In this transcript, Rick Kushner outlines a comprehensive approach to conducting new‑patient clinical examinations and integrating practice‑management tactics that boost efficiency and patient acceptance. He introduces the "talk‑over" technique, where the dentist narrates findings to an assistant using lay‑person language while the patient overhears, allowing the case to be framed before the patient is formally addressed. He details a repeatable exam sequence—blood pressure, nodes, TMJ, oral cancer check, periodontal charting, occlusal classification, missing teeth, third molars, existing restorations, and necessary treatment—emphasizing selective charting to preserve diagnostic focus. Kushner stresses translating clinical jargon into patient‑friendly terms (e.g., “infected gums,” “decay,” “large fracture”) while avoiding unnecessary technical words. He advocates for strategic use of radiographs: obtaining a full series with implied consent, reviewing films after the patient leaves, and completing treatment planning without the patient present to maintain flow in high‑volume practices. Staff empowerment is highlighted; assistants are trusted to chart, manage clinical duties, and handle managerial tasks within legal limits. A simple new‑patient ledger (date, patient name, doctor’s initials, referral source, first‑visit service, follow‑up, thank‑you note column) is presented as a vital tracking tool. Finally, Kushner stresses the impact of handwritten welcome/thank‑you notes sent immediately after the first visit, describing their role in building rapport, mitigating any negative first‑visit impressions, and securing the next appointment. Throughout, he blends instructional tone with confident, slightly provocative sentiment, urging dentists to differentiate themselves from peers and resist “mediocre” practice habits.
Topics
Talk‑Over Technique: Real‑Time Patient Communication via Assistant
A method where the dentist narrates findings to the assistant using lay language while the patient overhears, allowing the case narrative to be built before formal discussion.
Step‑by‑Step Clinical Exam Routine for New Patients
A repeatable sequence—blood pressure, nodes, TMJ, oral cancer check, periodontal charting, occlusal classification, missing teeth, third molars, existing restorations, and necessary treatment—designed to gather all data in one visit.
Patient‑Friendly Descriptive Language: Translating Clinical Findings
Guidelines for converting dental terminology into understandable, impactful phrases (e.g., "infected gums," "decay," "large fracture") while avoiding unnecessary jargon.
Strategic Radiograph Use in High‑Volume Practices
Policy of obtaining a full series of films with implied consent, reviewing them after the patient leaves, and completing treatment planning without the patient present to keep appointments efficient.
Empowering Assistants: Clinical and Managerial Delegation
Assigning assistants comprehensive charting, clinical duties, and permissible managerial tasks to maximize practice efficiency and staff satisfaction.
New‑Patient Ledger: Tracking Flow, Referrals, and Thank‑You Notes
A simple record‑keeping tool capturing date, patient name, doctor’s initials, referral source, first‑visit service, follow‑up, and a column confirming the thank‑you note was sent.
Handwritten Welcome/Thank‑You Notes: Immediate Rapport Builder
Sending a personalized, handwritten note right after the first visit to create a positive impression, mitigate any minor negatives, and increase likelihood of a return appointment.
Diagnosing Without Immediate Radiographs: Planning Ahead
Encouraging dentists to conduct a thorough clinical exam that enables full treatment planning before reviewing films, reducing patient wait times in volume practices.