When patients feel as though they are being sold to, they instantly put up a barrier that makes treatment acceptance less likely. It’s tough to prevent this happening because sometimes patients will mistake your suggestions for necessary or essential treatment as a recommendation for expensive treatment. So how can you ensure patients see their clinical condition in the same way as you, without either of you feeling as though you are delivering a sales pitch?
There is a gap between what patients want and what the dentists believe the patient needs. Since most chronic dental disease is painless, and most patients assume that if there is no pain then there isn’t a problem, it’s no wonder that we have trouble convincing some patients that treatment is necessary.
Patients generally have knowledge-gaps regarding dental disease. If they knew exactly what we knew, many more would want the same treatment that we would want for ourselves. Of course we can’t just give our patients all our knowledge, therefore we need to just convey the fewest key messages to get the job done.
The greatest motivator is how will the patient feel if their condition is allowed to continue untreated. In dentistry, there is a direct relationship between motivation and concern. To put it simply, if a patient has a £100 concern they are unlikely to request £1,000 treatment.
The examination
Most dentists will examine the mouth; talk about their recommendations and then in order to convince the patient, they begin talking about the reason for their recommendation. That would be a solution:problem sequence. I suggest that this sequence should be reversed to problem:solution. The treatment options should be held back for much longer than is natural to the dentist, because typically, dentists find themselves talking about the proposed treatment too early.
Three phases
Divide the new patient exam appointment into three phases: the pre-clinical discussion, which is the first conversation the dentist has with the patient; followed by the clinical exam phase; and then the consultation phase. All of this is within the same appointment time, and each phase has a specific objective.
In the pre-clinical phase, the clinician finds out about the patient’s past dental history and usually photos are taken for baseline records. This gives the dentist a quick preview as to what type of treatment is most likely going to be needed. The discussion also gives the dentist an insight into any possible resistance the patient might have to optimum treatment. This allows the dentist to drop some key pieces of dental education into the conversation, which will fill the patient’s knowledge-gaps.
During the clinical exam phase, the dentist can describe to the dental nurse, in plain English, the details of the visible dental condition. As the patient overhears these descriptions, they get a deeper understanding of the nature of their problems.
Finally, during the consultation phase, when the patient is sitting up, they can see their photographic images of their condition on a computer monitor. This process will have them realise that a problem exists. They now ‘own’ their problem. However, as they still do not know how the problem will be solved, they now ask you, the dentist, for solutions.
No more selling
Life becomes very different when patients are asking the dentist for a treatment solution. And it is so much more pleasant for dentists to be able to respond to a patient’s request for help, rather than to feel like they are selling treatment to a resistant, suspicious patient.