Chapter 6   Practice Management (PM) Courses

6-1.   Objective.

The objectives of these courses are to evaluate the efficiency and effectiveness of each student  in the management of a general clinical practice.  Practice Management (PM) courses are designed to maintain a system of accountability which will measure the student's ability to :

1. utilize clinic time effectively
2. manage patient records, oral disease and infection control in a professional manner.

Seven aspects of the clinical practice are emphasized and the grading system for the Practice Management Courses will be based on these areas of activity.  

 

1. REGULAR TREATMENT.   All active patients must be seen once monthly.  Exceptions may be  allowed for valid and documented reasons to discontinue or delay treatment.  The progress notes must reflect these  reasons.  Family members, fellow dental students and recall patients may be considered as exceptions.  

2. PROPER DENTAL RECORDS.  Progress notes are clear, concise and complete.  They should include all treatment information as well as results of telephone conversations or  correspondence.  This includes recording signed Oral Surgery progress notes on the treatment record (not the loose OS worksheet).  All progress notes must include student signatures,  student number and faculty signature.  The student signature will be at the end of each progress note.  

3. PREVENTION AND ORAL DISEASE CONTROL.  ODC evaluations are recorded properly in the dental record. If ODC mastery has not been achieved, then the patient's progress should be documented by monthly plaque checks.  

4. RECORD ACCOUNTABILITY.  All records are properly accounted for.  Any records checked out and kept overnight must be returned by 8:30 AM the following morning.  Records will be regularly audited to see if any are being kept out over 24 hours.  

5. CLINIC PARTICIPATION.  You must participate in patient treatment in all of the available clinic periods.  

6. INFECTION CONTROL AND DISPOSAL OF HAZARDOUS WASTE.  Sterile technique is followed and operatories are  properly  prepared  and cleaned after use according to guidelines posted in each operatory.  

7. PROFESSIONALISM.  Dentistry is a self-monitored profession.  Ethical professional behavior is expected.  Patient abandonment, unresolved patient complaints, repeated dress-code violations, and falsification of patient records are some examples of inappropriate behavior for which a student will be penalized.  Any such penalty will be commensurate with the violation and is discussed in the PM clinical syllabus.

6-2. Clinic Participation.  

A.  Senior Clinic Patient Management Program.

1. General.

Providing quality dental treatment for patients in a cost effective manner is essential to   establishing and maintaining a successful dental practice.  Many practicing dentists schedule patients 9 out of 10 available half-days each week, not including Saturday.  Student dentists should develop a practice management program for their patients, particularly in the senior year, that is no less demanding in time requirements than they will experience in the "real world" setting.  The Senior Clinic Patient Management Program is based on that premise.  However, it provides for greater time flexibility to allow for certain management problems that exist in a dental school practice.

The Senior Clinic Patient Management Program is based on direct patient care by student dentists in all of the clinic sessions available during the 9th, 10th, and 11th semesters.  Clerkship, immediate care assignment, assisting with a patient in Oral Surgery, Periodontic Surgery, Endodontic Surgery and Nitrous Oxide sedation will apply, as will "filling in" for the treatment of immediate care patients.

It is expected that the one week of spring semester will be needed to prepare for the SRTA Examination and it is not included in the Senior Clinic Patient Management Program.

2. Responsibility of Meeting the Participation Requirements.

The student dentist assumes the responsibility for meeting the requirements of direct  patient care during scheduled clinic sessions.  Absence from the clinic due to illness or other excused reasons can result in an "incomplete", in which case the student must complete the time lost or meet clinic production expectations as determined by the class coordinator.  Excused absence must be approved by Dr. Carole Hanes' office.

With mutual consideration, understanding, and effort between students and faculty, we will reach the goal we all seek, graduates who are superior dentists with primary concern for the well being of their patients.

1. Sophomore and Junior students will follow certain policies and procedures relating to clinic participation as published in the semester syllabus summary with the purpose of improving clinical knowledge and for generating accurate participation reports.

2. If a third-year student does not have a patient for the clinic period, then he will be directed to assist a classmate.

3. If a second-year student should have a patient no-show, he will remain in  the  assigned floor  clinic and  assist   a classmate.

6-3. Maintenance of Records.

6-4. Cleanliness and Orderliness.

6-5. Practice Management Suggestions.

1. After an assignment is made, contact should  be  made  with  the patient as soon as possible and a definite appointment  planned.  Except for the initial appointment, it is a wise policy to  plan future appointments while the patient is present in the clinic.
2. Be punctual in keeping  your  appointments  if  you  expect  the patient to do the same.  Do  not  let  your  patients  wait  for extended periods of time without letting them know you have been detained.
3. Arrive early to make certain the operatory  is  in  order  and necessary equipment and materials are ready for use.
4. Each patient should be seen at least once a month.
5. Write a schedule  outlining  the  plan  of  treatment  for  each appointment, and for all appointments  needed  to complete the total treatment plan.  Organization is the key element  in  good practice management.
6. Encourage patients with flexible schedules to  be  available  on short notice.
7. Remember  that  patients  are  sensitive  to  uncleanliness  and  disorderliness and will associate such with poor dentistry.
8. For accurate reports to be generated each student must  exercise consistent  care and   punctuality in record maintenance procedures.
9. No form is computer acceptable without complete identification data.
10. There may be times when treatment other than an emergency procedure is performed before the treatment plan is completed.  In these instances authorization to proceed must come from the Oral Diagnosis Department.  Scale and polish and root planing treatments may be approved by either the Periodontic or Oral Diagnosis faculty.
11. No fee ticket is computer acceptable without the instructor's evaluation, number and signature, and the completion date entered.
12. At the beginning of each semester the clinical expectations for that semester will be sent to each student in the form of a memorandum from the Office of Oral Diagnosis & Patient Services.
13. An incomplete (I) grade may be given for a Practice Management Course only when a situation arises over which the student has no control.  An I grade is rarely used  for  PM courses.