Do you ever sit, at day’s end, and ponder? Promptly at 8 a.m., Ms. Churlish canceled today’s 2 p.m. appointment to begin periodontal therapy. Again. Although her disease worsens rapidly (thanks in part to vile cigarettes), you’re not surprised she won’t be coming. During her last visit, you demonstrated bone loss on her x-rays and insisted she watch in a hand mirror as you spot-probed, pointing out bloody, even purulent discharge. (Most patients are reluctant to view this, but such clear and visceral evidence is difficult to ignore or forget, so I insist.) You also reviewed oral hygiene, dispensed educational pamphlets, stressed the urgency of her condition, and explained the systemic implications of chronic oral infection. You gave your all because her problems are significant, and as a dedicated health professional and compassionate human being, you really care. But even as you labored to educate and motivate, you sensed the message wasn’t getting through. What should, what could you have done differently? Would someone else or another approach have been more effective? The stakes—her oral and general health—are high. The facts irrefutable. There must be some way to reach her.
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We’ve all experienced the frustration of the scenario described above. Some patients understand and respond by accepting responsibility and entering treatment. Others listen politely, if impatiently, but the light is missing from their shifting eyes, and critical needs go unmet if we fail to connect. You present identical information in a similar manner to everyone, so why this stark difference in results? Perhaps it’s because individuals perceive information in a variety of ways?
Mastering the ability to consistently develop long-term relationships is the most indispensable ingredient of dental success. Understanding the fundamentals of human interactions is crucial to achieving this goal, as without effective communication, it’s impossible to form the positive, trusting connections that result in superior acceptance. And until patients comprehend and embrace a salubrious course of treatment, no matter how great our knowledge, dedication, and skill, we can’t help them.
Acutely aware of this, I’ve studied numerous books on topics such as the art of first impressions, understanding body language, neurolinguistic programming, transactional analysis, and many more. The scope can be overwhelming, so I’ll limit this discussion to the most simply understood and easily improvable facet of communication: verbal skills.
People process speech and thus relate to the world in four primary ways. None is superior or inferior, each has strengths and weaknesses, and while everyone uses all of these methods to a degree, most favor one primary mode. It is naïve, to put it lightly, to assume the same verbal approach will work equally well with all personality types. The presentation we deliver repeatedly is based on our primary orientation and will be optimally successful with approximately one-fourth of our audience. Few are satisfied with a measly 25% acceptance rate, so how can this be improved?
As we discuss basic personality types, determine into which group you fall. You’ll be able to identify specific patients within each segment (often due to your frustration of never being able to reach their type). Also, consider how your teammates, family, and loved ones access information, as improved vocal skills enhance communication effectiveness with everyone.
The first step to improved understanding is identifying which types we are interacting with, then tailoring our approach to their dominant perception. I’ll suggest a concise strategy for each unique group to empower them to understand and accept a soft-tissue management course. We’ll also consider how best to reinforce the idea that excellent oral hygiene and regular recare appointments play a crucial role in achieving long-term success.
Controllers (aka directors)
Strong-willed, decisive, and straightforward, domineering controllers must be in charge. Always rushing, they become upset if you’re running late, but cancel appointments willy-nilly due to changes in their schedule. They make decisions based on what is best for them and care little about how their choices affect others. Interested in results, not emotions, they are willing risk-takers who decisively choose a course of action.
Let’s eavesdrop on a bit of conversation:
Dentist: “Mr. Director, I’m extremely concerned about the condition of your gums.”
Mr. D: “Oh? What worries you?”
Dentist: “Please watch in our intraoral camera (or hand mirror). See these spaces or pockets along the necks of the teeth? They’re getting deeper. Notice the blood seeping from the places I’ve touched?”
Mr. D: “Yes, that certainly doesn’t look good . . . What should we do?”
Dentist: “The most effective approach would be a deep cleaning. We’ll numb your gums to make it comfortable.”
Mr. D: “How long does that take?”
Dentist: “We can complete treatment in two visits.”
Mr. D: “If that’s what I need, let’s get it scheduled.”
Mr. D has no interest in the details. Tell him what’s needed, how best to accomplish it, then shut up and appoint.
To improve oral hygiene and help directors be more faithful in recare, stress how compliance will be efficient, thus promoting health while saving time and money in the long run.
Analyzers (aka engineers)
The engineer never misses an appointment and is seldom late. Detail-oriented, they digest every tidbit of information provided, often requesting more. They are not risk-takers, but make slow, methodical choices.
Dentist: “Ms. Engineer, I’m quite concerned about the condition of your gums. Routine treatment isn’t creating the desired response.”
Ms. E: “What’s wrong?”
Finally, you have a chance to use the knowledge gleaned from years of professional education and dispense a copy of all your dusty periodontal handouts. This patient will want every detail and, after a lengthy dialogue, will probably wish to consider. You would do well to make a note to call her in a week. She will have questions, so reserve time to chat. If you rush her, she’ll become frustrated. Avoid pressuring such patients. They’ll reach a decision, but only when they are ready.
To reinforce oral hygiene and recare, provide abundant facts, answer inquiries, then wait patiently for their decision.
Promoters (aka cheerleaders)
These fun-loving folks are often storytellers and are likely to be among your favorite patients. They look at the big picture and don’t sweat the details, frequently making rapid decisions without the benefit of facts. Concerned with appearance and self-centered, they tend to live for the moment, but are unreliable, often forgetting appointments or arriving late. Discussing specifics of problems or treatment repels them. Oral hygiene tends to be sporadic.
Dentist: “Ms. Cheerleader, I’m very concerned about the health of your gums.”
Ms. C: “How so?”
Dentist: “Look at our intraoral camera picture. See how red, swollen, and unattractive your gums look?”
Ms. C: “Oh my goodness, yes! They are swollen and old-lady awful-looking. What can we do?”
Dentist: “With proper care, your gums can become as pink, firm, and as healthy as they were when you were a teenager.”
Ms. C: “Really? Then let’s do it!”
After patients say yes, quit selling and schedule. You can provide additional information as you proceed, but our cheerleader wants more attractive gums badly. Grant her wish.
When discussing the importance of oral hygiene and regular recare, stress how they will make her look healthier and more attractive.
Supporters (aka helpers)
Helpers have tremendous empathy for people’s feelings and are concerned about how their actions affect others. They are willing workers, but intensely uncomfortable with conflict. Reluctant to make independent decisions, they quickly concur with others’ choices. While not entertaining individuals, they seldom miss appointments or arrive late. They make an effort to comply with oral hygiene recommendations, and strongly encouraging them to accept care will prove highly effective.
Dentist: “Mr. Helper, I’m concerned with the condition of your gums.”
Mr. H: “What can I do?”
Dentist: “I’ll detail a specific course of action, and if you do exactly as I suggest, I’m confident that with us working together, your oral health will improve.”
Regarding recare and oral hygiene, prescribe a precise plan and stress teamwork. These people want to make you happy, and it reassures them to receive concise directions and positive feedback.
Authentic connection opens up a world of possibilities
Why go to all this trouble? Isn’t it enough to do your job and tell the truth? Let’s examine some of the numerous advantages bequeathed by enhanced communication.
Not only case acceptance, but patient comprehension and appreciation increase. Patients feel heard and understood, which makes you their valued asset. Your fatigue and frustration will decrease, as it’s more enjoyable to team with patients who appreciate excellent care. Clinical results also improve as patients work with you to achieve a mutually understood common goal. Practice income surges as more definitive care of all types is provided, but the most significant benefit bequeathed by heightened communication is intensified personal development. As verbal skills grow, your patients, coworkers, friends, and family will perceive you differently, and you’ll discover a world full of fascinating people you understand and enjoy.Editor's note: This article appeared in the September 2022 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.