Improve Your Patient Treatment Plan Presentation Skills. An Interview with Jorge Andre Cardoso

A customer’s acceptance of a treatment plan is the foundation upon which a prosperous private dental practice is built. A clear, quality plan can be the difference between success and failure.

As Dentists, we know that treatment planning can be a difficult process and the implications of a poor process are huge, therefore deciding on the best method of conveying a plan to our patients is one that has aroused great debate in our profession. We would all agree that a plan needs to be comprehensive yet concise, engaging and informative and portrays an image of knowledge and professionalism but how to package this has been a challenging process for most. This difficulty is exacerbated when trying to describe and plan for more complex high-value treatments.

Jorge André Cardoso (André) believes that he has found the answer in his software product Make Me Clear and describes the treatment planning process as ‘an art’. The software creates simple, automatic and editable explanations for diagnosis and treatment in a professional, stylish and clean design to support your image as an expert. We had the opportunity to meet with André and discuss this subject in greater detail.

Aalok Y Shukla:              Hi André, thanks for doing this interview with us. You’ve created this remarkable product, a software product called Make Me Clear. It’s designed to help dentists by getting more treatment accepted. Can you tell us a bit more about what Make Me Clear is and how you came about it?

André Cardoso:             Make Me Clear is an online software that is intended to help dentists present treatment plans. I’m a practitioner myself and I’ve struggled sometimes with the issue of treatment planning, there’s a lot of small nuances of all treatment planning presentation, and I couldn’t find a way to very easily and quickly present a written document that could be engaging and informative to patients, and that is how Make Me Clear was developed.

Aalok:              It’s important that you just said those two words, engaging and informative because getting treatment accepted is the absolute building block of private practice. You cannot do treatments unless you can explain them and get them accepted. If you’re able to improve your acceptance of treatment plans, you can then build your practice, improve your skills, and all of these types of things.

André:                 Exactly, yes. Well, treatment presentation, I like to say it’s normally science but it’s also an art. You are dealing with people who are emotional, and also the environment is really not that friendly for most of the people. You want to have a system in place that can be used not only by yourself but by your associates or even by the dental assistants, and you can generate in a very short period of time something that can actually, in my opinion, dramatically increase the case acceptance of patients.

Aalok:                  Because in your practice, Andre, you focus on high-end aesthetics, is that correct?

André:                Yes.

Aalok:                  Okay, so in your practice over many years, what has been the effect of getting more and more complex cases accepted? What has that meant for your working time and also for your practice satisfaction as a whole?

André:                 For me personally, my main goal in dentistry is to do high-end cases, and I dedicate a lot of my time to those kinds of cases. I think that over the last few years by using systems like Make Me Clear, there really is no doubt that it has increased the acceptance of my cases. In addition, the goal is not always to have the patient accept because sometimes the patient is not financially prepared and there’s nothing that you can do about it, but at least, engage the patient, then if he decides to do the treatment in six months, in one year, in two years, he will know where the best place to go is. Sometimes what happens is that I get referrals from patients that have been given a treatment plan, which is financially very demanding, and these patients although they did not do the treatment themselves because they were not financially prepared, they refer the clinic to other patients.

Aalok:              Wow. Another thing is the whole point about positioning your practice as the expert for the more complex cases which are more satisfying and challenging. A couple of things, what did you feel was limited in the treatment planning options that you had from your software in your practice management? What problems did you see with treatment planning that led you to develop Make Me Clear?

André:                 The first big problem is that most software that we use at the moment is made for dentists. They are not made for the patient as an objective, which means that there’s a lot of unnecessary information. For example, the patient may want to know the number of surface hits that the restoration includes, but visually he doesn’t need to see a very complex tooth chart. He wants to see something simple that he can identify himself. The goal of the software was geared towards dentists and not patients, but also visually it’s not very clear for patients, those were the two situations, the two biggest situations.

Another situation is that most dental software doesn’t generate a treatment plan, and the ones that do are only generating a list of treatments, and there’s nothing that you can do about that. For example, you cannot add observations very easily. You cannot change the names, for example, of the treatments. Sometimes they don’t include the prices. There’s a lot of limitations in the software out there. This is how I started to think about Make Me Clear. Something that is directed to the patients with the clear intention of information, and engaging the patient in the process to make him aware of the situations. To have a very visual area where the patient can identify himself. For example, we have three dental charts that we present to the patient. One dental chart is the ideal situation of the patient at their age. The other dental chart is the diagnosis that we have done. The third dental chart is the treatment plan. Only by looking at the dental chart, the three dimensional dental chart, the patient can immediately understand complex treatments like sinus lifts.

Aalok:                  Yes, like you said, most dental software, it’s a bit scary. It doesn’t make any sense and at the same time, dental treatment plans are generally quite expensive. All of this leads to a situation where the patient feels confused, and they also feel a bit apprehensive, and they don’t feel emotionally attached to the plan. Therefore they’re not going to go ahead because a confused a mind doesn’t buy. People need to know the context and it needs to be clear and understandable to them. The visual side I like very much because they can see what needs to be added for them to improve. Some people in life just have a need to complete things. They want to restore themselves back to health, and that gives them the opportunity over a two-year plan or a three-year plan to complete the treatment. One thing that’s made a big difference that I’ve seen is providing staged treatment plans, and Make Me Clear works very well with that. What influence and what importance do staged treatment plans have when you’re dealing with economies or world recessions and things like that André?

André:                 I don’t remember any other factor that has had such a huge impact on patient acceptance as staged in treatments. I usually like to say one metaphor, “Well, at this point in time, let’s say that your mouth is a house on fire. First of all, we need to put out the fire, and the second part we need to start to painting the walls and replacing the furniture.” First stage for example, it can be considered the basic treatments, that’s the first stage. The second stage can be providing function, providing back teeth to the patient. The third stage can be the aesthetic part.

When the patient looks at the staged approach, it’s much less scary. It’s much more easy for the patient to start the journey of treatment. It doesn’t mean that the patient needs to do everything in one go. He doesn’t have to place all the inputs in all the restorations in one go. We can have provisional restorations for example, and he can first provide health for himself, and then he can provide the aesthetics for himself on the second stage. There’s a lot of playing around that you can do, and I personally I’d like to divide my treatment plans in three stages; the basic stage, the functional stage, and the aesthetic stage. It’s dependent on the personal preferences of the dentist, which is the way of re-framing the treatments plans so that it can be more engaging for the patient. In addition, by staging treatments, you are not only doing a mental organization when you are talking to the patient, but you are also providing a mental organization for the patient himself.        

Aalok:                Totally, and also what that means is that from your own patient list, you’re not limited to just quoting what you feel that they could economically go ahead with. You’re acting as a true professional by educating them in all the different things they could do, and then six months from now when they choose to do the second part of the plan, you can suddenly find that you don’t need so many patients because you’ve got so much work to do on those patients?

André:                 Exactly. This means some of dentists work only on high-end practice which is fine, isn’t it? But I would say that the majority of dentists do not have a patient list that can be consistently doing full mouth rehabilitation, let’s say. There are several ways that you can approach a full mouth rehabilitation. Instead of going all the way for the ceramics, why not do some provisional composites, that’s stage one, isn’t it? At stage two, if the patient feels good then he can go for the ceramic restoration which means that your practice is much less prone to the financial availability that the patients have. Especially when we are talking in today’s climate where there is a lot of economic limitations, I think that’s very appealing to patients. It is not only that, you feel that you are having the most positive influence to the patient’s health.               

Aalok:             You also come out with a couple of innovations in Make Me Clear. Can you talk to me a little bit about the 360 health evaluation that you’ve got in there?

André:               Well, the 360 health evaluation is basically a brief summary of the dental health. I usually say that we have about two to three different moments for presenting treatment plans. A typical moment for me would be when the patient comes in for an emergency, and he has some pain in a tooth, okay. Of course you are not able to spend about 20 minutes or 10 minutes talking about treatment planning. What you do is you do a brief summary, you just say if the patient has gum disease or if the patient does not have gum disease, if the patient has some active caries, and in less than one minute, you can provide the brief report for the patient with some generic conditions that the patient can take home and then book another appointment for further evaluation.

This is a way of engaging the patient and making the patient responsible, and also a little bit curious to want to have the 360 completely healthy. We use a chart which is very easy to follow, and you print that, give that to the patient, and then you book another appointment if you want to do a more specific evaluation. I think this is very handy because in most situations, we feel sometimes frustrated because we don’t have enough time to be spending with the patient to do a correct treatment plan, and this way, you are flipping the rules. It will actually be the patient that will want to do the comprehensive examination, and then you book an appointment which is specific for that. In those appointments where we have a little bit more time, you can do the treatment planning in more detail.

Aalok:                  Yeah, and the very visual aspect of it, everyone understands the traffic light system, that is green as good, and red as danger. Other things that you’ve developed with Make Me Clear is the explanations of what conditions are because it’s one thing for dentists to say to a patient you have decay, it’s another thing to actually say what that actually means. Can you talk a little about the innovations that you’ve created because as I’ve seen it, literally, you spent seconds creating the plan but it explains everything?

André:               Exactly. Let’s say for example, in Make Me Clear you do the diagnosis and then you do the plan. Let’s say, you are diagnosing a missing tooth. In a missing tooth, what you have to tell to the patient is of course that there is a missing tooth, but also what are the consequences of that missing tooth. It should not be half a page of text talking about missing teeth. It has to be a short one or two sentences that can really clarify it for the patient. We spent a lot of time, a lot of months trying to optimize and test what would be the best explanation that the patients would accept. For each diagnosed item, there is a specific description, and for each planned item, there is also a specific description. For example, there is a specific description for a sinus lift. There is a specific short description of what is an implant, that’s in the plan. There’s also a specific description of what is leaking restoration, a very short sentence also. The wonderful thing about Make Me Clear is that you don’t have to write it. You just chart it once and then it appears on the treatment plan, so it’s very automatic. Also if there’s something that you don’t agree with there, you can always change and you can customize those descriptions. For a specific patient, you might want to add some specific observations, which you can also do. It’s completely editable, but also it comes with templates and descriptions that we think from testing really work.

Aalok:                  This is the thing, because nowadays there are more and more regulations and medical-legal things happening where patients might be saying, “I wasn’t informed of this. I wasn’t given alternatives.” What Make Me Clear is doing in a very time effective way, is making sure that every patient has all the alternatives, and also would have the consequences of the treatment, so you could never be left in a position where they’re saying, “You never told me,”?

André:              Exactly, yeah. We’ve had a lot of templates for informed consent, for payment options, for practice policies in terms of maintenance programs. Make Me Clear comes with those templates but you can also edit, then add your own templates. For example, let’s say endodontics, it includes informed consent of endodontics. Implants, the same thing. You don’t need to be adding documents to your treatment plan every time. You just click which templates that you want to use for that specific patient, and your mind is much more free to focus on what really is essential, and also protect yourself, of course.

Aalok:              What effects have you seen this having on practices? Are you seeing more complicated treatments and more proactive treatment as opposed to doing emergencies all the time or reactive dentistry. What kind of results have you seen from different people when they’ve been introducing this? What kind of treatments are they doing more of?

André:                 When I started this, I just thought that I would be saving time to patients, but what happened was quite different. It’s that, not only they are saving more time, but they are seeing more of the cases and treating more of the cases that they actually wanted to do which is very interesting  isn’t it? What happens is that once you give such a visually engaging, complete, stylish and elegant document to a patient, in a few months the likelihood that you get more patients to accept this kind of treatments will increase. That’s the experience that I have from our clients. That’s what I am seeing. People are doing more and more of what they actually want to do in their own practices.

Aalok:                  They’re feeling more fulfilled, using the skills that they’ve trained much better to do, and that’s ideal. Tell me, Andre, if people want to learn about Make Me Clear, where should they go and what they can do?

André:             Well, they can go to www.makemeclear.com. Now we are ready to offer a 30-day free trial. They can try it for themselves and find out. I think that in 30 days, you will able to generate several treatment plans, and play around with the software. It’s very easy to use. The user interface is very simple. You can also add images, x-rays, photographs, digital smile designs. Here you have a tool for a very complete treatment plan presentation for a patient.

Aalok:                  Perfect. Any dentist that wants to do more implants or do more aesthetic cases, more comprehensive cases, they should go to makemeclear.com and start the 30-day free trial. If we can put together plans and explanations that are so much more visually appealing it sets us apart in a competitive climate, just like you wouldn’t buy a car from a place that didn’t present in the right way. You want to make sure that your treatment has that kind of same experience, that high-end feel. Make Me Clear is something which allows you to do that very quickly, yet at the same time explained very thoroughly, and fulfills all the regulations and requirements by informing people so that they have all the resources they need to make the right decision.

André:               That’s correct.  One of the things that also happens is that most dentists don’t feel very comfortable presenting a complex treatment plan, and talking about high-value procedures.  It is like you were saying, with this they want a high-end professional feel. That can also justify the investment that you are doing.

Aalok:               Yeah, and the thing that I really like about Make Me Clear is it turns the whole treatment planning into a process because the software guides you through all the steps you do. What this means is that you’re automatically and comprehensively assessing all patients and automatically providing comprehensive plans for all patients.

Just the effect of assessing everybody, providing comprehensive plans for everybody, and giving them the explanation, and the experience that they can opt for more complex treatments is just going to have a really positive effect in everybody’s practice.

Andre:             Exactly. Most of the users that we have at this point in time are from the United States. We also have quite a few from the UK, but the generic thing that I have experienced is that there was really a very positive shift in the practice of each user.

Aalok:              Perfect. Well, thank you very much for doing this interview. To those reading make sure you get the trial and start educating comprehensively.

To start your free trial or to find out more information on Make Me Clear please click here.

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