Stop Saying ‘Emergency’: How to Manage Summer Schedule Disruptions

Alison Werner (00:05)
Hello and welcome to the Orthodonic Products Podcast. I’m your host, Alison Werner. On today’s episode, we are tackling a seasonal challenge that almost every orthodontic practice faces as the temperature rises: the summer rush of urgent patient calls. From loose brackets and wire pokes to lost retainers and aligners left behind on family vacations, these disruptions can easily derail your daily schedule and overwhelm your clinical team. But what if the key to managing this seasonal spike starts with a simple shift in mindset?

Joining me today is practice management consultant Andrea Cook. She argues that most of these emergencies aren’t actually emergencies at all. They are simply problems that require solutions. We’re going to discuss how to eliminate the word emergency from your practices vocabulary, how to empower your front desk team with the right triage verbiage, and the proactive clinical and educational steps you can take right now to protect your schedule and keep your sanity. Here’s our conversation.

Alison Werner (01:03)
Andrea, it’s so great to have you back with me.

Andrea (01:06)
it’s great to be here. It’s been a while. We’ve all been busy, but love being back.

Alison Werner (01:08)
Yeah, definitely. I know.

Exactly. Well, I’m really looking forward to this because we’re going to talk about summer topic. ⁓ It’s the summer. So we’re going talk about summer emergencies. So talk to me about, you know, when you’re working with clients, what types of orthodontic emergencies tend to increase during the summer months? And what factors do you think are driving those trends?

Andrea (01:33)
My two is two biggest that increase are bond failures and lost items. I lost my retainer, I lost my aligners, things like that. You know, I went camping and in the bear ate it, I don’t know. ⁓ so those probably are my biggest two emergencies. And I want to preface this whole podcast with a lot of these aren’t emergencies, they’re problems that we have in the office.

Alison Werner (01:38)
Hmm.

Yeah.

Mm-hmm.

Yeah.

Mm-hmm.

Andrea (02:01)
And if we treat them as emergencies, then that’s when we’ll talk about it in a little bit, but that’s when they have such a huge impact on our office that we have all these emergencies. We don’t. We have problems in the office that we need to deal with. And how we deal with them will dictate the impact on our day. So we need to manage them instead of them managing us. So but those are probably the two biggest ⁓ areas that I see over the summer.

Alison Werner (02:10)
Mm.

Ah, okay, that’s a good one. Okay.

Okay, okay. And like you said, those aren’t necessarily emergency. I mean, the bond. Yeah.

Andrea (02:31)
In in the orthodontic world, truly an

emergency is I have a herbs appliance that half of it’s out. ⁓ but s something like that, but if it’s a wire poke or a loose bracket, we can triage it and we can manage it from afar where it doesn’t have to be I have to be seen today and it has to be after four o’clock and those things. So those are the really only true. And if they get if they have an accident, they get hit in the mouth or something, that really isn’t

Alison Werner (02:38)
Mm-hmm.

Yeah, right.

Yeah.

Andrea (03:00)
us as well. It’s probably a general dentist that they should be calling. So we generally don’t really have emergencies, but we have to get that thought out of our head that these are emergencies.

Alison Werner (03:02)
Mmm. Yeah.

Thank

Okay, okay,

yeah, okay. So then, you know, as it beyond changing that mindset, what are some of the preventative steps practices could be taking to reduce the likelihood of those emergency appointments?

Andrea (03:29)
a lot of it is training on the team. First thing I’m gonna do is slow down on my bonding protocol, do a review of it to make sure that I have all the supplies that I need, I have all the education I need for to do the bonding, and I have the time so there’s not missed steps that I was rushed or we switched team clinicians during a procedure and something got missed. So I wanna make sure those pieces are in place in the office and then

educate our patients on what to do if you have a problem, not an emergency. If you have a problem, here’s what you do. If you can’t resolve it, give us a call and we’ll set up a time for you to see us in the next, you know, few days. Whatever. But yeah.

Alison Werner (04:07)
Yeah.

Yeah.

Yeah. So it sounds like there’s an aspect of this as clinical protocols, but then it’s also patient behavior and then maybe some of the office systems that need to be addressed.

Andrea (04:25)
All all three to make it through the summer with any sanity at all. It really requires all three of those, you know. And I before summer, I like to have a review of you know what’s our bonding protocol, of all the things just to make sure we’re all not skipping steps and doing things the way our office does is supposed to be doing them, following the protocol. ⁓ so if you haven’t started summer yet, I would I would make that a priority to do that step back and say.

Alison Werner (04:38)
Mm-hmm.

Yeah. Yeah.

Andrea (04:56)
⁓ making sure everybody’s on the same page.

Alison Werner (04:58)
Mm-hmm. Yeah. And then, you know, I like what you said, like, you know, a lot of this, aren’t emergencies, they’re problems. You know, it kind of sounds like it’s almost kind of reframing how you not only within the practice, but also the patient responds to a problem.

Andrea (05:05)
Mm-hmm.

Mm-hmm. And in for any orthodontic office, I encourage all of my offices to never have the word emergency in their office. It’s not on my phone recording, you know, if you’ve reached us after hours, if you have a medical or dental emergency orthodontic emergency, please call. We don’t. And we don’t the TC doesn’t tell them during the initial exam. If you have an emergency, you know, you can call us, you can reach us after hours. None of that. If you have a problem,

Alison Werner (05:22)
Mmm.

Andrea (05:44)
repair, we can fix that. Just give us a call on the next business day or you know, during patient hours and we can get you set up for a visit. So if we start with that, not in our minds and not in our patients’ minds, then it it eases them that in their head, if it’s an emer if they have a loose bracket, it’s an emergency and need to be seen. And it it it’s really not. But we have we have to let them know that it’s not. Otherwise

Alison Werner (05:48)
Yeah. Mm-hmm. Mm-hmm. Yeah.

Right.

Mm-hmm. Right.

Andrea (06:16)
They’re gonna call and say they have an emergency.

Alison Werner (06:17)
Yeah. Right, right, exactly. What are some of the tools that you see as effective for kind of triaging these problems and how can they have a positive, can they have an impact on saving chair time, staff workload? What are some of those tools?

Andrea (06:37)
Yeah.

Patient education is a big one because in our world we know all of these things and it’s not an emergency. But if you have a new patient or a newly bonded patient who just started and something looks different or feels different, that’s that could be very unsettling for them. And they may get anxious and I need to be seen, and you find out it’s, you know, one of the O ties is off. It’s not, but it’s that patient education, and it can’t just be one time.

Alison Werner (06:57)
Mm-hmm.

Right.

Mmm.

Andrea (07:07)
They

you know, they hear a percentage of the information that we give them, both in the TC room and at the chair. So we have to be reiterating that at every opportunity we can. So, Johnny, you’re in today. You know, what are your plans for the summer? ⁓ we’re taking a three-week trip to Italy. That’s an opportunity for me to say, Do you have enough wax? Do you know what to do if this happens? If you get a wire poked, do you know how to resolve that? Go walk through it with them to make sure. So when you hear those things.

Alison Werner (07:34)
Thank

Andrea (07:36)
Pick up on it and just don’t say, hey, you know, have a great trip. But make sure they’re setting up for I I’ve I’ve done everything I can to make it as easy for you as possible to resolve it. Or I can come to Italy and fix it for you. There you go. Sounds like a true emergency. I best come.

Alison Werner (07:47)
Mm-hmm. Yeah. Yeah. I’m willing to jump on the first plane.

Where do you see the role of like virtual care or remote monitoring tools in this workflow?

Andrea (08:11)
They’re very helpful and they’re very challenging for my offices. If they are used properly, remote monitoring can solve a lot of these problems because I can really see what’s going on. The challenge that we’re having in offices is having a team member there and available and has the time to monitor what’s coming in. I’m running two assistants short, Sally’s called in sick, and I’m trying to train somebody. So

Alison Werner (08:36)
All

Andrea (08:38)
True patient care in the office has to come first, and those things tend to get pushed off. And I don’t have the bandwidth or the time for it, so they don’t get done. ⁓ if you don’t go down that path, if you’re not on any of the remote monitorings, you can use your phone to help triage too. You know? Mom, can you take a picture of what you’re seeing in Johnny’s mouth so that I can look at it? So you can use that as a tool.

Alison Werner (08:43)
Yeah.

Mm-hmm.

Mm.

Yeah.

Mm-hmm.

Andrea (09:06)
And if if you’re not on the remote monitoring path. But it it’s it really helps triage those. It’s just the management gets to be a bit bit tricky for us.

Alison Werner (09:09)
Okay.

Right.

Yeah, especially if it’s late at night or over, you know, on the weekend. Yeah. Okay. Yeah.

Andrea (09:21)
Yeah, yeah. But I think I think they’re great tools for offices that

embrace it and really use it. And a lot of them use it for more aligner therapy. But with brackets, it there’s a vast amount of information that’s in there that can help us and triage that.

Alison Werner (09:28)
Mm-hmm.

Okay,

okay. How do you recommend that practices accommodate these problems without disrupting the rest of the schedule?

Andrea (09:50)
My first line of defense is we have to have whoever’s answering your phone, I don’t care who it is, tr trained on how to triage what is an emergency, what has to be seen, talking them off the ledge of saying, No, she’s got a bracket off. I we we need to be seen. ⁓ and helping them walk that patient through, you know, because when they call in and I have a loose bracket or something’s lost my retainer, I need to get in today by four o’clock. And we have to have the verbiage in place.

Alison Werner (09:59)
Mm.

Mm-hmm.

Andrea (10:20)
To let them know it’s not it starts with the TC, letting them know, it starts with the clinician who’s doing the bonding or delivering aligners or whatever it is. And then it goes to whoever’s answering the phone and being able to talk them down and fit them into our schedule. Their their lost retainer is not two days is not gonna make a difference to come in for a new scan. It’s not an emergency. you know, if it’s

Alison Werner (10:28)
Yeah.

Mm-hmm.

Yeah. Yeah.

Andrea (10:49)
If I just got my braces on and I have a bracket come off, you know, within a few days, I work harder to try and get them in because the the PR that goes along with it. But if it’s, you know, I’m six months into treatment and I have a loose bracket, give the front the verbiage shoes say, you know, is it causing him any pain? Well, it’s just a little bit sore. Put some wax on it. It’s not gonna change your treatment time, it’s not gonna affect anything. We can get you in next Tuesday.

Alison Werner (10:58)
Okay.

Mm-hmm.

Okay.

Andrea (11:17)
But it’s that verbiage that talks off the it’s not an emergency.

Alison Werner (11:19)
at.

Yeah. What do you wish that practices and staff really thought about around managing these disruptions or those potential disruptions, these problems?

Andrea (11:38)
⁓ they most of my ⁓ a lot of my offices are still in that emergency mindset and I really wish they would get back to we have a lot of not a lot, we have problems in our office, we have solutions, and not get wrapped up in the letting the patients dictate. Well, I it the brackets loose, I have to be seen today. And ⁓ managing them in a kind ⁓ educational way, but not letting them

Alison Werner (11:58)
Right. Yeah.

huh.

Andrea (12:08)
manage our schedule for us and say, Nope, I have to come in today by four o’clock. And you know when Johnny’s lost his retainer, he just told mom about it, but it’s really been lost for three months. You know that. So or my aligners or whatever it is. So ⁓

Alison Werner (12:10)
Right.

Yeah.

huh. Right, exactly. So

that extra week or three days to get a…

Andrea (12:29)
Is yeah, it’s really not gonna matter. But so I w I would like them to take a step back before summer and really manage their verbiage, their bonding protocol, ⁓ our supplies that we have enough what we’re doing with the patients as far as giving them what they need. Just do a step back before summer or now if they’re already in summer, and give everybody what they need. And then making sure my clinicians have the time to do the appointments.

Alison Werner (12:30)
Yeah. Yeah.

Yeah. Yeah.

Mm-hmm.

Andrea (12:58)
And they’re not either running two chairs to where they’re forgetting things. I’m in a hurry, so I forgot to clip those distal ends. I thought I thought so-and-so did it. Giving them the time and the tools to do what they need it makes a big difference. And I know we’re we’re stretched. We’re all just stretched right now. But without that, that’s where things get a lot of things get dropped.

Alison Werner (13:05)
Mm.

Yeah.

Yeah. Yeah. Yeah.

Yeah, yeah. It’s interesting because when you know, I came into this topic, we had talked about, you know, talking about summer emergencies, but really, it sounds like it’s we need to reframe, get rid of that word. It’s just it’s a problem. You know, I have a problem. I have a problem. Yeah.

Andrea (13:37)
It’s not in my office. Any of my offices. And I have a solution for you. Use your

wax. We can see you next Tuesday. I’ve I’ve resolved it. I’ve made you comfortable. I’ve given you what you need and I’ve educated you. So it’s not that I’m pushing them off and saying no, you can’t. But and like I said, put them in your schedule. And that when we accommodate one.

Alison Werner (13:46)
Mm hmm. Yeah.

Yeah, exactly. Stop it. We’re

Mm-hmm.

Andrea (14:05)
So I’m gonna let you come in. We’re we’re packed this afternoon. But I’m gonna let you come in with that loose bracket of four o’clock. That patient you accommodated has displaced probably 10 appointments around it and either made them run late or run over their appointment time because we’re accommodating one. So really think about the impact that one person or that one patient makes on the rest of the schedule and your team.

Alison Werner (14:24)
Mm-hmm.

Yeah, yeah. Okay, so if you could give an orthodontic practice one recommendation for reducing quote unquote emergency visits this summer. Don’t want to use the word. ⁓ What would it be? We got to call them problems. They’re problems. They’re not emergencies.

Andrea (14:42)
Ha ha ha.

Ha ha

Yeah.

Take that pause. Don’t wait till the end of summer to do it. Take it now. Even if you’re already in summer, take that pause and say, ⁓ what do we do in these situations? Making sure the team has what they need, the verbiage that they need. And when they get frazzled, the front desk, I know it’s late in the afternoon and they’re busy and somebody calls in, and so they just put them somewhere to get them off the phone. Make sure they have the verbiage in the tools. So take that pause in the practice and really

Give everybody what they need. Take a breath and say, what do you need? And take a look at your schedule. And if they’re overriding the schedule to get a lost retainer in or a lost aligner in, we really need to educate. That’s that’s not what we need to do in the office. We need to get them scheduled in an appropriate slot. Otherwise, it’s just sets the the team up for failure because they’re running behind. But like I said, displacing those patients. And I wanted to mention too one thing.

Alison Werner (15:46)
Yeah. Right.

Yeah.

Andrea (15:53)
When we at the pro if you can do it during the summer, it’s great to track what’s going on. Track what your emergencies are or what your comfort visits or whatever they are. But for offices that are having bond failures, I track I track patients that call in with a loose bracket. We track those. But we also track patients that come in with something loose. So you need to have a code in your management system.

Alison Werner (15:58)
Yeah.

huh.

Andrea (16:20)
that can track those two because sometimes I’ll have an office that has you know 40 loose brackets in a month. And then when we look at those patients that are just showing up with loose brackets, we’ve got another 40. So we have a bonding problem. So if they just sh the it’s not reported, it’s not recorded. So I when I run the report that says how many loose brackets did I have last month? It’s tracking those that called in and get coded that way.

Alison Werner (16:27)
Mm-hmm. Mm-hmm.

you’re under recording.

Okay.

Andrea (16:48)
But

having a code that we can track of and that’s where we get more accurate data and we can really see what our problem is so I can apply the correct solution. Otherwise I’m I’m seeing half of the problem or or maybe it’s all of but just may make sure we track it that way.

Alison Werner (16:55)
Right.

right.

Yeah.

Yeah. And to follow up on that, would you say that bonding failures are kind of of the summer problems, emergencies, are bonding failures kind of the one most common one that

Andrea (17:16)
Yeah.

Alison Werner (17:22)
relates to a system within the practice. Like a lost retainer, a broken aligner, that’s on the patient at home. Is it mainly the bond failures that are the ones that you’re actually going to be able to track and maybe create some kind of corrective to at least keep those to a minimum?

Andrea (17:31)
Yeah.

Yeah. And when we when I track emergencies, so I track people that call in, I track patients that show up with something loose or broken. This goes for brackets and attachments, anything I have bonded. Once I have that information, then I start looking at what happened within that. So I give the office about a month after a bond to take responsibility. If a patient is three months into treatment and they’re having loose brackets, that’s probably a different problem.

Alison Werner (17:47)
Yeah. Okay.

Mm-hmm. Mm.

there.

Andrea (18:09)
That’s

a patient education problem. What are you eating? Are you chewing on your water bottle or your mouth guard? Are you doing things that’s that are causing that? So we have to look at what the problem is and when it is, and then we can determine we have a clinical bonding problem because they’re all we’re having the majority of them are coming off within two weeks of a bond. Or are they three, four months into treatment? We probably have a different problem and we probably

Alison Werner (18:16)
in you.

Right.

Right.

Mm.

Andrea (18:39)
need a different solution for that.

Alison Werner (18:40)
Yeah,

yeah. And so it’s having that patient education ready to go depending on or clinical change, clinical workflow change to address. Yeah.

Andrea (18:47)
Yeah. Yeah. Yeah. But

we have to figure out what it is before we can slap a band aid on it and say this is what our problem is. We have loose brackets and start talking to your clinical team about you guys have to get your bonding protocol under control. It may not be that. It may be more patient based. So ⁓ yes. And it goes anywhere from

Alison Werner (18:56)
Yeah.

Yeah.

But there’s a solution to your problem.

It’s your mercy.

Andrea (19:15)
How products are used to what’s your curing light, what’s your isolation, there’s a whole th, you know, rabbit hole you go I go down when I’m working with an office trying to reduce theirs if it’s truly bond failures. So but it has to be done. Has to be done.

Alison Werner (19:23)
You

Yeah, yeah, yeah. Well, at end of

the day, stop making emergencies. Stop making your problems emergencies.

Andrea (19:34)
No more.

We’re gonna have problems, but make those problems fit into your world.

Alison Werner (19:41)
Exactly. And problems can be solved more easily than an emergency. All right, Andrea, thank you so much for joining me. I really appreciate it.

Andrea (19:45)
Yes.

Alison, thank

you. And I I hope everybody has a wonderful, problem-free summer. Yes.

Alison Werner (19:56)
There you go. Problem-free summers for everybody. All right. Take care.