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Rescheduling pt for SRP on a different day

Hello all! First, I wanted to say how forever greatful I am for this website. I am a new hygienist practicing for just a year (one year and one week, but who’s counting? ) and I have turned to this site countless times reaing others’ questions and answers. So, thank you for all the annonymous advice already given. Now, to my question.

I had a pt last week who has been seen in our practice for a few years and has always been an adult prophy with this office. She presented with localized 5mm pocketing and bop. I suggested loc SRP and DDS agreed with me. (As it turns out, pt had periodontal flap proceedure about 30+ years ago) The pt had shown up 10 minutes late, said she really wanted to be numbed for the deeper cleaning, and after perio charting and explaining her periodontal condition, there wasn’t enough time for the SRP and pt had to be rescheduled. The pt (who wasn’t very happy about her gum disease and really “just wanted her 2 free cleanings”) has a very strict schedule and can ONLY be seen on 8:00 on a Monday….sooooo the next avalable opening is 6 months down the road. The pt was very upset about not getting a cleaning that day. She asked if a deep cleaning is so important, why aren’t we doing ANY type of cleaning today? Does it make sense for me to wait an extra 6 months before getting cleaned?

What do I say to that? I know I did what was right and that her periodontal disease and very strict schedule isn’t my fault, but how do I explain to a pt it is better to come back later versus getting some sort of cleaning today? Of couse, ideally, there would be an opening or cancellation and she would get seen sooner, and she is on our quick call list, she ad just caught me off guard with her question and I was speechless for.second.



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1 Answer

Thank you so much for your kind words about the website! I’m so happy it has helped you!
 
Here are my thoughts: Regardless of whether a patient’s treatment is a prophy, perio maintenance, or SRP, when a patient is late, and you don’t have time to give proper and thorough treatment, I agree its best to reschedule the patient. You cannot lower your standard of care and rush through treatment because a patient does not respect the time you have scheduled for them. Tell the patient that quality of care matters and you need the full amount of time (the time that was reserved just for them) to treat them in a way they deserve. Yes, this patient’s treatment matters, but you need the proper amount of time to give such treatment.
 
On a side note, if this patient has such a “tight schedule,” she needs to adhere to her schedule, so in turn, you can accommodate her schedule. Actions have consequences, whether they are good, bad, or indifferent. Her being late had a consequence and that consequence is not your fault. Sometimes it’s easier for people to place blame and/or become mad about something, essentially projecting their feelings on to others, instead of accepting the blame for themselves and looking for solutions. The joys of serving the public!
 
After an explanation, some patients understand why you are recommending to reschedule, while others, no matter what you say, just won’t or don’t want to. Stick with your ethics and do what you feel is best. Also, make sure your doctor is on the same page (seems like you are) about late patient protocols and has your back in case the doctor needs to come in and explain to the patient. (If a patient ever becomes overly-mad, that’s when you get the doctor.)
 
On the other hand, waiting six months to begin definitive treatment isn’t such a great idea, however, you stated the patient will be called if there’s a cancellation and be put on your quick call list, so hopefully, that solves that problem.
 
I hope this helps a bit!

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