Two of my biggest challenges in implementing comprehensive care and doing the dentistry my patients could benefit from are:
- Communication of what I know in a way that resonates and isn’t overwhelming to patients
- Accepting that some patients don’t want what I have to offer (at least now), but that doesn’t mean you shouldn’t offer it to the next patient that walks through the door
I know I can be totally overwhelmed when I get back to the office after a workshop or seminar. I have all of the motivation in the world to give my patients better options and better dentistry, only to find myself speaking dental jargon in a way that has my team and my patients exhausted and confused. It’s been a recent struggle for me as I begin to implement airway prosthodontics and the Seattle Protocol into my own practice.
One of the challenges in communicating newly learned information to patients is that we are taught dentist-to-dentist, in a language two dental professionals can understand. It’s difficult to get back to our practice and then communicate that same information dentist-to-patient, where one of the levels of expertise and understanding has changed significantly.
If we don’t change our approach, we can’t expect our patients to wrap their heads around what we’re trying to say.
Luckily, I have an assistant that can understand both dentist and patient speak, and she will often jump in to “translate” what I’m trying to say. But the reality is that not everyone has that assistant, and it would be more efficient for us as dentists to communicate it simply and effectively the first time. Here are some tips I strive to implement in my own practice in order to improve my workflow, case understanding and, ultimately, case acceptance.
1. Teach your team to say it out loud. If we don’t practice how we’re going to implement something new in our office, we stumble over the conversation when we ‘try it’ on a patient. When we stumble over it a few times, patients are often confused, say no, the situation becomes uncomfortable and we stop trying.
Talking to a patient about a single tooth crown or filling is simple, because we stumbled over it repeatedly in dental school, had “coaches” to check in with every step of the way for reinforcement, and practiced until it felt natural. Taking a patient on a tour of their mouth with photographs for the first time without that coach sitting in the back to check-in with can be time-consuming, awkward and fruitless. Three or four times like that and you’re going to stop taking patients on tours of their mouth. I think this is the biggest reason we have an endemic of “CE hobbyists” that take the courses with the best intentions, but don’t fully integrate it into daily practice. I’ve fallen victim to this on numerous occasions. And thus, back on the hamster wheel we go.
I’ve personally started blocking out a day after returning from a course to review what I’ve learned with my team. If you have the first two or three conversations with teammates, stumble and get your message straight without the pressure of time constraints or wanting a patient to say yes, when you actually bring your knowledge to the treatment room, it’s not the awkward land of uncertainty.
In addition, if your team doesn’t know where you’re going with your treatment planning, treatment options, or a new knowledge base, they can’t cheerlead for you. If you’re learning to take photographs, do it on each other in the treatment room. If you’re learning to talk about airway constrictions, give each team member an exam and have them look at interesting findings on one another.
The biggest pushback I’ve heard from dentists about doing this is the cost of another day without production. It’s really expensive to take time off for continuing education, both in time away from the office as well as the actual cost of the course. We get back home, and the pressure to produce is on. I know for me, if I’ve signed up and invested in a course, I wanted to change something in my daily practice, or answer a question I kept running into.
One day of lost production for all future days of more profitable, less stressful dentistry is worth its weight in gold. I can’t recommend trying it, just once, strongly enough. And if you can’t get yourself to do a full day, open for half a day when you aren’t normally open, let the team come in wearing street clothes (it’s amazing how different the mentality is out of work attire!) and order pizza. Regardless of when you do it, try it out.
2. Ask the questions to feel your patient out. The reality of every practice is that not every patient is ready for the information you have to offer them at that time. Even if you can sell ice to an Eskimo, you will encounter patients that aren’t looking for what you want for them, even if it would make them healthier and happier in the end. If we can minimize the amount of rejection we face on a daily basis, our happiness level, confidence level, and overall well-being will increase exponentially. Finding out who wants it can be relatively easy, but it takes constant reinforcement.
As Gary DeWood always says, patients that want what you have to offer will ask for it - at least indirectly. If a patient asks how, how much, or how long, you’ve peaked their interest.
Don’t look at a patient's wear pattern and tell them they grind their teeth. Show them a photograph of the wear and say something like, “I can identify areas where there has been tooth loss along the edges of your teeth, does that concern you?”
If the patient asks if it should concern them, says it does concern them, or asks what caused it, you’ve been given permission to continue. If the patient says, “no, not really,” it’s a good opportunity to stop the direction you were headed and say something along the lines of, “if you hit a point where you want to know more about those areas of tooth loss in the future, feel free to ask your hygienist or me, and we can continue the conversation.” It saves the patient from hearing a bunch of information they aren’t ready to hear, and it stops the rejection that beats you down.
Continuously offering patients great dentistry and getting rejection after rejection is like hitting your head against the wall repeatedly. Eventually we smarten up and stop hitting our head against the wall … which translates over time to offering less to our patients. We slither back into our comfort zone and again diagnose how we were taught in school … decay, break, open margin, etc.
I’ve found when I circumvent the rejection by feeling out the patient before I give them all I’ve got, it feels a lot better in the end, and it preserves your energy for the one or two patients a week or month that really want to hear what you’ve got to say.
A last tip is to find your source of reinforcement and know when to re-visit that source. Avoiding becoming a “CE hobbyist” is a career-long commitment. Burnout in dentistry is real, and when you start to slip back into your old ways, seek out the kick in the butt that you need. For me, that’s getting my butt back in a workshop. Whether it’s as visiting faculty, as an audit, or in a new workshop, something magical happens for me at Spear that sends me home ready to go again. Maybe it’s your best friend, maybe it’s your team … but find whoever or whatever breaks the cycle when you feel it lurking and help yourself avoid the expense and aggravation of becoming a “CE hobbyist!”
(Click this link for more dentistry articles by Dr. Courtney Lavigne.)