For a long time I used to naively reason that I don’t take clinical pictures as often as I should because I need to invest in product “X.” I thought when I have all the necessary armamentarium, I’ll be able to take clinical pictures consistently.
I've realized that the key to taking routine clinical pictures was not the armamentarium or my lack of discipline. There was an absence of a systematic approach. If you find yourself in this bind, I propose that you look at the following four key aspects. Implementing these may bring about the consistency you have been looking to achieve.
1. New patient exam protocol: Taking a full series of pictures should be a standard part of every new patient exam. Every clinician who has done this for a year or more will tell you how this investment is well worth the effort. If you try to cherry-pick cases for pictures, your guesses will be wrong at least 50 percent of the time. Once you have a workflow in place, this exercise will take no more than 10 minutes. You’ll soon find out that skipping the process of taking photos to save 10 minutes is not worth at all.
When the operatory is set up for the new patient exam it should by default have the "Photography tub" which would have everything needed to accomplish the complete picture series. This includes the following:
- Mirror warmer (We use an electric heating pad.)
- SD card
2. Staff training: Invest time in training your chair side assistant and hygienist to take these pictures. Clinical pictures with mirrors are usually convenient with an assistant; however, one operator can take other photos. If the staff is taking the patient photos, you know it will be done with consistency.
3. Picture management: Having a smooth workflow of managing the pictures ensures that the valuable pictures taken are put to effective consistent use. Try the following protocol:
- Use one memory card for each set of individual patient photos.
- Transfer photos on an iPad or other tablet by an SD card reader. Tablets can be a great tool to talk about the clinical findings during the exam as described here.
- Transfer the pictures to each patient's chart and an external hard drive.
- Back up photos on an off site back up drive.
4. Slideshow preparation: Train a team member to place the pictures in a specific established sequence into slideshow presentation software like MS Power Point. You can add and modify this basic slideshow further based on a particular clinical situation. But a staff member can easily complete the initial arrangement since it is a simple repetitive sequence of steps for every slideshow preparation.
These keys will help in the following ways:
- At the end of each exam appointment these steps will allow for a quick "show and tell" (by loading images on a tablet) and you can give the patient a tour of the mouth and draw their attention to the clinical findings you discovered during the exam.
- If you decide that you want to invite the patient back for a separate consultation appointment, you will have a basic slideshow draft ready for a quick edit and presentation.
- Consistent picture taking will help you build a library of "before and after" pictures of your own cases. You will not find yourself apologetically looking at a wonderful completed anterior esthetics or implant case thinking, "I wish I had a 'before' picture to go with this beautiful looking 'after' picture.
Vivek Mehta DMD, FAGD, Visiting Faculty, Spear Education. Follow him on Twitter @Mehta_DMD.