Communication tips

Last year I attended a lecture by Michael Sernik who founded Prime practice but subsequently separated from the company. Then later that year I attended a prime practice seminar on communication and case acceptance. I took away a few things from those talks and I find my communication style to have been altered because of it. To be honest, before those talks, I didn't really have a communication style. I kind of just blurted out the facts and then it was up to luck whether or not the patient accepted my plan or not. Usually they would accept it if they already know of the preexisting situation and options. After the talks, I have been focusing more on educating the patient as to their preexisting condition, and focusing on the DREC (which they call the- Damaging results of the existing condition). I have found this to be helpful in getting patients to understand their situation and to be honest it matches well with how I actually want to communicate with patients. I am not there to sell a treatment, but to sell knowledge and understanding and assist them in making a conscious, informed decision as to how to approach the situation.

Well...yes, I am trying to sell treatment but I truly don't care if they go ahead or not. If I could summarise a few key points from the seminar I think it would be useful to myself and any other readers. I don't actually remember much from the seminars, the following are a distillation of how I approach the new patient exam and I know that the bulk of that approach came from these talks:

•  Proper records are key. If the patient can't see something, then they can't understand it. And if they can't understand it, any suggestion you make to address a problem they don't understand that they have sounds like a scam. And patients will resist scams. You will lose trust and lose the patient. Understanding comes first and then the patient needs to ask you for treatment. Records include well exposed Xrays and good quality photographs. Patients don't understand xrays like we do. They just don't. Photos though, anyone can understand. So many times a patient has seen my photos of their mouth and said something like "Oh my god, is that what they look like" or "I've never seen it like that before". And then at the end of the appointment something like "I was told that I needed fillings/ gum disease treatment before but they didn't explain it like you did". Even photos of their front teeth, blown up on a screen in front of the patient. People don't look at themselves like we can see them in photos. People can lie, photos can't. The patient can't question your credibility when you present them their situation in front of them in colour pixels. Photos are key for communication.
• Most people are visual learners. The same way people understand by seeing their own photos, they can understand the DREC by seeing photos of other people in similar situations. Time is the great destroyer and the best way we can deepen a patient's concern is to show them the consequences of not addressing their problem at this stage and what is likely to happen to their teeth, mouth and face over time.  On Michael Sernik's suggestion I got a tablet and have been categorising my clinical photographs into groups e.g Tooth wear, tooth decay, perio to help to explain to patient the cause of the disease as well as the progression of the disease. I have found this quite helpful.
•  The DREC we address to deepen the patient's concern regarding their condition. If their concern is deepened then they are more likely to want to accept treatment. For example, with a cavity that has hit dentine, a dentist may traditionally approach the situation by informing them of the situation, they have a cavity forming in the grooves of the tooth and they need to remove the decay and put a filling in place to seal the tooth off. They may do into the pathophysiology of the cavity and how sugar and bacterial growth interact to form the cavity and this is not wrong. However, addressing the DREC involves delving deeper into what would happen if the cavity wasn't addressed. E.g it will likely progress into a larger cavity and the tooth may be structurally weakened which can cause it to break. If it also progresses into the nerve area of the tooth, this can lead to a worsening in pain and can lead to an infection in the tooth which requires more expensive, more complex treatments to address. Whatever the patient's concern is the language with which we will speak. This is gained from an initial discussion with the patient, as to their history, their concerns and their goals. E.g if the patient is worried about spending a lot for their dentistry, by educating them as to their condition and targeting the risk of having to spend more money if the problem isn't addressed early, we can get them to accept treatment. If they are concerned about not being able to chew later on in life e.g if they brought up that their parents had dentures quite early, we can target the potential for tooth loss etc.

That is all I can think of right now. There are more communication tips that I took away from these seminars but I'll have to think of more another time.