the Ideal Day, there has to be an understanding and an acknowledgement that, that the appointment book is really directly linked to the deposit book, regardless if, again, I said at the beginning of my webinar, I'm going to talk about some things that, like production that may feel like this isn't the time to talk about how much we're going to make. But unfortunately this is the time because doctors and dentists have not been earning any income. And, and so they, as you know, many of you are on furlough, you're on laid off, you're on unemployment, but the bills keep coming in. And not every dentist did get the PPP or not every dentist did get the edil. So understand that it's really important right now to keep things in order. So let's talk about why create an ideal day? The first thing is creating an ideal day kind of creates time and energy for meeting each of the patient's needs. That's a given. It allows us for balance of the flow of the schedule and it reduces stress for everyone. We've all had days where either we've had a really slow day, but we end up leaving super stressed out, or we've had a really busy day and we leave super stressed out. We want to encourage a work life balance because I think more than ever, more people have kind of we as humans, at least I wanna believe this, have kind of again taken a pause, taken a breath and said, am I doing what I need to do? And I think you are in the sense that you're in dentistry. And that's not cut out for everyone. So how often do you say, you know what, it should have never been scheduled that way? I don't know why did we do that? Or believe that Everyone knows exactly how much time to schedule for each procedure. The reality of it is, is that front desk people right now might struggle a little bit with how to schedule because conceptually it's not the same. And I have to think, okay, doctor's got to go, take off the ppp, go and do hygiene checks, go back over here. Like, how is that whole thing going to work? So I have a great saying that I've used for years. Slow down to speed up, slow down to speed up. So how many times have you thought, all I know is the doctor wants to schedule to be busy, or you feel frustrated because the day was very busy, but yet there was little production. So we have options here. One is, I want you to begin with the end in mind. What does that mean, Jean? What do you mean, the end in mind? The end in mind is creating, I believe, a patient centered practice where those patients absolutely understand how much you value them, but they also. The schedule doesn't run the practice, the practice runs the schedule. What does that mean? We have patients that appoint with value, accept with value, meaning accept our treatment with value. They appoint when we need them to appoint. They pay with value because they value what we do and they speak with value. They invite others. Believe me when I tell you I did 25 non dental people with that CDC toolkit of the internal training and the external. I just sent them the external training. Of the 25, about two of them said, yeah, I don't think I'd go through the whole thing. Many of the others said, this is great. I wonder if my dentist is doing it. So what can we change that would. What could happen that would change our schedule? Well, we know right now we have a lot of open time. We know that in the old world we had patients that no showed or canceled their emergency calls that threw off our schedule. Lab cases were needed and maybe not there. We either scheduled too much time or too little time. But now with COVID 19, what would change our schedule? One staff is stressful. Patients are afraid. Patients cancel possibly more emergencies. They haven't seen dentists for, you know, three months.

Some patients are going to come in and say, I don't have insurance anymore. I lost my job. Maybe we have too much time scheduled or, you know, too little time scheduled. So how do we overcome that? How are those situations going to be addressed? I would urge you to have this kind of dialogue with your team. It's really important. I've given you a ton of tools today that you're going to be seeing in the next few minutes. In regards to helping you with that, the one thing is I would encourage you to have mock blank schedules and I would ask you all to hand them to your team and say, hey, ladies and gentlemen, I'd like you to create an ideal day. What would that look like? Now, in this world.

Everyone places what they believe would be the ideal day in the schedule by length and time and patience. If the doctor sees new patients, those need to be placed in based on how many you see in a typical month. So if you see 20 new patients in a month and you work 20 days, you'd have to leave space for a new patient in that schedule as well. And I would encourage you to share it as a group. Create a master weekly schedule of what it looks like so you can have that. So you'd have Monday, Tuesday, Wednesday, Thursday. What would that look like for you with doctors, appointments, times and the purpose for those values. So it's more important now than ever before when we're looking at scheduling, doctor schedule, it's going to be tempting to just throw anything in there because we just need a body. But the reality of it Is. Is that, you know, you don't want to be doing four root canals in a row. We still have to be methodical with how we're scheduling. Same thing with hygienists.

Excuse me?

Same thing with hygienists and their appointment times and their purpose and their values. Are we, you know, are we scheduling some scaling and root plannings? Do we need to block that out to make sure that if that's being diagnosed, we have a spot for them? We sure as heck don't want to create a sense of urgency and not have availability for them. Okay, so now what I'm going to do is I'm going to share with you. Bear with me here. Okay.

So I wanted to open this up a little.

Me a minute.

Okay. So you should be able to see my screen. All of you, I'm assuming.

So what I did was I created a couple of templates. One is I see a chat, maybe someone saying they can't see my screen. Yep, you can see the screen. Thanks, Taylor. Okay, so one of the things that I did was I created a template of one dentist, two hygienists. And what would that schedule look like? So Mary Beth Wheeler is coming in at 7 for a corner crown. She's 52 years old. Hygienist 1 is seeing Bernice Adamac at 7:20. Yo Yo Ma is coming in at 7:10. So you can see we've spaced them out. And depending on your comfort level, don't. You know, I'm not the be all end all. I have just put a lot of thought into this. I teach ideal day scheduling all the time. So I tried to put my COVID19 hat on and say, okay, how would this work where you still have space in between to change the ppe? The reality of it is we always change our gloves. We many times change the mask, but not always. And the reality is the ADA is not saying that you have to change your coat every patient. So most offices are using N95 masks or KN95s with a surgical 3 over it. And you may choose to change that in between each patient or whatever your choice is. I'm not the police for that, but I can tell you that you can kind of see how the day would go where we don't have any one person overlapped in coming in or coming out. So you can kind of get a feel for how the day would flow. You may. Or you may have a hygienist that says, you know what?

I feel more comfortable with 20 minutes in between each one. Now keep in mind, the sterilization or the sanitation that you are doing.

Pretty much, unless you're using a fogger with hypochlorous acid, is pretty much the same that you were doing. Now. You maybe weren't letting it dry, you maybe were wiping it with a paper towel, you maybe were cutting corners. But I think 10 to 20 minutes break in between each one gives you the time to use the utility gloves when you're, you know, getting the instruments to the sterilization area, which is the CDC guidelines, and so on and so forth, and then you see the afternoon. So this is a template with one dentist, two hygienist. If you're a dentist, one dentist, one hygienist, then don't worry. You don't, you don't need to worry. Now, several of you had been on an earlier webinar that I did and I spoke about a super hygiene day and I almost heard gasps, you know, it was like, oh, how does that work? Well, the reality of it is this. I would urge you to run a report from your software. You know that you have not seen patients since probably March 15th, and we're now at May 15th. Some of you are open in your states, some of you are not for hygiene. So by the time, you know, we're looking March, April, May, maybe June, you're looking at quite a few people that are backlogged. In addition, you have patients that are already in your schedule because many of you have pre appointed, which is fine, I'm a proponent of that. So your June and July and August, you're booked and you're saying, where in God's name are we going to put these people that are past due, that now are really past due, not counting the ones that were past due prior to March. So I propose a super Hygiene Day. A Super hygiene day. Again, you can do this in any variation if you want. Right now, you see, in most of them I have a 20 minute break in between, but some not. But one hygienist, one is start. Diane is starting at 7am, Brooke is starting at 7:10, Tony is starting at 7:20 and Angela is starting at 7:30. And then you space it out accordingly. So why would you do a super hygiene day? Well, because the reality is we have a lot more patients that are overdue for hygiene and we don't. I don't believe that most of you are going to go back and see your dentistry chairs filled till July. Like that just doesn't happen. So by doing a super hygiene day, it enables the Dentist to do periodic exams within. If you, and I say four, but if you had six chairs, you could do six. You would bring in someone to do exams with you. Perhaps. But definitely on a scale of four, if you have an associate, bring them in and you have eight rooms, do eight. That's fine. But think about the magnitude of how many people we could get treated for their cleanings, that need their cleanings, that want their cleanings. Am I saying turn it into a profimil? Absolutely not. But if you space it out again. Space it out, do your blocks, See what you can do without having people overlap in the hallways or overlap at the front desk. You will be able to rectify some of these backlog of these patients. So that's my two cents on that. And let me go back to my original slide so I can get into that.

And what's going to happen is it's going to start at the beginning. So you guys are going to have to bear with me.

Okay?

Okay, give it a whirl again. Let's see.

Hold on. Technical difficulties. Bear with me.

Share.

Sorry. Hang on. We'll get there.

There we go.

Love when it works like it's supposed to and hate when it doesn't. Oh, come on.

Okay, full screen. Zoom.

Sorry, guys.

All right, I think we're in business. Can everyone see that? Taylor, can you just shoot me a chat and let me know if you see that?

Okay?

Okay, perfect. Thank you very much. All right, so the other thing that you can be doing is, as I call it, recipes. You can create an hour and a half to two hour doctor time or even a three hour if you want, with what I would refer to as a recipe or like a rock time appointment.

So with that.

This was the super hygiene day that I referred to. So what are some benefits to longer appointments? One is a discussion has to be had about how the day would look in order to make every day be the best that you can make it when and where the team feels best to schedule procedures that are labeled as more productive or what makes more sense for the operatories. So one of the things is there's an action plan that I would encourage you to do and that is really kind of template it in your computer and make sure that you're really creating those templates the right way so that you know how to make sure those patients are going in the right slots. So why are you here? I mean, as dental people, as dental professionals, the reality of it is, is not everyone can do what we do. We know that. And it's incredibly fulfilling. And we love caring for patients and we are changing people's lives. You know, it definitely does. So how do we know every patient is receiving the best care possible? How do we know that we're doing what we need to do with this new normal? It's by keeping score. You know, all of us kind of remember keeping score as kids when you know, how many times did you hit the little league ball? How many times did you. How many boxes of cookies did you sell? Or how many times did you jump rope? Or how many times have you measured your kids along the baseboard of your door frame? So there's lots of ways that we keep score. But I think keeping track of our achievements, especially now, is even more important. We have to celebrate what we are doing. Right? This is a script for patients again. It's in the COVID 19 toolkit and it basically is a script for overdue hygiene patients, what you can be saying to them. So one of the things you know. Hello, Kathryn, this is Paige from Dr. Marshall's office. We're resuming our care for patients and I'm calling to let you know about the precautions we're taking to assure your safety and each of our patients safety. We have followed the CDC OSHA guidelines for sterilization and in prevention and cross contamination. Additionally, we have altered our schedule to space patients far enough apart so we will receive one patient at a time. May I email you our infection control document? So you're aware of our routine infection controls and additional controls confirm their email address. Or if you're gonna have your web people put it on your website, simply say, Catherine, can I suggest that you go to the website? We have a link there. It's right there and it says COVID 19. Click on that and it shows you everything that we've done and we've all signed it. By the way, doctor is so serious about the training and we are too. So, Catherine, you're due for your hygiene visit. You were due last March 10th. We have an hour available with Julie this Thursday at 2 or next Monday at 10. Which would work for you? Not. Oh, I don't know, Katherine. When would you like to come in? Direct them where you want them to go. So the next is. I've been asked a lot about PPE charges. Can I charge? Should I charge? What do I charge? There is a code that has been out there and it is the D1999 code. Our insurance is going to cover it. I would, if I were a betting girl, I'd say Absolutely not. I wouldn't even. I'd submit it, but I wouldn't say to the patient that you're going to get coverage. All I would simply say, Here's a script. Mrs. St. Louis, it was nice to see you today again. We really appreciate all of our patients, and it's sure nice to be back to work. I know Barb scheduled you for your next hygiene visit. Today's charge is $7 for your PPE. Oh, wait, what. What's that? So I'm going to have to pay every visit, every time. That seems kind of high. Well, actually, our cost per patient is $25, and Dr. Marshall's accountant advised her to pass the cost onto the patient or across the board, raise the fees to cover the cost. Thank goodness. Dr. Marshall said she would not feel comfortable doing that, but agreed that we would charge just the $7.

So I don't think it's inappropriate. I mean, the world knows PPE is hard to come by. The costs have tripled, quadrupled. It's not easy. Now some languaging skills for reopening. We've all been in the position of wanting an appointment with someone when, you know, they tell us exactly when we have to be there. So ophthalmologists, surgeons, orthodontist, even your local mechanic might say, this is when I do this procedure. So I would recommend that you kind of begin using this languaging again. It's a nice way to start this because patients don't know any different. And that is the best way to communicate with patients is to rehearse this and get your skills down. But to better serve our patients, doctor has his office organized to perform this type of procedure, this length of time, at either this time or this time, what's best for you, or the doctor prefers to do this type of procedure, this length of time at this time or this time, which is best for you. So it helps you to kind of be able to control a little bit of that schedule going forward. So I believe doctor and team, we need some mutual accountability. And it begins with, really, the team understanding what is the doctor's vision and how are we going to engage, how are we going to make sure that we're all okay? I love this caption of the three team members holding a hand and kind of reaching out for the other one. Like, come on, we can help you. Because we know that there's people on our team that are anxious and they're not where you're at, and that's okay. We need to discuss that. We need to also embrace change. We have to take the risk. It's going to require us to adopt a professional mindset just like those nurses and doctors on the front lines. I mean, are we dealing with that? Heck no. Will we ever compare to what they're dealing with? Absolutely not. They're beyond. But we are dealing in our own right with patients that everyone that's coming in we have to assume is COVID positive. And if you're not, you're silly. It's just like hiv. We always assumed every patient was HIV positive. You don't make mistakes when you assume everyone is that way. So ask questions. It's okay to ask questions. Be accountable for agreements and take your actions based on those agreements and effectively communicate with each other. Communication now is more important than ever. So I would ask you set three goals from what you heard me say today that you think you're going to incorporate into your practice. Three goals. That's not bad. That's easy to do. So how would you do that? Maybe set an action plan. Identify what problems and works need to be done and who's going to be accountable for that? Who's going to be your icc? Who's going to be responsible for unpacking the boxes? Really get nitty gritty. It helps you and them to feel a sense of ownership and to feel a sense of self awareness. Like, wow, this is great. I'm glad that I'm able to contribute. I When we do things like this and we hold people accountable, it leads to change. It leads to us changing our behaviors, it leads to us changing communication. And ideally it leads us to having an ideal patient care, which my philosophy has always been, you want to have a patient centered practice. They are the bullseye when you look at the screen. That's the patient. All of us are around it to make that experience superior. Absolutely, bar none. So guide our patients to the appointment times they want each day gently, kindly practice the language skills. And remember that hope is not a strategy. You can't just sit here and well, I think we're gonna do it and we'll be okay. We're gonna take a half an hour, an hour before we open and we're gonna get everyone on the same page. It's not going to happen. It will. It'll just happen half. You know what? So I love this saying. It's Andrew Carnegie. Teamwork is the ability to work together towards a common vision. The ability to direct individual accomplishments towards organizational objectives. It's the fuel that allows common people to obtain uncommon results that's what you're faced with now. You're faced with an opportunity to have uncommon results that are going to benefit the practice. And if the practice is doing well, the staff will do well. It's just a given. So I like this one, Henry Ford. Whether you think you can or you think you can't, you're right. So you've got to believe in the possibilities. We have to know that positive expectations can eliminate the negative ones. And we know one thing, and if you're not clear on this, let me be very clear with you. We talk to ourselves the most all day long. You're talking to yourself and you're answering yourself. You're talking to yourself and you're answering yourself. And we can be the most negative with our thought processes because typically what we do is we say something and then we say, yeah, but, yeah, but, but, but this could happen. But that could happen. We know all of that. But believe it before you can see it is important. So here is the COVID 19 toolkit.

Excuse me. Thank goodness I'm only by myself. People would be kicking me out of the room. All right, so I know, what is it going to be like when people sneeze and cough anymore, right? So the COVID 19 toolkit. Here's the screen. Take a picture with it. This webinar will go on our YouTube channel. I ask that you subscribe on the YouTube channel. You'll have access to all of my webinars. They're on there now. We're adding more every day. Takes a while to download and whatnot. But this toolkit is available to you. I would urge you to use it. I taken a lot of pride. Some of it is obviously my original stuff. Some of it is CDC couldn't do it any better than what they did. So some of it is ada. They did some great jobs on some of the resources, but it's all labeled and incorrect. Nice buckets. I've organized it. When I first got it out, I just kind of threw everything in there and was like, great. It's a great resource. And now, having gone to it many times, I've said, you know, I'm disappointed that I didn't organize it as perfectly as I would like it as a user. So I have done that. So hopefully it's to your liking and I hope you use it. The next thing is obviously, as Taylor mentioned, willing to offer any COVID 19 baseline analysis consultations through May. And now it's time for final thoughts and what your questions might be. In addition, I'm going to launch a polling that I would like you to answer so it does not link to your name. It's just a fun little exercise that we can do. And at the end of it, you'll kind of see. I have about five or six questions, so just begin answering. What is your position? Multiple choice. Are you a dentist? An associate hygienist, rda, rda, ef, rda, DA Administrator. I don't know if any of you are clicking it. I did say it was ready to go, but I'm not seeing anyone click. Is it not working? Oh, there we go. All right, thank you. We've got quite a few people on the line, so this would be a cool thing if, again, it's not linked to your name. I don't know who you are. I promise I won't spam you. I won't junk you up. Like, it's just a cool thing to do. Just from a basis. I think it'll be great for future webinars. I can kind of share, you know, with people. Hey, 75% of people feel comfortable staying home or doing whatever, so everyone can see it. Okay. I'm assuming.

Okay, keep going. Don't let me stop you.

This won't take very long. It takes a couple of minutes. Your involvement matters, and it's. It's a way to say to me, thank you. We appreciated what you did with the webinar. We like your webinars. And we'll absolutely take this silly little poll.

So we've got right now we have about 68% dentist on the line. No associates, 6% hygienists.

3% DAs. Go DAs. And 27% admin. Yay, admins. All right, how comfortable do you feel to open or return to your office? Multiple choice. 100%. 23% said 100%. 90% was 31%. 3% were 40% or below. 3% of you said 50% or below. 6% of you said 60%. So the average right now is it looks like 90% of you are very comfortable with going back. So that's great. 26% of you are 100% comfortable going back. Next question is, have you received any PPP or EIDL funding yet? PPP. 27% of you have received it. EIDL, 15%. Great, great. 27%. Both high number here, 44%. None. Isn't that something? That's just agitating, isn't it? Well, I hope you do get it. And anything I can do to help, I will.

Short of robbing a Bank. Okay. What would you like to learn about webinars in the Future Business System? 62% of you said 26% was tied for clinical and HR, 33% was legal and marketing, and 43% was leadership. Great, Great. For those of you that answered, wonderful. I greatly appreciate it. Keep going. I won't end it for a couple of minutes, but that's great. Please put your questions in the Q and A. I'm ready to take any questions that you might have.

And that is great. So I will share that with you as well. All right.

Okay. What final thoughts do we have? I've got two Q and A's and four in chats. So let's see. The first one.

Doctors and dentists. Do you mean physicians and dentists? I actually mean only dentists. I only consult and work with dentists. So if I offended anyone that's a dentist by using the word doctor, I'm sorry. Next question. How many hygiene patients was hygienist one seeing on a regular hygiene day as opposed to a super hygiene day?

The same number of patients, maybe one less, depending upon how much time we're losing. So if one hygienist was seeing seven or again, remember, on one of those super hygiene days, the day may have been longer. It may have been seven to seven. So you might have seen more. You also might have a teen that comes in in the morning and a team that comes in in the afternoon. You can spread that out. Good questions though. Okay, so any other questions I can answer? I see there's four chats. Let me see if there's any questions in those chats. Let's see here. Would it make sense to have a super hygiene day if we only have two hygienists?

Well, my question to you would be to judge if you should have a super hygiene day.

I would say that you would look at your schedule of past due patients. So, yes, you only employ two hygienists, but if you have four chairs, you likely would have two temporary hygienists come in and work the other two chairs and you would not have any dentistry those days. If you're doing a super hygiene day, the dentist absolutely cannot have any patients in their schedule because they're basically going room to room. So in a super hygiene day, it's under the model that you would have your existing hygienist and then you would have temporary hygienists come in as well. Good question though. Let's see.

Not seeing any other chats, but I have some more questions. Any thought on modifications for pediatric schedule? Yes, I would modify the pediatric schedule similar to what you are doing with.

The hygiene schedule. I would still allocate the time in between for cleaning up and re getting in. In regards to parents coming in with multiple children, I would encourage mom, depending again on how many rooms you have and if it's one family, if it's one family and we have them scheduled for an hour and a half, hypothetically, and they're the only ones there, then yeah, mom can come with those three. We're going to put them in the three rooms and we're going to take care of them. In regards to modifications to doctor schedule with pediatric practices, I would recommend that. I think every parent would understand this, that mom, I know that under, you know, we used to have you come back in the room, but we are asking. We really do not want anyone back there but the patient. If mom is absolutely pitching a royal fit and can't get past it because she doesn't understand logic, then firm in principle, flexible in procedure. What does that mean? You know what? I will make an exception this time. But I want you to know you're going to have to get your head wrapped around this. This is going to be the new normal. Or you can be very firm and say, I'm sorry, but realize that people's emotions are at all different ends of the spectrum. Go back to the grief stage. We don't know where she's at. Maybe she's at the freak out stage. She hasn't even accepted it yet and she's just freaking out about her kid. So be mindful of that. Like, don't be so, you know, like the rules, the rule, the rules, the rule. That's it. Firm in principle, flexible in procedure is. Our principle is this. This is what we ideally want to do. 99% of the time, flexible in procedure is, hey, I've got a patient here that's just losing it. Let's just make her day and let her be with her kid. Okay, next question. What to do if a team member or patient is non compliant during this Covid time? Great, great question. So let's address the team member first. So if a team member is non compliant during this time, I'm assuming non compliant means they're not wearing their ppe. I absolutely have had doctors already tell me, well, my assistant said she doesn't want to wear the face shield. And I said, well, guess what? When a patient comes in that is COVID positive and your assistant gets Covid, you have to have a leg to stand on. So you best have her wear the face shield if that's what your rule is. Now, the ADA guidelines is saying if you wear a regular surgical three and the face shield and goggles, you don't have to have the N95 underneath it. This is a personal choice with the doctor, not the team. If the team is non compliant, I would write them up and I would say this is a write up. The next time I have to write you up for being non compliant, I will be sending you home without pay. I want you to think long and hard about being non compliant. I'm not 100% sure about a patient being non compliant. Meaning like they won't let you take their temperature. I'm not really sure. So if you want to type in for me what you mean by a patient being non compliant, I'll happily answer that part. Next question. Are you saying that patients should have no cell phones due to their using them or because possible contamination? What about purses and coats then? I'm not saying anything about patients having their own cell phones. I'm referring to staff members having cell phones during a business day. I'm referring to doctors having their cell phones during a business day in their lab coats, checking on their cell phone between patients while they're waiting for an exam. I'm talking about that. I'm talking about no cell phone in the office for a staff member. It can be in the office, it can be in the purse, it can be wherever you store your purse and at lunch, have at it, go and talk and do whatever you want. But no cell phones in the office. Patients, your call. I mean, a lot of offices I've seen no cell phone use in the operatories. That's been around for a while. But if you guys are bugged, I mean, we've all seen. I've gone on the Internet and seen, you know, photos of patients sitting in the chair going like this or saying to the doctor, you don't have time for that anymore. We can't have patients on their phone telling you wait so kindly you would say, you know, Mrs. Jones, we don't allow cell phone use in the operatories. You need to hang up. So next question, pay for a hygienist, continue by the day even if only seeing two or three of the patients. Or just pay for pay to less patients. Or ask hygienists to see same amount of patients over a longer day. I don't want to stress out employees over working harder to make same amount of money, but it doesn't make sense to pay employee more for less production. The especially after loss of production for two or three months. Just want to be fair to the doctors and hygienists. I hear you. I think again, this is. I encourage people to have conversations with their staff. So if I'm the doctor, I'm going to say to the hygienist, hey, sue, you know, I've been struggling with this. I want to ramp up. I want to have a soft opening where we kind of just see how it goes and we all get our wiggles out. But then I'd like to space like 10 to 20 minutes in between each one. It may mean that we're going to work later. What are your thoughts about that? Oh, well, doctor, Absolutely not. No, no. I do not want to work any more hours. I'm only going to want to work the days I work and that's it. And I only want to work the hours I want to work. Okay, well, if I don't have as many patients to put in there, but I was paying you based per day x amount, how do you suppose we work out that?

Get them engaged in talking with you. They may say, well, let's just prorate it and I'll make less because I'm seeing less. You have to make a decision. Does that make sense for you? Does it make sense for your practice? You'll have to decide. Okay, next question. Patient refusing our screening or any of the guidelines for social distancing, etc. Or signing new updated forms. Things like the non compliant patient question.

I think that you have to make a decision. My feeling is I absolutely would not risk having a patient come in that you did not. They did not update their forms and I would simply say make it larger than yourself. Right. It's easier to blame. I always kind of say blame the Russians as a joke, but. But basically blame the cda. Oh no. This is a guideline that it's not even. It's out of our hands. It's the CDA or your state dental society and the ada. They recommend this. We have to follow these guidelines. So you're refusing then I guess we won't be able to see you. I guess we won't be able. So you mean you're going to leave our practice? I think you're going to face this at every practice. I'm confused why you wouldn't want us to take your temperature or answer these questions that are mandated. Like even your doctor is going to ask you these questions. This is the new norm. Help me understand that that's what. How I would handle it. I hope that answered your question. And I think I answered the hygiene question. And then I had. Thank you. So thank you as well. And let's see, I've got some chats. So let me go over to the chats. And.

Fun fact, Taylor has. I asked my dentist where he found a face shield that was deep enough for him to wear his loop. His teenaged neighbor made it for him as a boy Scout project. That is a cool thing. All right, thank you very much, Jean. Very informative as always. Well, thank you, Sanaz. I appreciate that. All right, so I think we are done. I know I ran over. I'm so sorry. 24 minutes over. I apologize. This is being recorded again. If you have any questions, please direct them to me. I will happily answer them. Please download our Covid toolkit. It's on the website that I gave earlier. And once again, I thank you very much for participating. Wait, I have two more questions. Oh, thank you. Thank you. Thank you, too. All right, thanks, everyone. Have a great day. Happy Cinco de Mayo. Go have a margarita and some taco Tuesday. Bye.