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Is it possible to do full mouth SRPs in only one hour?

I currently work for a corporation, and make the majority of my compensation because of production. They would like us to perform FULL MOUTH SRPs in one hour. This includes anesthetizing all areas needed, and adjunctive therapies such as placing arestin, irrigation and or laser therapy. I am very un-eased to be in this position, as it is unethical, and damn near impossible to do a good job scaling full mouth SRPs in one hour or so. I feel as thought I am obligated to do this or they will fire me for not hitting my goal production. I would love nothing more than to leave this office, but I am having a tough time finding a job elsewhere. Any input on what to do is very much appreciated. Thank you!



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10 Answers

This is a tough situation to be in. First, I want to point out that anesthetizing the entire mouth is not really a good idea. It puts the patient at high risk for self-mutilation (i.e. biting through their tongue) and depending on what anesthetic you are using you may be giving the patient above the “maximum recommended dose” (MRD) of anesthetic. This can lead to toxic reactions and overdose.

 

Most offices give at least one hour per quad, I’ve seen some offices even give two hours. I agree with you, in that having only an hour for all four quads is unethical. My first permanent position was at an office like yours and patient care was not a top priority and there was no changing the doctor’s mind on that. To be frank, he was more concerned about money coming in than any patient that walked through the door. What you have to ask yourself is do you think you are providing treatment that’s up to the standard of care?

 

These patients are paying for a service you provide, expecting and trusting that you are doing the best you can do. With abbreviated appointments you are not having adequate time to provide such treatment. I didn’t feel that I was providing treatment that was up to par in the standard of care that I believed in, which is why I moved on from that office. For most people, this kind of schedule causes major burn-out and takes a toll on your body as well.

 

I wish you the best of luck with your situation!

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I had an offer from an office like that and turned them down. I knew for a fact that I couldn’t do a good job in that amount of time. I would have to choose everyday whether or not to be way behind schedule or leave a bunch of calculus on the patients teeth. I can’t work that way. I also would of had to relocate myself and my family 3 hours away for this job. I would hate to do that and then quit or get fired. It’s a tough situation and I don’t envy your decision because there is good and bad no matter what you choose. Good luck.

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I had a working interview in an office like that, it was a horrible situation to be in. I got the job offer at the end of the day, but I turned them down, it’s not worth putting your license at risk.

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No, not if you want to remove all the calc build up and make glassy smooth surfaces.

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I do not feel like I could do a good and thorough job for a full mouth SRP in only 1 hour. If full mouth SRP is need for a patient my office does 2 appts with one side completed at a time (usually at 90 min per appt). And of course due to the troubles with anesthetizing the entire mouth in one appt…

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Not possible to do the job correctly and thoroughly! Its so hard to believe that their are offices out there that are this unethical! Not right!

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That is insane and there is no way in my option that it can be done well in one hr. Also how are you going to numb them? Give bilateral IA blocks?!? I would say no way.

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I also work for a corporation. I have done 4 quads of scrp in one hour and don’t feel I compromised the care I provide to my patient at all. The difference for me is I typically use Cetacaine anesthetic and it saves a lot of time. It’s fast acting. I have used it pt’s with 4mm and localized 5mm pockets. 1 hour for only scrp and nothing else is all I need most of the time. i Depending on the patient, radiographic calculus, or deeper pockets, laser tx I have the Dr anesthetize and allow myself 1 1/2 to 2 hrs. An hr for all you are expected to do is absolutely unrealistic.

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I think its an unreasonable and unrealistic request…1 hour for half the mouth maybe but even then it needs to be evaluated for the possibility first…I usually determine my time after debrisment appointment with me…if its a patient they scheduled for me that is incredibly difficult and its not going to happen that fast I readjust the scheduling myself for followups…grab those reigns and make the best result the goal…the patients appreciate a job done well…

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At my office I often perform 4 quads of SRP at once due to the type of patients we see (most will not return for the other half if they show up at all). I choose the amount of time I need most of the time and if I run over the assistant will seat my next pt and take BWX, the Dr. will do the exam etc. I usually use between 1 1/2 – 2 hrs and I do not feel that the patient’s care is compromised at all. I use a combination of Cetacaine and local blocks to ensure pt. comfort but I try not to do double IA blocks unless absolutely necessary. The most important thing is to make sure you are giving quality patient care. If you do not feel that you are able to within the given time I would try talking to the Dr about it or possibly looking for other work.

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