Why you don’t see all the patients you could?: bottleneck in the treatment

Process bottlenecks are the very reason why your projects get delayed, incur increased budgets from the added cost of delays, and the whole process of work becomes incompetent and unpredictable. This particular situation can also be reflected in the treatment process itself. However, bottlenecks are a trope of businesses that are backed by insufficient planning and efficient decision-making but can be rectified with the right plan.

Addressing bottlenecks in treatment

You have set a time limit of four years for a patient within which time frame, you expect to successfully accomplish the desired results. Your top priority here must be quality: how well you can execute the process, that is with the gold standard of orthodontic treatment, by taking the most systematic and fastest route.

It is also wise to pre-calculate your losses, that is errors lead to waste. The more complex the treatment, the higher the susceptibility to error and the lower the predictability of the result. This bottleneck can be avoided with the right decisions at your beck and call. However, your unwillingness to make decisions will continue to create deviations from the plan during the treatment.

How to get rid of bottlenecks in treatment?

If things don’t go as planned in the treatment, you can make use of the ABCD system to precisely get rid of your dilemma.

Consider the following scenario to cut down bottlenecks in the treatment process.
Twelve-year-old Torsten B. presents with a Class II. As a dentist, you have prepared four treatment plans based on the ABCD system:
Plan A: With removable functional appliances (e.g. TwinBlock appliance)
Plan B1: With fixed class II appliances (e.g. Herbst appliance)
Plan B2: Distalization appliances
Plan C: With a fixed appliance and extractions
Plan D: With fixed equipment and orthognathic surgery

Right from the get-go, it is easy to determine that Plan D may not be the most suited for a 12-year-old. Out of the remaining three plans, Plan A seems to honor the treatment process the best and is thus set at a 100 percent probability of working. Next, you determine the willingness of the child to comply with the treatment. The probability here must be halved: 50% he wears the appliance religiously, 50% he does not. Combining the two, you are at 75% of success with Plan A.

The problem arises if the child does not wear the appliance regularly, and even after four months, you see results that aren’t all too favorable. Here, you have a decision to make, either stick to Plan A and hope for the best, or be smart about it and choose between Plans B, C, & D.
As discussed earlier, Plan D may not be the most fitting and may be used faute de mieux. Plan B may be classified as more meaningful because it works in as tooth-conserving a way as possible and maybe preferred over Plan C. We‘re now estimating the probabilities something like this: A 0 percent, B 70 percent, C 20 percent, and D 10 percent.

It is important you define new probabilities at each decision point and explain them to the patient right from the beginning. Transparency is key to increase cooperation, probability of success, and patient satisfaction. If you’re faced with decision dilemmas that are not quite evident, say if you weigh variants B and C with 50 percent, you may not be able to decide between the two. However, at this time, you should remember that between the two, you cannot possibly make a bad decision since both are at 50 percent.

Making concurrent and cohesive decisions is crucial for your practice if you’re looking to avoid common (and often inevitable) bottlenecks. You must skillfully put your evaluation points in the treatment to then make your standardized decisions. Make a choice!

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