North Texas Dentistry Volume 8 Issue 3 2018 ISSUE 3 DE - Page 18

practice insight Patient-Centered Systems: How Cultural and Generational Trends Impact Patient Care by Bethany Petty Historically, practice management techniques and systems are created by the evaluation of what seems to work and what seems to fail – objective evidence and experiential deductions. While these deductions are relevant and useful, they are not compre- hensive. To fully evaluate a system or a technique, it is critically important to have a baseline understanding of the cultural and generational influences impacting the person in the chair. Systems created by focusing primarily on outcomes leads to inadequate systems and a doctor-centered practice rather than a patient-centered practice (Figure 1). An example of focusing on objective evidence is evaluating the results of treatment acceptance. A patient arrives in the office and requires dental work. The team implements the system that they have discussed for educating the patient and presenting the treatment plan. After the education, financial planning, and appointment set- ting, the team tracks the outcomes. Did the patient schedule? If the patient leaves without scheduling, the best teams attempt to understand why he failed to appoint. Teams might ask ques- tions like, “Was it money that prevented him from scheduling?; Did he seem to understand his treatment and why he needed it?; Did we provide him with all the necessary literature?” While these are excellent questions, they only focus on the objective evidence and outcomes – what the team did and how the patient responded. Then, teams take these outcomes and make changes as they attempt to tweak systems toward the desired outcome. In order to provide comprehensive care and to build systems that work, teams must attend to the subjective or unseen influ- ences on patients. Individual subjective influences include but are not limited to family history, personality, past experiences, expectations, motives, religious beliefs, and economic status. When dental professionals attempt to understand the subjective influences, 18 NORTH TEXAS DENTISTRY | they often focus on individual influencers such as these. In the previous example, it might include comments such as, “His whole fam [H]\Y[\Y]X]Y[ 8'H܂'H\]ZY] H\[]HXYۈ[K8'H܈8'x&]H[Y[HX]\ܛۈYH[Y\[H[\H[Y[K8'H܈8'H\۸&][H\H[ۙ^H] 'B[H\H\Hܚ]X[H[\ܝ[ۜY\\\XH[\ۈY\[[ܙHX]H[Y[\X\[\KXK[[\][ۘ[ܛ\˂[ܙ\^HۛXY]Y[[H]\X[[[ B\H[۝[YHݚYHH[[X]H\K\H\H^\]]\HݚY\[X[H[˂\ ܙ]H\[H^]YX]H]\K[Y\H\HX[HY]]\H[[[[ZX[[]KBX][ۈ[[\[^X][ۜ\H\HX[Hܝ[KBY\\\H\HY]]\[\[H[ [X H[[Y[]\Y\H[\^H[][[\Y[H[\[[][ۋX\ۙ\TQX[YYXK[H[\]][\H[[H]\HZXܞBوHܛ [X[]KHܛ\[[H[[[HY\›و[\[Y[[[Y\[HY][YK]\ܝXX[]H[[Y[Xۚ^\Hؘ[[\Xو\[B[[\H[Y\YY]]YYˈH]\H\ B\[[ܝ[]HY\[H[XY[[ݘ][ۋ]\\][Hܙ][H\]\[˜[[\Hۈ\ۙ[]YY[[X\][BYYZXY Xۙ [ZY[H[\[H[[ܛ [XZ[KBZ]YHXZ[[8$\[]Y[]\Z[]BYX][ۈ[Y]X[]H\KHX\وHXXH[ˈ[ٝ[\[\\HZ[\[HX\و