Many of you have heard me talk about the power of the “Nudge”—a concept popularized by a book of the same name. The central idea is that it just takes little adjustments in how we present things to influence big changes in people’s behaviors.
Here’s a fun-to-watch short video that illustrates the main thesis beautifully:
In teaching hands-on courses, I have the opportunity to try out lots of new dental materials these days. Stopping to think about how this process worked in my private practice, I realized that I changed materials for some very specific reasons. There were times that I actively sought out a new material or technique, normally because something wasn’t working. I had challenges with a material or its clinical application, or worse yet, I saw a failure after the fact that I attributed to a materials issue. In these situations, it was a great resource to have my supply rep or other clinicians to ask for a recommendation of something new to try.
What about when there isn’t a problem? I rate my dental materials in four areas: clinical effectiveness, handling properties, efficiency and cost. When I consider switching from something that I am comfortable using, the first motivation would be a product that improves the clinical outcome, and I will never switch to something less effective despite an improvement in the other three areas. If the clinical effectiveness is equal to what I am currently using, my motivation to switch drops off significantly and I have to ask myself the following questions.
Is it easier to use? If it is, this normally means improved outcomes with fewer areas for technical mishaps.
Is it more efficient? In the end, efficiency means time and time means money.
Is it less costly? No question what that means. I must say I very rarely have switched for cost alone; the magic of a product that works – that I know and use with proficiency – almost always wins out.
So where does that leave me today? I realize that my comfort with the known sometimes gets in my way of finding new products that do meet my criteria. Maybe the issue is really deciding that “change” isn’t a bad word!
An article in The New York Times, When Stress Takes a Toll on Your Teeth, talks about a recent unexpected phenomenon dentists are seeing as a result of the recession. The article begins with this:
“With economic pressures affecting millions of Americans, dentists may have noticed a drop in patients opting for a brighter smile, but they are seeing another phenomenon: a rise in the number of teeth grinders.”
It goes on to quote a New York dentist as saying, “I’m seeing a lot more people that are anxious, stressed out and very concerned about their financial futures and they’re taking it out on their teeth.”
This is, of course, sad news for those patients. But it illustrates what I have been saying throughout this economic downturn: there are opportunities in every kind of economy. The fact is most of your patients are not directly affected by the marketplace turmoil, but they are worried, and may need extra coaching to see the value of dentistry. The ones who are putting off necessary treatment will inevitably return later with bigger issues to deal with. And as this article shows, the economic stress is actually creating new dental issues for some people. All in all, as tough as this recession has been, dentistry remains one of the professions that is best positioned to come out of it ahead.
How is the recession affecting your practice? Leave us a comment and let us know!
At a recent Live Patient Experience I observed Lee Brady taking a few patient pictures, one of which was the one above. I don’t know about you, but I have a hard time getting people to show me this one.
“Lick your lips and let your teeth part, open a little, open a little, open a little, NOT that much! Relax…relax…RELAX…RELAX! OK, let’s try that again.”
I listened as Lee asked the patient to lick his lips and then breathe continuously through his mouth for a minute. She was already set up directly facing the patient and focused in. She captured the image, a beautiful record of this patient’s exposed teeth when lips are resting. She had taken the smile close-up first so that the smile close-up and lips at rest close-up are the same magnification. Thanks, Lee!
Frank leads the audience through thought processes behind a retrospective journey of dental techniques and materials.
I’ve been saying it for years: it doesn’t really matter how great your clinical skills are and how good the results you can achieve if patients don’t perceive that value.
The video clip below comes from Ted.com, one of my favorite online playgrounds. (TED stands for Technology, Entertainment, Design. It’s an annual conference that brings together some of the most innovative thinkers from a variety of backgrounds to give short compelling talks.) In this presentation, Rory Sutherland, an acclaimed advertising guru, gives his thought-provoking (and funny) insights into how “all value is perceived value”—and how changing peoples’ perception of value can, for instance, make the humble potato into a must-have status symbol. It’s an inspiring reminder of the power—and even the obligation—you have to shape patients’ perceptions.
We did it! The patient has integrated all that we have seen and discussed and they “own” it. They want to hear about the best solution; they want to do what is in their best interest! That means all we have to do now is smell tooth dust and do the case, right!? Well, sometimes we’re not only performing the dentistry; we’re in a support role as well.
Have you ever had a patient get partially through treatment and just run out of gas? They may stop making appointments or they may just say they don’t want to finish.
We have to remember is that our patients are just like us; they have highs and lows and ups and downs. Have you ever noticed that a patient whose home care has always been good comes in with gingivitis and heavy plaque? Something in their life has gotten in the way of what they know they need to do to ensure their long-term dental health. Once we reinforce what they said they wanted at the beginning of the relationship they get it back together and get healthy again.
I notice this even with my patients who are dentists (most are) – who else should know better about oral health? Yet, they will dolphin up and down, just like “normal” people.
I think the key to being successful with our patients whose cases are complex and involved is to stay engaged at every visit. Help them remember what they wanted when we started and support them as they wrestle with the stuff of life.
Sometimes they just need to be reminded of what the brass ring looks like!
This video is part of an ongoing series on Defining Success. To view the series from the beginning, click here. To receive notifications when new blogs are posted, subscribe to the Spear Online RSS feed.
How about both? The question of whether or not to include retention and resistance form came up again during a Posterior Partial Coverage Bonded Restorations live patient program. I can’t think of a dentist that I know who isn’t cautious about removing tooth structure unnecessarily. This quest has created a quandary with the advent and improvement of dentin bonding. Do we or do we not have to remove the tooth structure to add to the preparation features that prevent rotation and create retention and resistance to a restoration tipping off a prep?
Part of the answer is the ability of the laboratory technician to fabricate the restoration when a die is being used. The restoration is not “bonded” to the die. It can make fabrication and adjustment very challenging if the restoration keeps falling off the die, or if it is unclear how it fits, as rotation is possible. In addition, retention form and anti-rotation features in a prep make the bonding and cementation process more predictable in my hands, creating only one way a restoration “fits” and the ability to hold it firmly against the margins during bonding.
Adhesion works. Bonding to enamel and dentin are viable clinical techniques that represent a bulk of our restorative modalities today. Bond degradation and bond failure are also realities we deal with. If I can add features to the preparation of a tooth that help reduce the demand on the bond and potentially increase the longevity of the restoration, in addition to making the procedure more reliable, why wouldn’t I? As a pragmatist the answer is clear to me. I’ll do both.
Frank shows a few slides from his 2009 IFED presentation, highlighting esthetics and honoring his mentor Dr. Lloyd Miller.
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