Getting on the same wavelength

If you`re not asking your patients what they want, you`ll never know. Here are some suggestions on keeping your internal dial tuned to the needs of your patients.

If you`re not asking your patients what they want, you`ll never know. Here are some suggestions on keeping your internal dial tuned to the needs of your patients.

Paul Bass, DDS

How effective is patient education in your practice? If that query sounds a bit too general, you might ask yourself these more specific questions:

(1) "Does our case-presentation process predictably lead to case acceptance?"

(1) "What percentage of our active patient base is consistently seen in our recare program?"

(1) "How many broken appointments do we experience in our recare program? What about operative appointments?"

(1) "How difficult is it to reactivate patients by phone when they have been off recare for a number of months?"

(1) "Do our patients seem to feel resentful when they pay for our services?"

The answers to these and other similar questions should serve as an indication of the true effectiveness of your patient-education efforts. Patients whose dental values are at the center of focus during the patient-education process will tend to:

> accept your treatment recommendations

> stay active in your recare program

> show up on a consistent basis for prescheduled recare appointments, as well as operative appointments

> be easily reactivated by phone when they have inadvertently fallen out of the recare system

> pay for valued services with a feeling of gratitude and appreciation, rather than a feeling of resentment.

The real issue is actually not education; it`s value! I could lecture for countless hours on geology, medieval cultures, or any other topic, and yet you may have no desire to show up for our next "appointment." The obvious reason would be the lack of value you place on knowledge in those areas.

However, if I were to educate you for countless hours on your favorite subject, you would most likely find the conversation interesting, and you would look forward to our next "appointment."

What`s intriguing about a value-driven conversation is how we all value things differently. Consider, for example, the following "life values:" love, freedom, peace, security, and adventure. Now, rank these five values in order of importance to you, with one being the most important and five being the least important. Next have each member of your team complete the same ranking process.

When you share the results, you will find every imaginable order of importance, with probably no two people being in total agreement. What some people rank at the top will be ranked at the bottom by others.

What`s the point? We all have a different "values hierarchy" in life. What`s important to me may not be important to you. While this may seem irrelevant and insignificant on the surface, further review will reveal a huge void in the patient-education process when we consider a hierarchy of dental values.

What if we were to ask patients to rank five "dental values" in order of importance? We would find the same type of disparity, even in a small group of individuals. Let`s test this theory: Which of the following dental values is the most important to you: esthetics, comfort, longevity, function, or long-term cost-effectiveness? This time, for simplicity, only select your most important dental value, and ask each of your team members to do the same. What did you discover?

Now ask yourself, "When I educate my patients, whose value filter am I speaking through?" and "Whose value filter does each team member speak through?" The answers are obvious.

By now, I am sure that you have realized one of the reasons we have struggled for so many years with truly effective patient education. We simply aren`t always on the same wavelength as our patients. If we are educating them with respect to longevity, but their highest dental value is esthetics, we will find them somewhat disinterested. It is as if we are broadcasting on FM while the patient`s receiver is tuned in to AM. We are missing the mark.

If we knew the patients` highest dental values, then we could "speak their language" and connect with them in a way that would truly educate them at the deepest level. How do we find out the patient`s highest value? We ask!

As a part of your new patient`s experience, try asking him or her, "What do you value most about your dental health?" or "What`s most important to you about your dental health?"

The patient`s response will be your key to unlocking the patient-education door - perhaps for the first time. Actually, we`ve all effectively communicated this with our patients at one time or another because we just happened to be on the same wavelength. In other words, we shared their same primary dental value.

Now we can connect every time simply by asking the same basic questions, and then tailoring our conversation to address the issue through the filter of the patient`s primary value.

Incidentally, before you ask either of the above questions, it`s best to "pre-frame" the question with an explanation of its purpose. For example, "Mrs. Jones, we pride ourselves on providing personalized care and service in our practice. We want to be sure that we are serving you in the best manner possible. Since patients have different values and priorities, I would like to ask you a question or two in order to determine what is most important to you about your dental health." Pre-framing the question helps set the stage for the follow-up questions and ensures a more free-flowing response from the patient.

So now that we know the patient`s highest dental value, what do we do with that information? We simply use it as the common thread in the fabric of education, regardless of which specific topic we are addressing in the patient-education process.

Whether you happen to be educating a recare patient or a new patient, the objective is essentially identical: To direct the education conversation through the filter of the patient`s highest value. If, for example, we are educating a recare patient on the value of staying on a consistent preventive-maintenance program, and the patient`s highest value is comfort, we might take the following approach: "Mrs. Jones, as you can see on these X-rays, the decay we found between your back teeth is very close to the nerve. Since you had mentioned that comfort is your top concern, I`m really glad we saw you today. As you might imagine, in the next few weeks you could have a severe tooth-ache. In fact, this is why it`s so important to stay on a consistent preventive-maintenance program, so we can catch future problems before they cause unnecessary pain."

As a second example, let`s say that the patient`s highest dental value is longevity, yet the clinical findings are identical to the first example. I might change my words to: "Mrs. Jones, as you can see on these X-rays, the decay we found between your back teeth is very close to the nerve. Since you had mentioned that keeping your teeth is your top concern, I`m really glad we saw you today. As you might imagine, in the not-too-distant future, some of your teeth could be in jeopardy. This is why it`s so important to stay on a consistent preventive maintenance program, so we can catch future problems before they put you at risk for unnecessary tooth loss."

As you can see in these two examples, the difference is very subtle, yet very powerful. If we are addressing the clinical findings and the need for preventive care through the filter of Mrs. Jones` highest dental value, the conversation will be meaningful to her. If, however, we are simply speaking through our own value hierarchy, we have no leverage to use in guiding Mrs. Jones to recommit to our recare program.

Let`s change the scenario with Mrs. Jones. Her clinical condition is now moderate periodontal involvement. Once again, our intent is to have her recommit to our preventive program. The first conversation might sound something like this: "Mrs. Jones, as we called out the pocket measurements around your teeth, I`m sure you noticed that they were mostly in the four- to five-millimeter range. As you saw on the chart earlier, this level of breakdown shows that a significant disease process is present in the supporting bone around your teeth. While you have suffered no discomfort from the disease process at this point, further breakdown would certainly necessitate periodontal surgery, which can be a somewhat uncomfortable experience, both during and following the procedure. Fortunately, at this point, we may still be able to avoid surgery, provided that we get you started in our soft-tissue-management program right away. Also, I`m sure you can understand the need for consistent preventive visits in the future in order to avoid the unnecessary pain so commonly linked to dental problems."

Taking the second scenario again, with her highest value being longevity, a few slight shifts in the conversation will reflect her primary value of keeping her teeth for a lifetime. "Mrs. Jones, as we called out the pocket measurements around your teeth, I`m sure you noticed that they were mostly in the four- to five-millimeter range. As you saw on the chart earlier, this level of breakdown shows that a significant disease process is present in the supporting bone around your teeth. While the disease process is currently treatable, further breakdown would certainly jeopardize your opportunity to keep your teeth for a lifetime. As a result, once we finish your treatment, it`s important that we keep you on a consistent preventive program to ensure that your teeth will last a lifetime."

As we start to grasp this concept, we must ask ourselves a few questions. Is it possible that the only people we have been able to educate effortlessly have been those with similar values to our own? Is it also possible that all of the struggles occurred because we were not on the same wavelength? What would happen if we were now able to be on the same wavelength simply by asking a few questions and entering the patient`s world? Yours will probably be the first office even to inquire about patient values, let alone educate in the context of that value.

Since patient education is the responsibility of the entire dental team, it`s a good idea to have your team trained in these and other similar technologies. Meanwhile, as a valuable homework assignment, have your team evaluate the individual dental values in the left column of Table 1 when linked with each individual clinical finding in the table`s right column. As you list every possible pair of combinations, determine your leverage point on each and how you would best educate that patient.

As you experiment with these tools, you will find the patient-education process to be much more engaging, and your patients will be more open and more accepting of your recommendations. Additionally, you will find your day to have more diversity and your relationship with your patients to be more rewarding. You will find that, perhaps for the first time ever, you are consistently giving patients what they desire most.

There could be no simpler formula for success than this: "Discover what people want - and give it to them!"

For more information about this article, contact the author at (800) 687-3393. For a free copy of "10 Ways to Improve Patient Education in Your Practice," send a fax to (931) 455-0522. A biography of the author appears on page 8.

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