Review of Findings (ROF) Part 3: The Why

So far in this series, we have looked at the who and when of review of findings (ROF) visits. Then, in the last article about the details of the process, we covered the "how." In this final article, I want to spend some time examining the “why.”

This is a key factor to consider because a great deal of psychology surrounds the review of findings visit. It is an opportunity for both the dentist and the patient — a mutually beneficial endeavor — and it should be approached with that spirit of creating value and mutual benefits.

Many dentists ask me how I can afford to offer a patient 30 minutes of my time and not bill for it. I tell them that I cannot afford not to do it! In today’s fast-paced world, medicine and dentistry have, in many respects, become commodities that lack bespoke, thoughtful, individual-focused moments. So, a review of findings is an opportunity for you, as a clinician, to educate the patient on the uniqueness of their dental needs and explain how you want to provide tailor-made care to help them. When done well, it is an experience that sets you apart from the commodity experience many patients have become accustomed to. The patient gets VIP treatment: 30 minutes with the dentist, a custom plan, and knowledge of their unique dental needs and how to address them.

This is special. This builds trust and deeper, more meaningful relationships. This leads to more satisfaction and better referrals. This visit opens a space for conversation with the patients, often ones that would not happen chairside in an operatory. Patients tend to be more comfortable in a chair sitting casually around a table. They are less anxious and more inclined to listen and engage than they would be in a clinical environment. Because they are more engaged, they are often more open to what you have to say and the treatment you are proposing. This relaxed level of engagement also allows you to understand better the patient’s communication style, why they ended up in your office, and what their expressed and unexpressed wishes are.

While the review of findings should still highlight all your observations from your examination's airway, esthetics, structure, function, and biology categories, the ROF can be modified for different types of patients. For example, I changed my approach to the review for the purely cosmetic patient. Patients who seek cosmetic care often require time with the dentist to assess the driving psychological force behind the care desired. Questions to think about may be: Are the patient’s goals achievable? Do they have signs of body dysmorphia? Do they speak badly about many dentists that came before you? The ROF visit helps determine if this patient is the right patient to treat in your practice, and helps you distill exactly what you can accomplish with the patient.

For cosmetic patients, I often look at studio portraits of the patient with them in the ROF visit. I also like to show before-and-after photos of my work to figure out what esthetic they may prefer. What do they want to change? What do they like and dislike about their smile? These are examples of how you can make the ROF visit unique and your own, and how to adapt to fit the patient’s needs.

A great question to pose to a patient during the ROF is, “Do you see what I see?” The better you can get into a patient’s head, the more successful you will become at addressing a chief complaint. This simple question can help engage and focus the patient if they need it. Some patients may become overwhelmed during the ROF. It is especially important to gauge their mood and their ability to take in what you are saying. Sometimes, the clinician needs to adapt to the patient’s capacity so that the patient can accept what you are showing them. You can even acknowledge that the information being provided is a lot. The key is to adapt to the patient and keep them actively involved. This is the co-diagnostic process in action.

The goal of the review is to give the patient a thorough understanding of what you have observed in your comprehensive examination. Secondarily, you are assessing the level of commitment and desire the patient may have to treat their oral health conditions. You are also building value for what your practice can offer. You are providing compelling reasons as to why a patient should pursue dental care with your team. You are showing patients that you are highly knowledgeable and caring and that you want to — and can — meet their oral health needs and goals.

By taking the time and effort to provide patients with a thorough review of findings (ROF), you will watch your case acceptance numbers soar and your internal referrals grow.

Dr. Margaret Frankel is a contributing author for Spear Digest.