Because patients are treated while they are in pain. If you stop getting sick, the patients disappear. If we are talking about therapeutic treatment, then you can do without a plan: the patient is keenly motivated. But as soon as we talk about prevention, some complex procedures or complex treatment, problems begin for both doctors and patients.
Very, very few doctors are able to show the target state of the patient and the set of measures that from "was" lead to this "became". The standard treatment interface is this: you, patient, come to me, the great doctor, until I say that enough is enough. I know better what to do and how.
And is it important. Because, logically, you need to describe the patient's condition at diagnosis, show him all the problems, show the exact treatment plan for each, put it together in a comprehensive plan and explain to him. So he will understand what exactly is happening, how long it will take, how much money is needed and what exactly the estimate is made of.
We acutely felt this in dentistry already during the transition from the economy segment to the middle segment and immediately began to make the corresponding modules in the software. As it turned out later, treatment plans helped to solve a number of other problems - from theft inside the clinic to the separation of the roles of doctor and administrator-consultant.
But let's start with the fact that each doctor treated patients in a creative and unique way, on inspiration and intuition.
Ordinary situation
If in therapeutic medicine doctors need a treatment plan in order for the sisters to actually execute it (that is, at the level of “preparing for surgery, cutting, then giving so many antibiotics and other droppers, if it doesn't get worse”). Treatment plans are often regulated by the compulsory medical insurance, and for deviations from them there is a-ta-ta. The patient is not able to get such a plan in his hands, and it is believed that it is not necessary: the doctor saves as best he can. With the transition to VHI and paid medicine, the situation changes slightly, because it is not the need that comes into play, but the needs of the patient. When it comes to prevention and aesthetics (as is most often in dental clinics and centers), then, in fact, the treatment plan resembles a construction estimate: it is better to discuss everything in advance, so that after a long
In the last post, I talked about how we organized our own treatment plans in order to move from economy to medium, and then to premium. Now I will explain in more detail why this is important. It turned out that almost no one in Russia does this, and no one does it systematically at the CRM level.
So, the patient was examined in dentistry. Then the doctor takes a piece of paper and begins to write: "Based on the examination, there will be so many implants, so many crowns, and there will be canal retreatment." An assistant with a calculator is sitting next to him. At the end of this procedure for the inventory of teeth, a seemingly target plan is obtained: they looked at each tooth, described its condition, described a list of actions that lead to the ideal, and divided these actions into estimate points. This is done manually every time from scratch. Pretty lucky if there is some kind of standard form.
As you might guess, the manual method is bad for three obvious reasons:
- For two patients with the same problems, there will often be two different treatment plans.
- For a patient with a large number of problems, the complexity of the plan will be entirely up to the doctor.
- Something may fall out of the plan, and something may be accidentally added.
In addition to obvious reasons, there are several more implicit ones related to the theft of personnel and, in particular, doctors. Moreover, theft is both arrogant and malicious, and implicit "for the benefit of the patient", which does not make the clinic any easier. But more about that next time.
So far, the most important thing is that the result is an invoice that resembles the estimate that builders bring when ordering a cottage. It is impossible to read such an invoice without an expert, and to understand the need for this or that line without a doctor is also impossible. Because in the bill everything goes in a row in the form of the number of services and their names without reference to the situation in the patient's mouth.
As you can see, each action is signed and logically follows one from the other. The administrator can easily explain why exactly it is needed and why this step in general
What have we changed
Firstly, we made diagnostics in the form of "it was-became" and decomposed the problems in our teeth. At first, these were standard forms and treatment schemes, then they began to be gradually automated and only then entered our CRM for dentistry StomPRO as the main functionality.
So, here the patient has teeth, there are several problems:
For each tooth, we describe a strategy of action:
Usually we get three treatment plans: the most expensive and high-quality on the best technologies, the plan is about one and a half to two times cheaper on the technologies of the previous generation and some compromise between them option.
Actions are written for each patient's tooth, and not just everything:
That is, the most important thing is formed: the patient knows which tooth will experience what and in what sequence. The full amount of costs for the entire treatment plan is visible (if we are talking about commercial treatment, if VMI, then we do not show the amount, only a list of manipulations).
And then the magic begins, which allows you not to lose the patient.
Why do I need to show the entire amount at once?
This is one of the first objections we hear from clinics that prefer to hide and obscure the treatment plan. The logic is that it is easier for the patient to agree to start treating and prosthetic teeth, if you do not show him all the prices or if you lower the forecast twice in a conversation. They say, then, when the work has already begun, it will be possible to acquaint him with the true state of affairs, and he will not go anywhere.
Yes, this really increases the conversion in those who agree to treat teeth or deal with their aesthetics in the middle segment (in premium, on the contrary, it scares away, and in economy only therapy and extractions). But at the same time, in the end, the clinic loses: at some point, when it is necessary to make a large advance payment, the patient simply disappears. And this happens exactly before the installation of the implants, after the complete sanitation has been completed. That is, the clinic is actually preparing patients for someone else, only more honest.
The second peculiarity of the middle + segment regarding such treatment is that when it comes to one monthly salary of a patient, the decision is most often made spontaneously. But when the amount of full treatment is somewhere between two or three months' earnings (and this happens quite often, especially when it comes to a family with a mortgage), then these costs generally need to be planned. And plan ahead. And if the patient does not know how much will have to be spent, then there is no way to plan them. The result is the same: you need to make a large prepayment for implantation, but there is simply nowhere to get it. The patient disappears.
Here's an example: you need to spend a million and a half in a year and a half for a premium patient in Moscow. If the total family income is about 400 thousand rubles, this is normal. But if the income is less, and the plan is not voiced, then when 700 thousand one-time rubles arrive, the patient will get stuck - and this is after the therapist, in the most dangerous place in terms of losses, because the patient is in that part of the plan when you can just refuse. It turns out that modern implantation immediately after bone grafting immediately generates a large prepayment.
Why is planning important for the doctor and administrator?
The second feature of planning is that you need to carry out many actions in parallel. Each individual tooth has its own program, which leads to the fact that it will first be healthy (or extracted), and then aesthetic (the extracted ones will be replaced with implants).
In the case of a treatment plan on a piece of paper, the doctor begins to implement it in a chaotic manner. Again, depends on the availability of standards in the clinic. If there is a very simple approach to the processes, then there are no standards, and the doctor just looks into the patient's mouth and thinks at each visit what to do now. If the clinic is advanced, standards are introduced. We immediately decided to go with automation, which brought standards to our dentists. Actually, this is also in the basic CRM functionality.
Without standards, the situation turns into the fact that when the patient gets to the doctor, the first time is orientation on the ground. Records are kept, but haphazard. If the treatment is on a whim, then the patient said that we would start with this, then the doctor decided that he would start with another. As a result, the patient is put together like a puzzle after the sixth appointment. It may turn out that at first, like everywhere else in Russia, first the asphalt was laid, then the pipes are changed. I know hundreds (!) Of cases when a patient had their teeth removed after they underwent medical procedures that would simply not be needed if they thought about a holistic plan right away.
The third main feature is that in terms of treatment, one must proceed not from the comfort and capabilities of the doctor, but from the comfort and capabilities of the patient. This is expressed in the fact that many clinics leave tooth extraction for sweetness in front of aesthetics. That is, it looks like this: first, several painless procedures, then almost everything is ready for sanitation, then three extractions, and then preparation for implantation. The extractions themselves are painless inside the clinic, but when the anesthesia is released, the patient begins to suffer. Not from pain, but from the fact that there is no tooth, blood first drips from there, then you need to limit the intake of certain food, this place is a little swollen and aching. You don't want to experience this a second or third time without strong motivation.
Therefore, the removal should be planned in the middle of the process, and not left for sweetness.
The meaning of the action is that the patient must always understand that he is progressing and moving, and stopping the treatment plan is the loss of something unfinished. That is, the extractions must pass as part of the flow, so that the patient ends up with the orthopedist at the same time, and not just part of the teeth.
Here, see how the treatment plan looks like, scheduled in time:
It shows all the planned appointments from the treatment plan, which have already been performed, which are planned: how much they will take in time and money. Available to the administrator at any time.
In addition to a single board for the treatment plan, we make a summary in the schedule. Color indication is:
- By reception type: parallel / serial / expired.
- According to the composition of the reception: treatment / examination / consultation.
If the appointment is overdue, it is displayed in red, and tasks appear to call the patient, reassign the appointment.
You can immediately call from the schedule:
Choose a new appointment as a result:
Well, and the best part: imagine what chaos begins without automation if a patient suddenly flies off on a business trip and misses one of the appointments. In clinics that work on paper, the entire appointment schedule needs to be redone. In clinics without processes, the puzzle begins. If there is automation, then it is enough to simply postpone the visits - and all the others in the plan will be transferred after them.
When the entry was moved, it was reflected in the patient's card and changed on the appointment board:
That is, the work schedule will be performed in the same order, just with a delay.
A very important part, which is forgotten, is that if you do not do this and do not plan all long procedures in advance, then the patient will not be able to choose a convenient time for himself, but will constantly depend on short therapeutic methods of the “first-disciples”. If you book the time for all procedures for a regular client in advance, then the total revenue of the clinic is higher, because the patients of the orthopedist at the time of delivery of work bring in much more money than the patients of the therapist when treating a local problem. At the same time, the therapist's patients do not disappear anywhere: their appointments are actually booked around the occupied long slots. This choice between persuading the patient to start 15 minutes earlier or later means almost 10% of the clinic's revenue in the middle + segment. And it is also done automatically, because no paper will be enough to calculate this by hand.
It makes no difference for Masha's conditional administrator to schedule a patient for Wednesday evening or Thursday morning. What if Wednesday is the 31st and Thursday is the first of the next month? At the same time, we are talking about the reception after the final fixation to the patient of the final work with 20 veneers. This is actually a plus or minus several hundred thousand rubles, which in case of uncontrolled situational recording "on a whim" will be replaced by two or three free consultations and two or three stage receptions of 10-15 thousand each. As they say, the money that the clinic did not earn this month, it will never earn this month.
When a patient spends a lot of money on teeth and gets a good result, he still tells everyone around about them. When a woman at 47 smiles with a young smile, a lot of questions immediately arise. When a businessman casually drops that his car is cheaper than teeth, then everyone wants to know how it is. In this way, people bring new dear patients from their circle of friends. And the plan also helps them explain to their friends what was done to them and why it was cool in this particular clinic (in terms of “what they have, what they don’t have in other places”). In general, the patient always has a systematic and understanding plan in his head. We will heal the gums, remove all caries, remove these two teeth, put implants, then move on to prosthetics. When the patient is not explained what is happening, he does not feel progress.
Do you need planning in general?
In my opinion, yes, it is necessary. We have quite a strong medicine in Russia by world standards, but its marketing is very weak. For some reason, it's often a shame to work expensively, and the same approaches and standards are imposed on the upper segment as in the middle and economy. From my point of view, this is a market: if you can, due to the service and approach, increase the cost of the clinic's work and raise its position in the region, then this should be used. This means access to more expensive and modern equipment, better salaries for doctors (that is, a more professional team) and does not spoil the lives of patients in any way. Because in the case of optional actions (aesthetics and everything that goes beyond the VHI), it is a matter of free choice where to do it. And if the patient is ready to pay extra for the quality, or in general for the opportunity to carry out the operation in his difficult case, he will have a choice.
So far, alas, I see that even in the most expensive cases, the treatment plan is often either absent in the form of a separate entity, or is drawn up in a form that is understandable only for the doctor and is poorly communicated to the patient. For clinics, this means that the same administrator cannot guide the patient on what is happening and how and what can be swapped or moved and what not. And the patient is also forced to blindly believe instead of being aware. Clear algorithms of actions with clear prices and goals show that there is progress. This is very important for patients.
And the very emergence of a treatment plan as an entity greatly changes the work of a clinic administrator, turning him from a “girl on a phone with an incomprehensible load” into a specialist who uses his working time very effectively. About this - next time. And yes, I remember that I was asked to show one process in automation from start to finish. This will be just the reception of a difficult patient.
And the question is: how often have you met with the fact that they could provide you with a complete treatment plan and show you what is needed for and in what order all this should be done in those clinics of any profile where you applied?
PS For more details on how the treatment plan works, please visit our website here .