Book by thomas king

Chairside Manner Thomas King

Chairside Manner

Thomas King

To: I

dedicate this book to my mother for she is excellent with all the topics of the chapters that are in this book. She’s the one to inspire me to do this as she keeps telling me stories of what goes on in the orthodontic office and- essentially- teaching me good chairside manner in the process. Apparently she’s the one usually called over to deal with the “difficult” patients but they don’t turn out as such because of the way she treats them.

Office, Flowers iii

Table of n o C e D

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Wo r k s Cited

Preface

Ente renc e 4 Chap ter 1 5 Chap ter 2 7 Chap ter 3 Appr 11 ecia tion 17 18

2

Preface Kicking off this documentary I didn’t know what I wanted to do so I decided to choose a location that would be most accessible and nothing else- that location being Merna Tajaddod’s Orthodontics. It wasn’t until after interviewing the people who worked there that I figured out what I would research for the documentary which is chairside manner. Though I may have been the first to get their interviews done before it had been assigned, it was kind of in vain. I didn’t know what questions to ask them as I was making them up on the way over to the location and whatever answers I got back, half were redundant. Though I did get a good amount of responses that correlates to the topic of chairside manner. The

Tray with instruments, Indoor sign

problems with trying to interview the people and the place is that it’s extremely hard to find time to be there and if I am then only one person is there plus a lot of things are confidential to record. I have been able to learn how to scrape by on what little I have and use it well. I have also learned that when I try to make a schedule for myself I tend to overshoot greatly.

Nonetheless I like the practice of chairside manner and I do think it should be practiced more and be taught as it’s applicable to each and every job. Hopefully you would be able to take away from this the understanding of how important chairside manner as a tool can be.

2

Enterence

I

t sits there, backrest up and seat waiting for the next patient to sit in it with a bag over it to keep whatever bodily fluid you secrete off of it so that it never stops looking inviting. Next to it though sits complacently on a sidedesk a tray holding the many sharp and blunt- but sterilized- tools that will soon be used on you. You sit down because you’re told to and at the specific chair only, and now all you’re looking at is the wall. Suddenly the backrest lowers and lowers until you’re laying down. Let the operation begin.

Not surprisingly a lot of people unconsciously think this way when they enter any medical structure. The place is like an impending doom to them. To ease this horrific response, those in the medical field can perform what’s called bedside manner, but in this case, since this is about a dentist practice, it is called chairside manner.

Chairside manner has, for a long time, been important since there were healers and still will be important. The reasons for why chairside manner is needed has changed, replaced, or has been added, but the core reasons have stayed. Our modern reasons to be general is that it instills a level of calm in a patient thus making it easier for the doctor to operate. Bedside manner can prevent mental scarring of the patients and instead make them feel more comfortable, and it can also help boost the population of healthy people as they won’t prevent from coming to get operated on. For the business side, it can increase workflow and the amount of patients seen because, since the patients will be easier to handle, they won’t take as long and will help the business earn more profit.

Operatory chair 4

Chapter 1:

How Orthodontists Care for Their Patients

W

hen caring for patients there are two components that needs to be checked off: mental and physical.

To begin, the mental component is chairside manner. The effect of chairside manner can be great on patients. For example, Jen, a dental hygienist, says you cannot say “No problem” to a patient. The reason being is because of the word ‘problem’ in the statement. You may understand what the doctor says but since the word ‘problem’ is in the sentence, your brain subconsciously takes it in and thinks there’s a problem, even if there isn’t any. If the patient is already nervous about being operated on, this could cause significant problems. The topic of chairside manner will be explored more later on.

The physical component is dire to obtain too. On the floor, as it’s called where the patients are to be serviced, it is imperative that everything stays as sterile as it can be and not be contaminated. People in general have an innumerable amount of bacteria in their bodies and those can spread very easily within the practice. Getting STIs can be as easy as accidentally being pricked by an unsterilized instrument.

Think about it this way, you enter a restaurant and sit down at a table. The table hadn’t been cleaned from the last few people who sat there so there’s bits of food and spilled drink littering the table. When you get your drink of water there’s lipstick still on the rim and when you get your food (a grilled cheese sandwich for simplicity’s sake) there’s residue of the last meal that the plate held, plus for some reason when

you lift up a bread from your sandwich there are bugs in your cheese. All of that does not sound appetizing and that’s basically what patients will see if the practice isn’t properly cleaned.

To prevent this, special machines are used and procedures are done to keep things spic-and-span.

The autoclave, one of the few machines used in the practice, sterilize the instruments that have been used or not used during a patient’s operation. The autoclave is a pressure chamber that releases hot steam for twenty minutes to burst open any existing organisms, effectively killing them. One important thing has to be done though to make sure the instruments are clean: replacing or cleaning the filter. If this is not done, the organisms will still live. After this process,

Jen creating a retainer the instruments are put into sealed bags and dated.

The procedures done are usually performed before the patient arrives. Disposable plastic covers are fitted onto the operatory chair, along with a disinfectant wipe-down of all the handpieces such as the drill, air suction, and water dispenser. The same wipe-down goes for the side table and the tray that holds all the instruments. At the end of the day everything is cleaned from the floors, the patient sink, and the aforementioned. The chairs are also set with a press of a button to be presentable the next day to look professional and inviting with its cleanliness.

6

Dealing With Those T ypes of Patients

Chapter 2:

F

rom the front desk to the back, all employees have to comply with patients but the types of patients they get are mostly different.

The front desk deals with patient appointments, sign-ups and the like. They also have to follow through with complaints. Jade describes her experience like so:

“When patients and patients’ parents come in they are quite upset because of something that happened and usually we do take reponsibility for what happened on our part. Although, some parents they don’t wanna admit if they were to do something wrong or if something went bad with the treatment and so it’s harder to work with patients at those times because they basically want you to admit that you were wrong and that we made a mistake and somehow make amends for it by giving them something when, in actuality, it was on them. And some patients take it to an extreme because sometimes you have parents that scream at us. Thank god it doesn’t happen too much.”

Come to think of it, front desk is very similar to a help desk at any other store whether it be a Walmart or Front desk

“Learn how to be polite but still be strict… you have to be firm but in a polite way.

That’s been kind of a challenge, especially with some patients or their parents but I’m learning as I go.” a Game Stop. The employees that work that particular position have strikingly similar complaints about their job and how they handle it, even though the topic the help desk assesses is catered towards the type of establishment it’s for. Look up a review on why someone quit their job as a help desk and you’ll get plenty relating to customers.

Jessica has a way to get through with this situation. She says, as front desk, to “learn how to be polite but still be strict… you have to be firm but in a polite way. That’s been kind of a challenge, especially with some patients or their parents but I’m learning as I go.”

8

With patients and their guardians there comes a trend.

The information tend to seem conformist but most the time staid statements are true. Like with Asian and Middle Eastern ideals. In their cultures, the son is considered a god and thus doctors may get more the wrath of worry from their parents over a little bit of extra wire sticking out from their son’s braces. Knowing that they view their sons in this way may help with understanding why some patient’s parents act this way.

That isn’t the only way parents can make things difficult though. There are those times when a parent will reflect themselves onto their child a little too much. You would think that since the patient is the one that’s getting worked on that the parent wouldn’t be so nervous or in pain, but they are. They will say that their child is not doing alright or will keep asking them how they’re handling.

Others may fret over their child saying that their wire is hurting them but when it is not. The best thing to do is to ask the patient if this is true and, if not, reassure the patient’s guardian.

For the record, patients will be the same too. Some will be anxious and others will look to their guardian for a way out. They can get so squeemish that they think the doctor is hurting them, when

“I barely had the scaler in his mouth when he flinched back, even though I didn’t do anything yet, didn’t touch him yet.” in reality their moving around is making it harder for the doctor to operate carefully.

Jen recalls “I barely had the scaler in his mouth when he flinched back, even though I didn’t do anything yet, didn’t touch him yet.”

Jen is usually the one to deal with the “troublesome patients” which are the special needs patients. Her approach is to not force them to do anything. Not to be rude, but it is like handling an afraid cat or dog. They don’t know you and they’re afraid so it’s best to try and earn their trust. Being kind and gentle is a good way to start. When bringing up something they don’t particularly like (example: being at the dentist) give them a good incentive (like they would get nice, pretty teeth at the end). It is important that they have an incentive or a goal, rather. Always make sure they’re comfortable like making sure to move the light away from their eyes and asking if anything hurts. Keep reminding them that everything’s okay and explain why. Always explain why for what you’re doing or are about to do. If something has to be done, be sympathetic. Say they don’t like getting an x-ray and are upset. Be upset along with them but, again, give incentive.

All this is the practice of good chairside manner. It takes a while to master it, but once you do, it’s a lot easier on you, as the doctor, and the patient.

Kids basket full of toys, Examining chair 10

Chapter 3:

Evaporating Workplace Stresses

O

ne of the worst problems that can cause a landslide of stress and is also very easy to cause is called a patient mill. A patient mill is what happens when a practice over-books their schedule with patients which causes a domino effect.

First the patients aren’t getting the treatment they need. They’re being brought in quickly and being brought out quickly which means what’s said in chapter 2 goes out the metaphorical window. Since that’s done patients are more harder to deal with along with more complaints which adds up to more places in the schedule being booked. Patients don’t like patient mills because they don’t feel like they’re getting the correct treatment they need.

Doctors feel this way too which stresses them out. Doctors are like exercise elastic: they can stretch and stretch, dealing with a lot of stress, but when the stress is continuous eventually they’ll snap. Not saying that they will come to he workplace with a gun, just that a new change might take form. Either they quit, or worse, they “submit” to working in a patient mill, for their own reasons.

Doctors who practice under patient mills happily are the ones gaining profit from it because with more patients comes more money. They don’t necessarily care about what the rest of the staff thinks. Just like a molding piece of pineapple in a fruit bowl, it spreads. Eventually the staff turns

bitter and upset mainly from all the stress.

The doctor who is alright with running a patient mill is also stressed.

The remedy to solve this is just simply to stop, rearrange the schedule, and learn to care for your patients. A patient mill gets no press but a well-run and caring practice does.

A simple way to relieve stress is to have technology on hand. Technology can go a long way, especially in the way of comfort. Jade, the front desk, has to look up patients’ information via finding their folders. She says “Pulling out the files is like stressful and painful because sometimes the staplers stick out and they cut my hands and then they get paper cuts a

lot of the time and most the time they’re everywhere, or not where they’re supposed to be so we find them like in every nook and crevice all over the place.”

At this establishment though, they are slowly but surely moving on to digital files on a program called TOPS. This does spark a bit of a problem because “everyone’s grabbing it and not putting it away.” Once it’s done though, it will be smooth sailing for the front desk on this end.

“Pulling out the files is like stressful and painful because sometimes the staplers stick out and they cut my hands and then they get paper cuts a lot of the time and most the time they’re everywhere, or not where they’re supposed to be so we find them like in every nook and crevice all over the place.”

15 Retainer model, Lab machines, Instruments in front of an autoclave

Appreciation O

ut of everyone, I really thank my English 3 teacher, Mr. Greco, for helping me with the documentary. If it wasn’t for him I would’ve had a lot of trouble figuring out how to organize all the information that I’ve gathered into 3 simple chapters along with some additional things to add to them. It was also him, since he isn’t so involved in this topic of chairside manner than I am, that helped point out the things I should explain and bring up because I know what these things are but others don’t.

17Mugs, Freestyle logo provided by https://www.facebook.com/FreestyleAcademyMVLA/

Works Cited

Dizon, Jen. Personal Interview. March 3, 2018.

Jessica. Personal Interview. March 3, 2018.

Cavug, Jade. Personal Interview. March 3, 2018.

From that one book

“Stress� Harvard Health Publishing. Accessed March 22. 2018. https://www.health. harvard.edu/topics/stress

Gladwell, Malcolm. Blink. New York: Little, Brown and Company, 2005.W

18

T

homas is still living at his parent’s house and currently doesn’t have an occupation. He spends a lot of his time exploring his mind, reading, and creating things while listening to music. He likes to make art, compose lyrics and music, animation, storyboards, blueprints of space-retaining inventions/furniture along with blueprints of house plans, and plushies. His preferences change fairly often so what he does will change quite frequently. Same can be said for his tastes in music, for example. Though some things do tend to stick like his goal of becoming a brain surgeon in the future. The reason for aspiring for this occupation is because Thomas finds the brain interesting and really enjoyed the dissection labs he had in 7th grade. He states that if he can’t become a brain surgeon, then he would go on to become a chiropractor as he frequently helps realign his mother’s back and some others too. Other than that, Thomas is usually quiet and normally won’t speak unless spoken to- his speech pattern has been described as “like a grenade” from his parents as he tends to not talk for a long period of time and suddenly gives a remark in the middle of conversation. He has a strong sense of judgement and cracks dry humor without awareness.

Chairside Manner Thomas King