Written by Scott Perkins, DDS Friday, 31 January 2003 19:00
How valuable is the written word? Think about the professionals who actually depend on the written word to make their living—lawyers, authors, marketers, and journalists, to mention a few. The written word is also extremely important to many other professions, including medicine and dentistry.
THE POWER OF PERSONAL CORRESPONDENCE
Let’s say a patient visits two healthcare professionals in 1 day. A few days later the patient receives two letters in the mail. The first letter can hardly be differentiated from any piece of ordinary junk mail. In fact, the patient almost trashed it, but recognized the return address of the healthcare professional she recently visited. The mailing address was printed on a computer label. When she looked inside there was a preprinted form letter thanking her for her visit, with the signature of the healthcare professional beneath it.
THE PROHIBITIVE EXPENSE OF COMPREHENSIVE DOCUMENTATION
If we timed how long it took to perform handwritten correspondence, comprehensively written charts, and written staff directives, we would probably find that we spend about as much time writing as we do treating. Have you ever wondered why doctors’ handwriting is so poor? The doctor is trying to get through with his notes because he knows his schedule will back up if he doesn’t. Therefore he “rushes” his writing. If dentists kept great records, dentistry would probably cost 30% more. We don’t get paid for writing, we get paid for treating, and our treatments are usually “piece-meal,” so we have to keep moving or we won’t be profitable. It’s a lot easier to take the time to write up a $20,000 heart transplant case than to write up the application of a sealant.
Findings: During the course of a periodic exam it was found that said patient had a lower left second molar with a dark stain in a central groove. Using an explorer, I carefully probed the groove. No decay was found.
Option No. 2: Prescribe a prescription strength fluoride. I would instruct the patient to place a small bead of the fluoride on a soft bristled toothbrush with polished end bristles (to reduce the likelihood of toothbrush abrasion), then to apply the fluoride to the teeth for a period of at least 2 minutes, followed by expectoration. I would be careful to instruct the patient not to swallow the fluoride.
Prognosis With and Without Treatments
Suggested treatment recommendation: With careful placement and reasonable home care and regular dental visits, with careful periodic inspection to ensure that the sealant remains intact, and assuming no sudden change in the oral environment, the sealant has a reasonable chance of lasting 5 to 7 years.
Option No. 1: There is a possibility that the tooth might become decayed because the invagination is not possible to keep clean. Reduced sugar intake and OTC fluoride toothpaste afford a degree of protection.
Option No. 2: This is better than option 1 but probably not as good as the treatment of choice recommendation. The prognosis is fair that the tooth would remain decay free if the patient devoted himself to good preventive home care and appropriate application of prescription strength fluoride.
MY FIRST EXPOSURE TO DIGITAL VOICE RECORDING
One day on an airplane I was looking through a catalog and saw the very first digital voice recorder. I ordered one immediately, and I have owned them ever since to manage my thoughts and ideas, for staff management, for development of articles, for treatment planning, and many other uses. There is no tape to rewind and fast-forward, or time delays and confusion. Voice files are stored digitally so that they may be accessed by going to different folders. These days you can even name those folders, and there are many ways to manage voice files. There is no question in my mind that the ability this technology provides for capturing and converting my thoughts to written text has helped me to succeed in my professional career better than I ever could have without the technology.
HOW TO HARNESS THE POWER OF DDVT
Now that you understand how to create voice files, you can take the final step and use DDVT to create all forms of written communication that is personalized to the specific individual or situation for which it is intended. To use DDVT you create a voice file that contains the information you desire, then this file is e-mailed to a DDVT service such as DentalVoice.com, where your file is transcribed into written form and e-mailed back to you. In this modern world of global communications, it is interesting to note that the actual voice files are e-mailed by DentalVoice.com to transcribers in India or other global locations, where labor is so much less expensive than in the United States. Transcribers in India and elsewhere do an excellent job of converting your voice files into written form at a cost that now makes DDVT affordable for dentists. You may have to make minor corrections to their transcriptions, but this is done very quickly. Once you receive the transcribed file, you can then e-mail it to whomever you wish, or print a hard copy if desired.
To use DDVT you will need:
- A digital voice recorder (Olympus DM-1)
- Flash media (Smart Media 64 Megs [holds 12 hours])
- A flash media card reader (hooks into your computer)
- An account with a DDVT service (DentalVoice.com).
The Olympus DM-1 comes with a holder that hooks to your belt like a cell phone. Whenever you want to dictate something you simply pull it out, press “record,” and begin to speak. At the end of the day, you pull the flash media card out of your recorder, plug it into a card reader that is connected to your computer, and then you simply send an e-mail and attach your voice files. The files are sent to the DDVT service where they are transcribed and e-mailed back to you, and they will be waiting for you the next morning. It’s easy.
(Note: To order a detailed audiocassette tape and/or videotape that includes step-by-step instructions for harnessing the power of DDVT, call  454-5161 or visit Simpledental.com.)
WHY HAVEN’T WE EVER DONE THIS BEFORE?
It has been only very recently that several technologies have converged to make DDVT affordable and profitable for the field of dentistry. The technologies are dense flash media, cheap broadband width that allows fast internet connections, the ability to digitize voice files, and more recently, the latest voice compression algorythms that allow files to be compressed 20 to 30 times the size of a WAV file.
WHY NOT USE COMPUTER VOICE TRANSCRIPTION?
The promise of computer voice transcription (talking into the computer, whereby specific software transcribes your voice into the written word) has been around for more than 10 years, but it still has problems. It is much better than it ever was, but it takes a lot of effort and time to make it work. You must be in the same environment every time. You must make frequent corrections. There is a high degree of error as the software attempts to translate an individual human voice into the written word.
As dentists, our communications are generally horrible. Ask any malpractice attorney what kind of records the average dentist keeps and he will simply laugh. How many personalized pieces of written correspondence do you put out per month right now? Probably none. How many fully developed patient narratives do you produce each month? Again, the answer is probably none. How many written directives do you produce to organize and mobilize your employees each month? If you are using verbal commands, chances are that all sorts of tasks are delayed. Delayed tasks decrease productivity. Decreased productivity shrinks profits.
Disclosure: Dr. Perkins has a partial financial interest in SimpleDental.com.
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