Dental Diaries: Spring cleanup

The annual rites of spring have begun. The robins (and the rest of the birds) are back. The eagles are nesting. And Major League Baseball has had its opening day, with both Chicago teams off to a less-than-sterling start.

One of the other rites of spring is spring cleaning. Our yards have the remnants of last year's leaves removed, the soil gets tilled to receive new growth, and the grass receives its fertilization. And that's just on the outside!

Our offices also need a little spring cleanup. Aside from sprucing up the reception area (do you still have magazines from 2011 or outdated pamphlets?), we need to go through our files to assess the active patients in our systems. For those of us who have an open file system, it is always great to have patients see lots of charts. It inspires confidence in the practice. But are we fooling ourselves into keeping these charts long after patients have left the office?

For the many offices that still have paper charts, how long is long enough to keep those files active if the patient has not returned to the office? A year? Two years? Three? We are required by law to maintain our records for specific periods of time, as per our respective state dental acts. But we are not required to keep them in our active files.

Not only are there paper charts -- needless files with countless items inside -- but we are maintaining paperless records of treatment plans. In any office with a patient-management system, treatment plans are entered for future procedures.

When doing an assessment of what "outstanding treatment" we have in our system, the files of patients who have not actively been participating in our practice for years will still enter into the mix. If one conducted an audit of procedures to be done, looking toward future production, these "lost" patients are included, lending to a false number.

We recently completed our file spring cleaning. Every six months we assess our patient files and determine who has been active and who we estimate, in good faith, will be returning.

We assume that the patients we have tried to contact over and over for an appointment but who have apparently disappeared from the face of the earth are not returning. We transfer their files to a separate filing system, inactivate them in our patient management software, and delete the treatment plan. If these patients do return, we will need new radiographs and a new treatment plan. Paperless offices simply deactivate inactive patients but should consider spring cleaning their treatment plans, as well.

Another step we perform is bundle the patient records per year of inactivation. As previously stated, we are required to keep files for a specific period of time. After that time, files can be destroyed. Unless an office has a huge storage facility, or files are stored in the cloud, patient records can legally be destroyed. This makes it simple when it comes time to purge the system.

Spring cleaning can be cathartic. It does make us "let go" of those patients we really thought would return and some of those we would prefer never come back to our office. Somehow it is easy for patients to move on when they change benefit carriers or decide that they don't want to spend the money on dentistry anymore. Spring cleaning the files makes it a little easier for us to move on, as well.

Just like April showers bring May flowers, purging files makes room for all the new patients truly interested in dental care.

Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at [email protected].

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