by Sudhakar R. Chokka, DDS
The dentistry would be easy if the patients would just get out of their own way. If we didn't have to persuade, influence, coerce, scare, and dare I say "sell" our treatment plans to our patients, the dentistry of our dreams would be waiting in almost every operatory. All our training, all our countless continuing education credits would be utilized regularly and patients would receive the care they desperately need. Our income would increase, our skills skyrocket, our collection of before-and-after photos would be the envy of our colleagues, and -- most importantly -- the oral health of all Americans would improve radically. If only it were that easy.
The modern dentist has to realize that patients are more sophisticated than ever before. They have unrivaled access to information about dental care and your practice. With that in mind, many dentists still favor an aggressive approach when it comes to presenting their treatment plans. They are left befuddled when their patients leave without a return appointment. "If only my patients understood and valued my recommendations," laments many a disgruntled dentist. To be effective, dentists must customize an approach that involves understanding each patient and giving them what they want. Nelson Mandela said, "Don't raise your voice; improve your argument." Today's dentist must realize the argument is not clinical, but emotional.
The basis of most dentist-patient interactions assumes the rationality of patients. The clinician tells the patient what is "wrong" and the clear-thinking, rational patient accepts the diagnosis. What happens more than we care to admit is that the irrational occurs.
Despite your overwhelming logic, typical patient responses are: I'll think about it; When I win the lottery; I'm too old; My kids need braces; etc. ... The voices of cold reason were talking, as usual, to deaf ears.
The intent of case acceptance should revolve around understanding the patient. The creation of a relationship should happen first and treatment recommendations second. If the dentist does not know any personal information about the patient, the diagnosis is perceived as for the dentist's benefit, not the patient's. The savvy clinician understands that case acceptance is directed by patients' preferences, not dental logic. To improve case acceptance, the dentist must operate in the realm of the patient's perceptions and emotions. It might not make sense, but to your patient, your empathy rather than your expertise of chronic TMJ pain might tip the patient to accept your treatment. It's counterintuitive that your mastery of porcelain laminates is less important to your patients than for you to understand how their smile has embarrassed them all their life.
Many patients want to see you in another role besides a dentist. To know you're a husband or wife, a sibling, a son or daughter might be the deciding factor that enables them to trust you. Disclosing personal information about yourself breaks down barriers. Trust emerges when the patient can see you other than a dentist. Get curious about your patient. It might appear as common sense, but ask questions about their occupation, family, hobbies, and past dental experiences. Ask what obstacles must be overcome to start treatment. Ask what would change in their life if they fixed their teeth. Sit back and listen to what the answers are to these and other probing questions. The dentist must actively listen for deeper understanding.
When speaking to patients, the dentist should use vocabulary that's easy for the patient to understand. Avoid confusing dental jargon. Share stories with your patient of how your dental work has transformed other patients' lives. It's likely your patient will realize, If he did it for them, he can do it for me.
If the patient cannot accept the entire treatment plan, break it down into portions that can be done incrementally. Make your case for case acceptance to the patient. Don't make it to a dental learning center, don't make it to your colleague, and don't make it to your study club. Your patient is the one who has to say "yes." Your likelihood of success is greater when your patient feels heard and understood.
Case acceptance is necessary for both the patient and the dentist to realize their highest aspirations. It is also important for the dentist to focus on the process of case acceptance rather than the outcome. An intentional approach to know the patient will result in success and fulfillment for dentist and patient. The dentist has to realize the way to their patient's mouth is through their heart.
References available from the author upon request.
Sudhakar R. Chokka, DDS, has been practicing dentistry for more than 20 years. He is a lecturer, mentor, and National Dental Board Advisory Member for Pacific Dental Services and has authored dental articles for various publications. His practices are supported by Pacific Dental Services. You may contact Dr. Chokka by email at [email protected].
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