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Communication: Key to patient trust & loyalty?

Sept. 1, 2004
How does a patient become satisfied with his or her dentist?

How does a patient become satisfied with his or her dentist? Chances are, it's not from the patient's assess-ment of the dentist's credentials or clinical expertise. Although experience and expert technique — particularly in providing pain-free treatments — are undoubtedly valued qualities, a patient develops satisfaction with a dentist because the dentist and her team have cultivated a trusting relationship with patients through effective commun-ication.

Developing strong, lasting relationships with patients isn't easy. The time constraints facing today's busy dental practices seriously threaten the amount of "face time" most dentists get to spend with their patients. Unfortunately, one of the first things to suffer when schedules get tight is communication. Weak communication — such as rushing through the explanation of a procedure or after-care instructions — can quickly erode the dentist/patient relationship, increasing chances of noncompliance with treatment and the likelihood that patients will become disgruntled enough with their care to switch practices. Insurers further warn that lack of communication — particularly concerning treatment expectations — is what often leads to malpractice suits.

In addition, despite recent advances in dentistry such as painless treatments, new materials, and innovative technologies, many people still avoid dental treatment altogether. This, too, may be a symptom of a communication breakdown between the dentist (and the dental profession in general) and patient. Because dental technologies haven't been explained clearly, some patients fear the unknown. For those who don't understand or haven't been exposed to this information, dental anxiety continues to make some patients avoid the dental chair at all costs.

Communication techniques that empower

How can you educate patients and build their trust in you, especially when many perceive dental treatment as a negative experience? One way is by creating an atmosphere that fosters open, collaborative communication. Resist establishing the dentist/patient relationship as a solely didactic, autonomous experience. Rather, the goal should be to create a partnership that involves cooperation with the patient in both decision-making and the care plan. Cast aside the image of the dentist as the all-knowing matriarch; rather, in the role of coach or mentor, the dentist can provide instruction and guidance that empowers the patient to participate in decisions that affect his or her own care.

Empowerment also involves reassuring patients that they have a measure of control during treatment. For example, most patients are comforted knowing they can stop a procedure, if, for instance, it becomes painful, by a pre-established signal to the dentist. In addition, the timing of a procedure during the visit affects the patient's perception of control:

  • Explain the reasons for a procedure before performing it.
  • Explain the steps of a procedure before performing it.

Following these recommendations will help lay a foundation of trust, strengthen the dentist/patient partnership, and increase compliance with treatment regimes and self-care. Similarly, those who normally fear dental treatment will be less threatened and more motivated if they are confident, comfortable, and encouraged to play an active role in their own well-being.

How clear are your messages?

Safely empowering patients, however, requires clear communication to ensure patients have realistic expectations and understand their treatment options. In addition to weak dentist/patient interpersonal communication, the media and advertising have contributed to the rise in unrealistic expectations of providers, their services, and treatment outcomes. To help reduce the chances of a misunderstanding:

  • Create a comfortable, nonrushed atmosphere for the patient exam, and allow adequate time.
  • Ask questions to determine if the patient has any false, preconceived ideas; counter those ideas with clear information.
  • Make an effort to understand and empathize with the patient's concerns.
  • Explain alternatives to as well as the benefits and risks of procedures.
  • Describe the expected outcomes of a treatment or procedure as well as the possible and undesirable ones.
  • Avoid using dental industry jargon and other language that might confuse or put off patients.

Using nonverbal communication

Your nonverbal communication can help send clear messages to your patients that you are honest, knowledgeable, and caring. How you speak, gesture, dress, and respond to your patients and staff strongly influences patients' perceptions of the practice and of your trustworthiness as a professional.

Positive, nonverbal communication fosters cooperation and builds rapport with your patients:

  • Use an open, attentive posture (leaning slightly forward shows interest).
  • Face the patient while talking.
  • Use eye contact.
  • Nod your head in understanding, but not excessively.
  • Smile.
  • Use appropriate touch, such as a handshake or a pat on the hand or shoulder.

Negative, nonverbal clues — even if unintended — send a subtle message to patients that you may be hurried, unconcerned, or indifferent to their care. Nonverbal, physical clues to avoid include:

  • Speaking with your hand on the exam room doorknob.
  • Fidgeting, such as drumming or tapping fingers.
  • Avoiding eye contact.
  • Using closed body language, such as crossed arms.
  • Glancing at the clock or your watch, especially while the patient is speaking.
  • Closing the patient's chart.
  • Turning away from the patient while speaking.

Being a good listener

An important communication skill often ignored by today's time-strapped health-care providers is the art of listening. Listening well isn't easy and rarely comes naturally. Being a good listener is an active experience that involves conscious effort. Using positive, nonverbal cues while listening is important, such as eye contact, nodding, and attentive body language. Let patients know you are sincere in your attempt to understand and empathize with them. You may achieve this by employing several listening techniques:

  • Repeat key words and ideas or paraphrase what the patient says to clarify: "So, what you're saying is that in the morning your jaw aches on the left side, but it gets less painful as the day goes on."
  • Show empathy and understanding by acknowledging patients' feelings and concerns: "I see how that must have made you nervous. I understand that your friend had an unpleasant experience with this procedure."
  • As hard as it may be, don't interrupt unless what you are hearing is unclear.

Making a positive, lasting impression

Be aware that your staff — dental assistants, hygienists, and office personnel — who have poor communication skills can quickly negate even the best efforts of the dentist. We've all witnessed employees who are insincere, rushed, unfriendly, or bored, and their actions and attitudes create a highly negative impression of their employer.

The dental team should be trained in effective methods of communication for several reasons. First, their communication skills, in addition to their competence, are key to building trust in your practice. Often their conversations with patients will be lengthier than yours, so while there may be more time to build rapport, there also is more time for communication blunders. In addition, interactions with your team are usually the last contact patients have with the practice. Leaving a positive, lasting impression is paramount.

Second, team members who use good communication techniques can obtain important patient information that may save you time during the exam. An investment in staff communication training can produce major returns, particularly in patient retention. Formal training is helpful, but also keep in mind that people remember most what they witness day to day. If you practice effective communication techniques in the office, your team will emulate your behavior with patients.

Importance of ongoing communication plan

Developing effective communication with your client base involves more than achieving a good chairside manner. Patients must know you and your team care about them and their dental health not just during the yearly checkup or other office visit. Add value to your communication efforts by providing ongoing educational materials to your patients. Handouts, pamphlets, videotapes, and newsletters heighten patient awareness of your practice and advances in dentistry.

In addition, many practices use new media such as email and Web sites to communicate with patients. These technologies offer immediate patient access to the practice and links to educational materials. For example, Web sites explain procedures and services, provide directions to the office and hours, and allow online scheduling and balance checking.

The woman dentist as communicator

For years, communication experts have recognized that men and women communicate differently. Men are generally problem-solvers who report factual information, while women converse to connect, cooperate, and gain rapport. Women dentists, it would appear, have the edge on maintaining positive, stable relationships with their patients. Although it may be easier by nature for women dentists to bond with their patients, dentists can improve patient retention by further cultivating their innate communication tools. Skillful communication will help build a stable practice of patients who trust you and your team and who are willing, satisfied participants in the dentist-patient partnership.

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Ann Biswas
Ann Biswas owns BisWrites Communications, a full- service communications firm that provides business writing and creative project management. She has taught business communication and writing at the University of Dayton. She is an instructor of communication at Wright State University in Dayton, Ohio, and is the editor and publisher of "The Working Communicator," a bimonthly newsletter that teaches the fundamentals of business communication to health-care professionals, executives, and employees. For information about BisWrites and "The Working Communicator," visit www.biswrites.com and www.working communicator.com. Ms. Biswas may be reached at [email protected].