Stamp out fear of rejection

July 1, 1998
The fear of rejection during the presentation of a large case may pose an ethical dilemma in and of itself. In overcoming the phobia, let the patient do the talking about his or her values.

The fear of rejection during the presentation of a large case may pose an ethical dilemma in and of itself. In overcoming the phobia, let the patient do the talking about his or her values.

Bill Blatchford, DDS

Dentists can deliver a premium product, which is specifically made for each individual, has great value, is used every day, enhances beauty, and lasts a long time. Yet, many dentists, though technically able to deliver a beautiful smile, will stop short in presenting a compete case or even multiple units because of the "fear" factor. This decision greatly affects dental ethics because we are allowing our fears to dictate our diagnosis. How ethical is that?

The fear of rejection when presenting a case is always present. The real question is, do you allow this fear to compromise or halt a complete diagnosis when your internal standards and your heart tell you a single restoration will not fulfill this patient`s expectations?

We rationalize our fear of rejection and smaller diagnosis with excuses like insurance maximums, patients being financially out of their league, or my patient didn`t need the work because no pathology was present. The end result is that the dentist`s fears shape the patient`s desires.

Have you defined for yourself your standard of excellence in your practice? The dentistry you are now delivering creates your reputation tomorrow. Once your ideal dentistry has been defined, action is called forth. Are you diagnosing and presenting the ideal in your practice or does this fear factor have you selling short? Is there a synapse between what you technically can deliver and your willingness to offer that standard to patients?

How strong are your standards for excellent care? How comfortable are you, technically, in assuming responsibility for a complete case? If a complete restoration is really the only answer for a patient, do you continue to repair one or several teeth at a time, matching the worn-down occlusion? What is the fear that keeps you from presenting a complete case?

Fear of rejection is lurking in every enrolling situation. What causes this fear for you? Explore your own standards and values and be clear on your standards of excellence. Believe in yourself, your training, and your values.

One way to overcome the fear of rejection is to learn to ask your patients questions to uncover their values. Shift the conversation to find out what is important to them. Words like, "You need" should be eliminated from your vocabulary. "You need" puts all the focus on the doctor and his/her value system. To successfully present treatment to a patient, we need to uncover the patient`s agenda. Find out what is important to the patient and let them talk 80 percent of the time.

The staff also experiences fear of rejection during case presentations. Complete your staff`s excellent dentistry and exhibit examples of what you can accomplish. Include your staff in technical courses. Build employees` confidence in your ability to deliver complex and larger cases.

You are the only messenger of your patient`s dental dreams. No other store has the ability to renew a smile with longevity. Your patients cannot buy a new smile off the shelf. Since you are the messenger, you have an ethical obligation to present excellence and a complete plan for the patient to choose. Your patients believe and trust you. Don`t sell them short with an incomplete diagnosis because you suffer from the fear of rejection. Is it ethically fair for you to decide that this patient will not even hear about the new possibilities in dentistry because of your fears?

One of the heaviest lids in case presentation is our own fear of rejection. Dentists have an ethical obligation to their patients to become technically competent, set standards of excellence and learn case presentation skills where the patient drives the conversation about values. Be the messenger of your patient`s dreams. Stamp out fear in case presentation!

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