Are we really doing the best exam for our patients? Why is it that this topic is rarely discussed and peer reviewed amongst dentists? As I reflected on my growing experience, I felt that I have not been giving my patients the best examination I could. This may apply to many other dentists as well, so I thought I would share a few things I have learnt.
As dentists, our clinical performance is often limited by a number of factors, such as those dictated by the commissioners and regulating bodies against a backdrop of medico-legal issues. This often forces us to try to fit square
pegs into round holes whereby our history taking, clinical examinations and treatment planning becomes dentist-centred rather than patient-centred. So I consider it appropriate to redesign our examinations to demonstrate high clinical standards within the professional regulations while empowering the patients with the knowledge to understand what may be the best solution for them. This may be done by breaking the exam into a synced series of three sets of six blocks, each with its own patient centric objective. The three sets are divided into:
- listen
- intra-oral
- presentation
There isn’t the space to explain the lengthy details of these sets here, but as a quick example - in the listen phase, we should not assume that our patients know we are listening to their complaint. We need to prove to them that we are listening to their problem through a combination of behavioural and verbal strategies. This will consequently
instil confidence and trust in them, which brings the exam to a good start.
Our personalities can influence our patient management through a concept called ‘position’. Equally, a patient’s personality may affect their interaction with the communicating dentist. Therefore, two dentists could say the same thing to a patient who may then perceive it differently depending on their position and their individual way of portraying it. Other concepts I have learnt include ‘lead’ and ‘social’. How we ‘lead’ the exam involves the natural way
each dentist builds trust with a patient; and ‘social’ involves the way each dentist connects naturally to the patient throughout the exam.
It is important to remember that we should not attempt to sell a treatment plan. As long as we provide the best natural and professional patient-centred examination through which the patient may choose to value and trust us as their dentist, then any rewarding recompense would be a pleasurable side-effect. No longer are patients considered clients that are purchasing our wisdom, skills and experience. On the contrary, the culture of healthcare has changed whereby we are service providers and as long as we humbly maintain this position, there will be mutual benefit to all parties involved.
I am indebted to Dr Asif Syed and his very well presented ‘Protecting your percentage’ course for teaching me these
concepts, that have changed my clinical practice for the better.