I came across this side-income option after a dentist friend nonchalantly mentioned how she was doing this on the side for a while until the demand was so high that she couldn’t keep up.

Imagine you’re in your office and your nurse calls you out of your exam-room to see a pediatric patient who isn’t looking too well. You walk in, another nurse is already checking the pulse, blood pressure, temp, and oxygen levels. You recognize the child is febrile and hypoxic and you call 911, start IV fluids, and stand by until you can hand the child off – all while maintaining a cool composure without freaking out your staff or the patients in your waiting room.

This is not how smoothly medical emergencies get handled in a dental office – hence the need to train the staff of a dental office to handle medical emergencies.

Identifying the Need

A dental office sees the same patients we see in our medical offices. They inflict the same level of pain and have the same back-office chaos as us.

Some patients vasovagal in the dental office, others have heart attacks, some get allergic reactions to lidocaine, others get asthma attacks.

Dental assistants, hygienists, and dentists aren’t well-trained to handle such emergencies. Some dentists even feel a great deal of angst anticipating something going wrong without being adequately trained to handle a medical emergency.

It’s not about resuscitating the patient according to ACLS guidelines, we’re talking the basics of dealing with an emergency situation.

The Dental Office Model

Dental offices aren’t tied to hospitals and so they rely on the 911 system should a patient experience a medical emergency.

Some offices focus on adults while others focus on pediatric patients – Pedo offices. To break this down further, some offices work with the medically fragile such as special needs pediatric cases.

Dental offices perform minor surgeries and some even perform General Dental Anesthesia or IV sedation. These outpatient surgical procedures are major interventions with potentially serious outcomes.

Sometimes a separate dental anesthesiologist performs the anesthesia and at times the dentist performs both the dental surgery as well as the anesthesia.

Dental/Medical Emergencies

For you and I it might be simple to:

• stabilize the patient
• keep calm
• communicate to the situation to family members
• maintain a professional demeanor
• activate the proper emergency protocol
• keep going about our work-day

Medical emergencies in a dental clinic can turn into disasters. A pedo case might turn into an asthma attack or a child might be left unattended after anesthesia and fall off the post-op bed.

An adult may collapse from a heart attack and the team will panic and not handle the situation efficiently. One person will go to call 911 only to be stopped by a family member while everyone is standing around waiting for the ambulance to arrive.

There might be yells or screams from the dental exam room which the patients out in the waiting room will have to experience without any idea what’s going on.

Opportunity for Income

If you bring value to a business then you stand to make money – a portion of what you can save a business is what you can pocket by identifying that value opportunity.

Dental offices are both privately owned as well as run as a corporation with multiple offices. This latter corporate model is becoming prevalent with one central management group which tries to run a very tight ship.

The corporate dentistry model is the most lucrative to pursue while the private dental practices are the easiest to reach. After identifying your initial target audience, you need to know what it is you are marketing.

Teaching Medical Emergencies

You would essentially become a lecturer. You will be offering your services to various dental offices to train the staff and the dentists on how to deal with medical emergencies.

There are 5 factors which you want to address in your Medical Emergency Course for Dental Offices:

1. recognizing an emergency
2. managing emergencies
3. handling the office setting professionally
4. providing CE credits
5. testing the skills of the attendees

Training Setting

For the private dental practice it’s often best to come in early in the morning before the office starts their day and begin the training at that time. This is ideal for very short training sessions or refreshers.

For new offices or those that have no experience with such issues whatsoever it’s best to have the office close down for an afternoon and that’s when you can perform your training.

For large corporations which own multiple dental offices it’s best to reserve a conference room and break up the lectures and hands-on sessions over several days.

These larger groups might have 50 dental assistants, 15 dental hygienists and 20 different dentists who are all employees. By offering multiple training days you can offer more opportunity for training sessions – more income.

The Need for this Service

So if you were to pursue this, how would you know if there is a need for this service? You can perform market surveys or you can ask your dentist friends how and where they gain their emergency medical training.

I’ve done my own research and often times these molar-panic trainings aren’t done at all or are offered by traditional Continuing Education companies which do a shitty job.

You can market this quite easily if you are a physician – who better to recognize and manage an emergency than a doctor? One of the most engaging parts of such a medical emergencies course is the Q&A session and with a medical background you’ll do a far better job than your competitors.

Marketing

Just because a risk is present doesn’t mean it’s recognized.

One option is to write letters or emails to dental offices near you and highlight the risks that medical emergencies pose to a dental practice. How it can affect the morale of office staff and create a potential PR issue for the dental office if not handled properly.

You can mention the various packages you offer and how you perform your training. A short YouTube video could be your best marketing tool.

The Course Outline

When I was discussing the course outline with my friend it became clear that the depth of the topic doesn’t need to be very involved.

You become a consultant for these offices to recognize the need for a better workflow, for systems, and for possible equipment such as a simple portable oxygen monitoring device and an AED.

The best pearl I took away was to just open it up to Q&A and you’ll hear 457 different stories about patient emergency cases that staff have had to deal with over the years.

What better way to teach than going over each one of those cases!

1. Common Medical Problems

Your course outline can discuss various medical issues such as:

• diabetes
• hypertensive emergencies
• asthma
• anaphylaxis
• stroke
• syncope
• lidocaine toxicity

You don’t need to go in major detail here. I think you’ll be pleasantly surprised that some dental office staff believe that a patient with a low blood sugar needs their insulin – as they have seen on TV.

2. Recognizing Emergencies

An emergency rarely starts out as an emergency. Recognizing the early signs can be very helpful in preventing an emergency in the first place:

• slurred speech
• rapid respirations
• blurred vision
• chest tightness
• difficulty swallowing
• arm weakness
• slumping over in a chair
• looking blue or pale in the face
• weaker, slower pulse

You can show images and talk about how to handle such situation and what common interventions in a dental office could exacerbate such issues.

3. ACLS/BLS

It’s easy for you to get licensed to teach ACLS/BLS and certify attendees. That’s what my friend was doing though she did give that up because the need was so high and it was very time-intensive.

You can always refer certain members of the staff to obtain ACLS certification so that emergency medications can be administered.

4. Activating An Emergency

When we activate an emergency we mean that we are recognizing the emergency, communicating it to those around us, calling 911, and then administering any life-preserving interventions within our scope.

Imagine you are a dental assistant and your biggest fear is dealing with such a case and not knowing what to do.

When a patient is in a medical emergency it obviously wouldn’t be good for everyone to panic and yell and scream and run around. It’s better to have a code-word which won’t alarm the patient in the next bay or patients waiting in the waiting room.

When this code-word – “Blue Bear” – is vocalized then everyone knows to take their position and everyone will know what to do.

5. Communication/Coping

This next part is often something that 1 office staff person is tasked with so that other patients are kept calm and family members are informed of the emergency without instilling any panic.

This is important for the PR of the office and it’s worth spending extra time on.

Coping ties into this because right after an emergency a busy dental office has to go right back into work-mode. Being able to have a debriefing at the end of the day or allowing some members a moment to cope is critical.

Income Potential

The corporate dentistry groups will often pay the highest for such a medical emergencies course because they are all about efficiency and minimizing risk.

You can offer 4-hour sessions for a group of 8-10 (not more) dental office staff at $2,000 per session. This might seem expensive and it’s good to feel out your competition – if there are any – and adjust your prices accordingly.

My friend and I are going to be doing a similar lecture series for a large corporate dental group and we’ve gone back and forth with them on email to come up with a price and we’re not dropping lower than $2,000.

Private Dental Office

A private office may have tighter margins so it might make sense to lower your price. You’ll also have fewer people in your training sessions and the setting probably will be less intense.

You can offer a 4-hour training session and finish it in 2.5 hours. A personal touch might be to set up a time to return in a couple of months and have a quick debriefing with the staff to see if they have any follow-up questions.

Continuing Education Credits

You can get licensed very quickly and easily for $150 to offer CE credits to not only dental assistants but also hygienists as well as dentists.

This might be a huge bonus to the staff who can feel more competent at work and get their CE requirements met.

The dental office owner will oblige because it’s a double-satisfier for everyone.

Outsourcing

This is the next level once you have a good course outline in place. Should you have a market where the demand for your services is high then you can hire a paramedic or flight medic to teach your course for you.

I would just point out that one of the best parts of being an MD/DO (or NP and PA) and offering such a course is that you get to offer real-life answers to real scenarios. You also get to network with dental offices which has its own advantages.

Continuity of Education

It’s important up-sell your services. This section could be a book in itself and I think the longer you do this kind of work the more likely you are to identify further needs for your clients.

Offer Refresher Courses

If you’ve done a 4-hour or 8-hour training for a dental group already then offer to come back every few months to do a 1-hour session.

Maybe they have been trained by someone already and you can still offer the 1-hour session. If they recognize how much more knowledge you can offer and how good of a job you do, maybe they’ll bring you back for a full session.

Offer In-Office Simulations

As an add-on you can offer to do in-office simulations. Each person can switch roles and play the part of the patient having the medical emergency, the front desk person, the patients in the waiting room, the dentist, etc.

From what I hear this is a popular service request.

Specialise in a Niche

You might offer special training or advanced training for dental assistants who work directly with dental anesthesiologists. This is in high demand as the outpatient DA’s are getting major shit for their occasional bad outcomes.

Special-needs pedo cases have their own unique issues and if an office uses a lot of sedation then you can specialize in the common complications with sedation patients. You would certainly charge much higher fees here because you’ll have fewer clients.

When it comes to offices that do full anesthesia the sky is the limit. You can talk about all sorts of topics and really delve down deep:

• proper venipuncture technique
• IV fluid problems
• how to monitor End Tidal CO2
• reversal agents
• how label syringes
• how to read monitors
• show them the oropharyngeal anatomy
• how to use a precordial stethoscope

The Big Picture

The point of this income opportunity isn’t necessarily to sell you on this particular business model. Instead it’s helpful to hear what other medical entrepreneurs are doing which may spark some opportunity ideas in your own field.

You might see 5 PPH in the Urgent Care and can do that consistently. More importantly, you know exactly how you achieve those high volumes and how to teach it to others. That’s a skill. A sellable skill.

This is also the kind of course you could teach virtually.