Developing a superb chairside manner

Oct. 1, 1998
Communication is a skill learned throughout life. From the moment we take our first breath, we begin a lifetime of learning to communicate. Some of us become quite effective as communicators, while others never seem to develop the skill. Are these skills just given to some naturally and denied to others? Granted, while some people are endowed with the "gift of gab," this by itself does not make you a great communicator. My grandmothers used to say that a person who talked incessantly could "talk

Five steps help simplify a lifetime of learning to communicate.

Dianne D. Glasscoe, BS, RDH

Communication is a skill learned throughout life. From the moment we take our first breath, we begin a lifetime of learning to communicate. Some of us become quite effective as communicators, while others never seem to develop the skill. Are these skills just given to some naturally and denied to others? Granted, while some people are endowed with the "gift of gab," this by itself does not make you a great communicator. My grandmothers used to say that a person who talked incessantly could "talk the horns off of a billy goat!" In reality, a person can say very little with many words. Good communicators learn this skill through a lifetime of concentrated effort.

Conversely, we can speak volumes with few or even no words. Most of the remarkably powerful speakers have learned how to get their message across without embellishing their points with extraneous verbiage. Can you remember that "look" your mother gave you that said, "You better straighten up right now"? She didn`t even have to open her mouth to say it, but you knew exactly what she meant.

Learning to recognize nonverbal communication can be a powerful tool in the hands of a good communicator. Have you ever considered how your own nonverbal communication affects your patients? For example, the way in which you enter the operatory can say much about how your day is going. If you rush into the room in a flurry, your patient is bound to know that you have a need to be hasty. This definitely is not a good sign to a patient nervously waiting in the chair. On the other hand, if you enter the room relaxed, with a smile and a friendly greeting, you communicate to the patient that you are in a good mood and that all is well, which would tend to generate a calming effect on the patient.

The best communicators have developed a keen sensitivity to others` feelings. It is this sensitivity that enables you to develop a superb chairside manner.

A good chairside manner involves five aspects. As you read the following discussion, ask yourself if you need to improve in any of the five areas.

1) Look. Eye contact is vitally important in establishing an effective communication bond. Never stand behind your patient while talking with him/her. In addition, make sure the chair is upright and you are seated when explaining something to a patient. People feel vulnerable when they are reclined. Keep your eye level in line with your patient`s so you do not speak "down" to him/her. One more suggestion: As dental professionals, we often train our gaze to the other person`s mouth while conversing. This tendency becomes second nature. However, we need to be sure to cast our eyes to the other person`s eyes, not downward to the mouth. A wise person once said, "The eyes are the window to the soul."

2) Listen. Effective communicators have the ability to "read" other persons. This ability is gained through listening and internalizing the feelings of those being listened to.

As dental professionals, we need to develop our listening skills to hear what the patient says verbally and nonverbally. This is called "listening through the lines." For example, you walk into the operatory where the patient is seated and say, "Good morning, Ann! How are you today?" The patient replies, "Fine," in a wistful, weak tone, which really does not sound "fine." She`s just answering what she thinks you want to hear. Her tone would make a sensitive listener suspect she is not really "fine," possibly because she is nervous about having to be in your chair today. This gives you an opportunity to allay her fears by asking, "Could it be that you are a little nervous?" The patient nods her head in affirmation. You continue, "Well, we`re glad you`re here, and we`re going to take really good care of you today. Don`t worry about a thing; this will be a piece of cake!" Then pat her on the arm and do what you said. Make her visit a pleasant and painless experience.

Many times, we engage in selective listening, where we hear only those things we want to hear. We tend to zero in on things our patients say that are good for us, while dismissing or ignoring other parts of the exchange.

Asking patients open-ended questions like, "Can you tell me about your past dental experiences?" or "If you could change anything about your smile, what would it be?" gives you an opportunity to listen, listen, listen. Listen with your eyes and ears. A teacher once said, "Since we`re created with two ears and one mouth, we should listen twice as much as we talk!" That sounds like pretty sound advice.

3) Linger. In order for this concept to be workable, there must be good control over the schedule. The way you leave the operatory is important in helping the patient to form a positive memory of the appointment.

One of the saddest scenarios I have seen occurred in an office where the doctor finished the procedure and then left the chair without a word to the patient. The patient turned to the assistant and asked, "Is he finished?" This should never happen! Linger long enough to put closure on the appointment. Make sure the patient leaves with a positive word from you.

Sometimes, patients have exciting news that they are anxious to share. You should feel honored when they share their joys with you. You must be willing to linger and listen.

Additionally, some of our patients come to us with personal problems. I`ve had patients open up and share extremely personal problems with me. Maybe I seemed nonthreatening. People often feel a desperate need to unburden themselves. In these rare instances, I can be a sympathetic listener. You should consider it a compliment when a patient trusts you enough to share a problem with you. However, you must be willing to linger.

4) Touch. An appropriate touch to a patient conveys warmth and caring. A playful pat on the head of a child, a sincere handshake with a male patient, or a pat on the arm or shoulder of a female patient conveys that you genuinely care. A petite female doctor I know is quite good at using "touch" with her patients. I have observed her patting the hand or arm of her patient while waiting on the assistant to load the anesthetic. Many of her elderly patients hug her at the end of the appointment. Although hugging may be totally inappropriate with most patients, many of our elderly patients welcome (and even initiate) a hug from someone whom they perceive cares for them.

You may have to step out of your comfort zone to use touch as a display of caring for your patients. But an appropriate touch to a patient can be quite effective in conveying the message, "I care about you as a person, not just your teeth."

5) Identify. The ability to identify with what our patients are feeling is very important in establishing good communications. Identifying dental problems is easy for us. However, identifying what will make a particular patient happy is not always easy. If we see our patients as total beings and not just a set of teeth, then we will be more successful at establishing the trust that is essential in any good doctor/patient relationship.

Can you feel what they feel? Do you care enough to try? Are you willing to be not only their dental caregiver, but also their friend? If your answer is "yes," you have the foundation that is necessary for building long-term, connected relationships with loyal patients.

The big five - look, listen, linger, touch, and identify - are the essence of developing a superb chairside manner. In forming connected relationships with your patients, it becomes more difficult for them to leave you, even if their employer chooses an HMO in which you do not participate.

So, how does your chairside manner measure up? Do your patients see you as a friend and a caregiver? If you put those five verbs into action, your patients actually will look forward to their visits with you. Sharing long-term, friendly patient relationships can be one of the most fulfilling aspects of your professional career.

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