In My Opinion...Communicate!

May 1, 2001
Dr. Gary B. Means is a practicing family dentist in Edinboro, Pa., with more than 25 years of experience.

by Gary B. Means, DMD, PC

Dr. Gary B. Means is a practicing family dentist in Edinboro, Pa., with more than 25 years of experience. He is also the owner of Professional Credit Reporting Service, Inc., an agency that helps dentists control their accounts receivables. He can be reached at (800) 315-1514.

Prior to the 1970s, complete dental care, as we know it, was not a major emphasis in dental offices. The focus was more on emergency care, restoring teeth with amalgam and porcelain fillings, etc. As a result, the need for treatment consultation wasn't as necessary or as important as it is now. Today, we dentists have at our command the technology to literally rebuild mouths and beautify them.

Beginning in the '70s, comprehensive care began to be emphasized in the curriculums at many dental schools. Comprehensive care was a new philosophy in treatment and included a thorough diagnosis, radiographic exam, and treatment planning schedule, including preventive, perio, oral surgery, endo, ortho, restorative, and rehabilitation. The problem that arose was how to communicate this all-encompassing treatment philosophy to the patient.

Some practice-management consultants recommended giving the patient three options for every tooth. This theory, although quite logical, simply did not work. It required far too much talk on the part of the dentist and an understanding often beyond that of most patients' ability. Even more importantly, it caused a great deal of stress and confusion to be placed on the patient. Dr. Earl Estep, author of "The Obvious Secret," explained in the late 1970s that patients who are stressed or concerned about a treatment plan are likely not to go on to accept that treatment. This is why the consultation is the most important tool in the interaction between the patient and the dentist.

In order to effectively communicate to your patients during the consultation, you must first be aware of the different ways in which people comprehend and understand. Studies have shown that 50 percent of the population in North America respond and comprehend visually, 25 percent are auditory, and the remaining 25 percent are kinesthetic. In light of those facts, you are likely to understand the need to include in your consultation three different ways of communication:

Visual: Aids such as the intraoral camera, photographs, models, and diagrams will effectively communicate to these individuals.

Auditory: This patient is more likely to require a verbal description to best understand.

Kinesthetic: This patient will best understand the situation when you communicate the emotions or feelings that they communicate with or without the treatment.

When you combine all three of these techniques in your consultation, you will not only effectively reach 100 percent of your patients, you will also likely overcome a barrier to treatment.

Allow me to share with you the value of the intraoral camera while I'm on the subject. Once again, technology has come to our rescue. The intraoral camera serves as an invaluable diagnostic tool. Its 50x magnification will often reveal leaky margins or cracks that were not apparent during the visual exam of the patient's teeth. After our intraoral exam, we take and store pictures of every tooth or surface that may need work. Then, when I sit down to do the treatment plan, I have several pieces of valuable information at my disposal. Nothing in all of dentistry bridges the barrier of trust like this marvelous tool. Patients no longer must "take your word for it" and make decisions on words alone. They too can see exactly what you are seeing and will ultimately have a better understanding of the situation.

In our office, we try hard to dissolve any barriers to treatment. We have developed a "user-friendly" office that does not have any ego, fear, financial, or rules-oriented barriers attached. This is achieved by the way we handle ourselves, the words that we use, and the overall appearance of our facilities. Using unfamiliar words and allowing patients to feel pressured to make an immediate decision on their treatment will undoubtedly cause them to feel overwhelmed or stressed by the situation. On the other hand, if the patient is made to feel more "at home" by the interaction with your staff and facilities, he or she will be more comfortable accepting and making financial decisions about treatment.

In most cases, a new patient who contacts your office will know exactly what type of procedure he or she needs, but may be unfamiliar with you and your facilities, resulting in anxiety due to the lack of an established trust-based relationship. By being more flexible and allowing your new patients to choose their initial procedures, you will eliminate the rigid appearance associated with many dental practices. Don't run every new patient through the same set of hoops by forcing him or her to go through certain procedures before taking care of the real reason he or she called in the first place.

When a new patient calls, allow him or her the opportunity to tell you the type of desired treatment. Whether it be an emergency tooth, a periodontal problem, or just a new-patient complete exam, fulfill the patient's wishes and you will have already earned a degree of trust. Yes, your staff must adjust to two or three different scenarios for a new patient, but first impressions are everything, especially when it comes to new patients. This doesn't mean your practice is out of control, unorganized, or patient-run. Undoubtedly, running your practice this way will require a higher standard of organization and teamwork, but if you have assembled a great team with exceptional management, organization, and people skills — especially people skills — this will come as no challenge.

Under no circumstances am I saying that we dentists should manipulate or coerce our patients into procedures that are not needed through the use of communication skills. What I am saying is that we dentists share a responsibility to move the patient forward into treatment by communicating effectively and creating a "want out of a need." For a dentist to sit idly by watching teeth and/or gums deteriorate borders on malpractice. I can't tell you how many times I've heard a new patient say, "Oh, I know about that one, Doc. My last dentist was watching that one for a couple of years now." What are we watching for? A fracture? A painful disaster? Some kind of miraculous healing? I label this kind of treatment as supervised neglect on the part of the dentist. We were not trained to watch teeth and gums deteriorate; we, as dentists, were taught to restore teeth and practice prevention. It is our responsibility to use good communication skills to effectively communicate to our patients during our consultations with them.