Referring the Periodontal Patient Flashcards
Refer (ri-fur’) vv.-.-
To direct or send to a source or send to a source
for help, treatment or information; to submit to an authority for … a decision or examination.
((The American Heritage Dictionary)
Dental Referral-
When a dentist sends a patient
to another health professional (i.e. periodontist)
for evaluation, diagnosis and/or treatment (or 2nd opinion)
skipped
Perio Referral
Rationale (WHY?)
(9)
To do something you don’t want to do.
To assure the proper treatment options are offered
When there is a question regarding the appropriate
therapy; many lawsuits are based on the failure to
treat periodontal disease appropriately.
To offer patients procedures not routinely performed by yourself.
Difficult cases you are not comfortable treating.
More advanced periodontal disease and attachment
loss (Stages III-IV, Grade C progression, or high risk modifers)
For aggressive or unstable cases not responding to
your prescribed treatment regimen.
To help convince a skeptical or unmotivated patient
to accept treatment.
Because it is the standard of care in dentistry
To assure the properTo assure the proper treatment treatment options are offered
–% of Stage III-IV periodontitis treated by GP’s.
Don’t assume that putting your patient through —
has solved their periodontal condition
66
SRP
Because it is the standard of carestandard of care in dentistry.in dentistry.
What a reasonable dentist would do under the same
or similar conditions while applying scientific,
evidence-based concepts; not the # of doctors doing it
skipped
The Process- An
Effective Way
to Refer (HOW?)
(8)
#1: You (doctor) make the case to the patient for the
referral and the rationale (concern, urgency and condition for further care).
#2: Recommend a specific periodontist and explain
your reasoning to the patient.
#3: Distribute the specialist’s card or referral
information to the patient as a means of introduction.
#4: You and your staff should attempt to physically
arrange the patient’s appointment with the
periodontist while the patient is still in your office;
your perceived sense of urgency is crucial for
#5: Provide the periodontist with a letter of
introduction or referral memo on the patient
with,
a) your reason for referral;
b) your expectations; and
c) any restorative treatment
you have planned.you have planned.
#6: Decide what radiographs are indicated and
who will take them.
#7: Fully document your referral
recommendation and steps taken in patient’s chart.
#8: Follow up with the specialist if you do not
hear anything within a reasonable period of time.
Common Challenges from
the Periodontist’s
Perspective
(4)
Referring office pressures the periodontist to
do the evaluation and treatment at the same visit.
The referring doctor quotes a fee to the patient
for the specialist’s services
Insufficient information provided to periodontist
about the patient you are sending over.
Getting non-emergency patients appointed on an expedited basis
Results and outcomes are promised to the patient in advance of the actual visit to the periodontist.
— is under-estimated.
Teeth with pulpal symptoms are not tested
for — prior to referral (take PAs)
Requests for limited exams when —
Post-op healing time
vitality
full mouth
periodontal problems exist
And More…
Completing definitive restorative therapy
on perio-involved teeth prior to referral.
Failure to diagnose and treat — issues that are contributors to many perio problems.
Treatment planning based on what dental — will cover.
Referral to “—” a difficult patient.
Ignoring the periodontal — in the
hopes that they will just go away.
occlusal
insurance
dump
symptoms
skipped
What You Should Expect
(RESULTS)
(7)
Acknowledgement of your referral.
Reasonable time frame to see and treat your patient.
Specialist communicates with you regarding
their findings, diagnosis, recommendations and
next step.
Your preferred method of communication?
Thorough explanation to your patient concerning their proposed care
There are no “kickbacks” or referral “splits” permitted in dentistry.
Periodontists generally don’t “steal” referring dentists patients.
The referral as an opportunity for your patient to find another dentist (with help from the
specialist)
Who sees the perio patient for continuing
maintenance visits? How often?
When in doubt,
refer
Keep lines of — open.
communication
Have your patient’s best — in mind
when treatment planning a case.
interest
Periodontal disease is both treatable and
preventable;
seek appropriate help.
Share maintenance responsibilities on all
high risk patients (Stages III and above)
