The message the body delivers

March 1, 1998
No matter what your position in the practice, how you communicate with the patient can "make or break" your success. When you are making a financial arrangement, scheduling an appointment or presenting the dentistry, your skill in communicating will determine whether or not a patient will comply with your recommendations or directions.

Cathy Jameson`s four-part series on communication starts with 60% of the message - body language.

`What you do speaks so loud that I cannot hear what you say.`

-Ralph Waldo Emerson

Cathy Jameson, MA

No matter what your position in the practice, how you communicate with the patient can "make or break" your success. When you are making a financial arrangement, scheduling an appointment or presenting the dentistry, your skill in communicating will determine whether or not a patient will comply with your recommendations or directions.

As my dentist-husband, Dr. John Jameson, puts it: "I knew how to do the dentistry, but it was when I combined great communication with my clinical expertise that I took the lid off of my practice. Knowing how to do something doesn`t mean you will get to do it! With dentistry, I had to learn how to educate my patients through excellent communication."

We utilize language in four ways - reading, writing, speaking and listening.

Most of us have had education and training in the first three areas. However, very few people have ever had training or actual instruction in listening. Ask yourself this question when building and maintaining a relationship with a patient - or with anyone for that matter: "Which of these four communication skills is most significant?" Did you say "listening?" If so, you agreed with the vast majority of people. What if you were asked, "Which of these four communication skills do you perform the poorest?" If you answered, "Listening," don`t be so hard on yourself. Remember, listening is a skill. Thus it can be learned. If you have not had professional training in listening, there is no reason why you should possess a mastery of this challenging skill.

Many things get in the way of good listening in the dental environment. Some "often-mentioned" barriers are:

- Time

- Interruptions

- Distractions

- Doing too much talking yourself

- Preoccupation

- Attitude about the other person

- Physical well-being

- Emotional well-being

- Bored with what the other person has to say

- Ego: "I already know what they are going to say," or, "I already know the answer."

There is no way you can eliminate these "listening inhibitors" completely. But a study of listening skills can improve this critical aspect of relationship-building.

Business experts tell us that, unless you have built relationships based on trust and confidence with clients, they will never purchase your product or service - in your case, dental care.

The oral cavity and the hands both are considered an intimate zone of a person`s body. Thus, with the ultimate of respect, building a relationship of trust and confidence becomes mandatory if you are going to enter a person`s mouth and either restore it to health again or change your patient`s smile.

There are four separate, and yet related, types of listening:

- Body language

- Tone of voice

- Passive listening

- Active listening

In this first article, I am going to concentrate on body language. Body language accounts for approximately 60 percent of the perception of a message - whether you are sending or receiving the message. Therefore, it behooves you to pay close attention to the message you are sending. Your posture, your gestures, your facial expressions and your eyes can all become your ally during your presentations. Body language can help you become both a more effective and a more persuasive communicator!

You know about positive body-language messages, but let`s review them. Then ask yourself:

- "Am I really presenting a positive message with my body language?"

- "Am I making it comfortable for the patient to converse with me?"

- "What kind of message am I sending with my body language?"

Eye contact - This probably is the most acknowledged, positive body-language expression. Be aware of your eye contact. Learn to focus on a person`s eyes when you are speaking or listening. If you find yourself constantly darting away, make yourself focus. The more you practice this skill, the more confortable it will become.

If you have trouble focusing on a person`s eyes, try to focus on one eye at a time or between the eyes. The other person will not be able to detect where you are focusing (exactly), but will certainly perceive that you are in eye contact with him/her.

Don`t overdo! Don`t stare too intensely; don`t intimidate the other person. Focused, comfortable eye contact sends a message of "I`m with you" or "I`m tuned in."

Your eyes may be your single, most articulate "communicator." Your eyes reflect sincerity, caring and interest ... or the lack thereof!!

Lean slightly forward - A slight leaning toward the patient gives the feeling that you are interested and that you are in emotional contact. Don`t get too close during conversation - about two-to-three feet is comfortable for most people. Any closer and you get into an individual`s "personal space" or "intimate zone." You will be entering that zone when you enter the mouth, but it is best not to be too close during conversation.

Be aware of your posture. Sit up straight, energize. Don`t slump. Slumping gives an "I don`t care" message.

Begin on the same level - Take the time to sit down and roll your chair around, establish eye contact and then begin communicating. Dentistry poses many challenges when communicating with patients, with body positioning being one of them. Standing up, looking down at a patient (sometimes upside down!) adds to the intimidation of being in a dental chair.

When you are standing up and the patient is lying down, you are in the "power" position. This is fine in certain instances. But, when you are asking questions or making recommendations, this is inappropriate. The person simply will not hear you as well - and you cannot hear the patient as well either!

Being on the same level is important at the checking-out phase of a patient`s appointment. If the business administrator is sitting down and the patient is standing up during the checkout process, the patient is in the "power" position.

All clinical data should be in the business administrator`s hands prior to the patient`s arrival, so that she can be prepared to collect any fees and schedule the next appointment. In this critical moment of a patient`s appointment, the business administrator needs to be standing so that an "adult to adult" relationship is established. Remember: Body language accounts for 60 percent of the perception of a message - whether you are sending it or receiving it. So, take the time to do things right. Think of the impact. Do what you need to do to make the most of each and every interchange.

Uncross your arms and legs - This isn`t easy. Many of you are simply more comfortable having your arms or legs crossed. However, subconsciously, this may give another person the perception that you are closed to them - that you may not be listening and you are uninterested. All of these things probably are not true. However, all the right words in the world can be worthless if the body language delivers a different message. So, concentrate.

You can do it! Uncross those limbs!

Take off the mask - If possible, when you really are trying to listen to your patient or when you really want the patient to listen to you, take off the mask. Infection-control measures do a great deal to physically shut you off from a patient.

So, when possible, drop the mask. Don`t dangle it from your ear! Take it off or drop it to your chest.

You may think this seems obvious and that no one would have a conversation while masked. But, I bring this up because I see it so often. I know there are times during a procedure when you will be talking to a patient or giving instructions and you cannot drop the mask. I am talking about the times when you want to make a point to the patient and when you want the patient to really hear you - or when you really want and need to hear what the patient is saying. During these critical moments, drop the mask.

Nodding or shaking your head - This type of reflection can very softly, but very effectively, let patients know that you are "with them," that you "hear what they are saying" and that "you care." Nodding or shaking the head does not necessarily mean that you are agreeing or disagreeing. It simply is a way to let the person know that you are in tune with him or her. This is what listening is all about.

Facial expressions - Before anyone will believe your message, you have to look as though you truly believe it yourself. You need to get across that you believe in the message of health and beauty that you are presenting. So, be enthusiastic about your message and let your enthusiasm show! Focus on your message and not on "being nervous" or "I wonder what`s she`s thinking" or "She may think this is too much."

These distractions will take away from the impact of your message, and your facial expressions will be a direct reflection of your inner thoughts. Be aware of - and eliminate - distracting mannerisms or habits.

Do you tap your fingers or feet? Do you shake your leg? Do you constantly clear your throat? Do you have any habits that are irritating and annoying? If so, these defuse the impact of your message. Eliminate them. How? Ask for input from your teammates or spouse or videotape yourself. Turn off the sound and see what kind of message you are sending. This is tough, but it can be a real eye-opener.

Not what, but how - The study of body language is not new. The areas that I have highlighted are areas that deserve respectful attention. Know that, as Paul Harvey says, "It`s not what you say; it`s how you say it." Once again, you may say all the right words, but if the body language is not in a positive state, the entire effect of your message can be misconstrued.

Listening, then, is a part of this two-way process we call communication. According to Kevin Murphy, president of CDK Management Associates & Consulting, "Listen-ing is a two-way exchange in which both parties must always be aware of the thoughts, ideas and emotions of the other."

He also notes that "Listening is a natural process that goes against human nature." He may be right!

Finally, if you believe that listening is your most valuable communication skill and if you feel that you can improve, then get in touch with your body language. If 60 percent of the perception of your message is body language, then careful attention and improvement in this area will be in your favor.

In Part 2 of this series, I`ll discuss tone of voice. The tone of your voice is responsible for 30 percent of the perception of your message. Does your tone of voice help or hurt your message?

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