Mastering the art of communication

3M Dental is proud to sponsor the Dental Economics year-long "Mastering the Art of Communication" series.

Part 1

Communication is not "telling," and the ultimate goal is to create relationships.

3M Dental is proud to sponsor the Dental Economics year-long "Mastering the Art of Communication" series.

Sandy Roth

Last summer, I had the opportunity to facilitate a think tank meeting of oral surgeons and periodontists who were invited to share the keys to their success. Because this group was so clinically-oriented, I was astonished when literally every participant chose communication and relationship building as his or her focus. It was exciting to see these strong clinicians recognize the importance of behavioral aspects of dentistry and attribute a major part of their success to these factors.

Clinical skills alone are not enough to make a practice successful. The keys to success include:

* Strong leadership and management by the dentist and his or her leadership and management team.

* A group of skilled individuals who have learned to work together as a team.

* Strong, healthy relationships with patients.

Each of these factors springs from the ability to communicate well. In fact, effective communication is probably the most fundamental determinant of practice success. Dentists who are poor communicators are ineffective leaders and managers. High functioning teams cannot exist when the members fail to communicate well with one another. Healthy patient relationships are dependent on open and honest communication as well.

If communication is so important, why is it that so many people have trouble with it? Almost no one would disagree that strong communication skills are essential, yet there often is a great deal of misunderstanding about what those skills actually entail. Perhaps it is because we tend to think of communication as a skill that involves talking and choosing the "right" words. When dentists are frustrated by problems with their patients, they often think that if they had some better words those problems would go away. A great temptation is to turn to packaged scripts when lacking confidence about verbal skills.

This strategy, however, does little to improve communication. Good communication skills don`t come from scripts that provide the right words to say. In fact, good communication skills may not involve saying anything at all. One thing is for certain: Communication is not telling.

Communication in a health-related practice has two components: (a) representing yourself authentically and confidently and (b) learning about others. The goal of communication is to learn where and how you connect with others and identify differences where they exist. When this is done, you will know if and how a relationship can be built. Thus, the ultimate goal of communication is to create relationships.

Communicating with authenticity and confidence

It is difficult to represent yourself effectively if you don`t know who you are, harbor uncertainty about what you believe, or lack the confidence to reveal yourself to others. Mere words are hollow and meaningless in the absence of authenticity. But when one has gained personal clarity, words flow more naturally. Most people who have serious communication problems are basically unclear about how they feel and what they are thinking. Perhaps they haven`t taken the time to reflect on their own values, beliefs, or style. Whatever the reason, if they can`t sort out their confusion or murkiness, they are likely to remain quiet.

When the dentist is noncommunicative, the entire practice suffers. Expectations are rarely clear, feedback is virtually nonexistent (except "the look" which is often an expression of displeasure), and the practice can thrash about like a headless entity. No wonder staff members are confused about what to do or how to represent the practice. On the other hand, when team members are unclear about themselves, they have a tendency to become highly reliant on the dentist to tell them what to do, when, and how. They can withdraw and contribute little beyond the bare minimum, becoming more of a burden than an asset. These team members might become significant contributors, but not until they become strong enough to develop their own skills.

Giving unclear dentists and team members a package of nice-sounding words won`t help them communicate better. Personal clarity is their first step. Similarly, timid people, be they dentists or team members, are frequently awkward communicators since they lack the confidence to express themselves. They often feel fearful that others will overtly disagree or disapprove; so they say nothing rather than run the risk of exposure or feeling foolish. These people need a safe environment in which they are encouraged to gradually express their thoughts and feelings without encountering judgment or disapproval. Confidence builds as a result of these successful events. They can develop a mastery of important communication skills through practice, practice, and practice. Because most dentists are introverted in their style, team members may be called on to help him or her become more revealing by asking questions and encouraging more open communication.

The Guided Team Meeting my friend Terry Goss and I have created to accompany this article will help you learn how to support people in expressing who they are. We encourage you to use each of the Guided Team Meeting exercises that will accompany this series because learning doesn`t occur unless you actually take some action. Reading will only help you understand a concept.

Learning about others

The process of learning has four distinct steps: Curiosity, which leads to asking questions, which requires listening, and is followed by clarification. The best communicators are also the best learners, and learning requires an active curiosity. If you are curious about an issue or other people, you will be more inclined to seek information by asking questions and listening with focused interest. You can`t fake curiosity and interest for very long. Therefore, authenticity is an important part of learning. The final step in learning about others is clarification to ensure that what you heard is what was intended.

Thus, effective communication is both a process and its result. The goal is to create relationships that are based on understanding and clarity. Perhaps this way of looking at communication explains why so many cookbook approaches don`t work. These strategies suggest that people can become good communicators by memorizing a set of pat quips and answers without regard to the uniqueness of the situation or the people involved. When you memorize and regurgitate the "right" words from a script, the "right" words for one situation may be very "wrong" for another.

In addition, scripts can leave you without a response if the other person takes an unpredictable turn or responds in a way not anticipated by the formula. Communication is not a one-direction process. It happens when there is a free-flowing interaction between two or more parties.

Many dentists, hygienists, and other team members believe that a major part of their job is to educate their patients so that behavior will change. Naturally, they want their patients to take better care of themselves, act on what they know, and engage in preventive behaviors. As a result, they often look for better ways to say what they want their patients to know, usually with an aim to influence, cajole, or perhaps even manipulate - thus, the traditional dental lecture at checkup time.

Yet, there is abundant evidence that information alone does not change behavior. Each year, many people drink and drive, get into their cars without putting on a seat belt, and smoke cigarettes. They do all of this and more in the face of mounting evidence that these behaviors are harmful and potentially life-threatening. What makes us think that dental messages will be received any differently? This perspective fails to acknowledge that communication is about forming relationships, not simply telling.

Frankly, if information alone was an effective way to change behavior, more patients would be healthier by their own hands. I suspect most of you can list many patients who have heard what you said but who have not changed their behavior. Although information, imminent disease, or breakdown might be motivating to you, your patients will often not respond in similar fashion even when presented with glossy brochures, video lectures, and reprints.

The first job of every staff member, then, is to communicate by asking questions and listening so that healthy, functioning relationships can be built with patients. Asking questions and listening helps patients express what they want and why they want it. This process helps people arrive at the best choices for them. What makes a choice good? When it makes people`s lives better. Almost without exception, people are more likely to act on what they know when they can relate how those choices will improve their lives. If they believe that acting on information you relay will have a positive outcome for them, they are more likely to take action than they would if they relied on your educational approach without personal assessment or evaluation.

I`m not suggesting that no information be conveyed to patients. On the contrary, giving patients information (telling) is very important, but timing is everything. Of course, patients want your thoughts, opinions, and recommendations. But your comments are more meaningful when they are delivered in the context of a relationship that is based on mutual understanding and respect. Even then, you must relay information only when the patient is open to hearing it. If patients have shut you out or closed down for any reason, you are wasting your breath. If you dispense information prematurely, the patient won`t be ready. If you withhold it too long, the patient can feel frustrated and unheard. That`s what makes good communication an art form.

Throughout the year 2000, 3M Dental, Dental Economics, and I will take you on a journey to explore important aspects of communication. Join us each month, and we will help you create a more successful practice with integrity and character. We`ll wind our way down a trail that will lead to a mastery of communication through skill building and application.

Who wants to become a better communicator? Everyone! So join us for a great year of learning.

For more information about this article, contact the author at (800) 848-8326.

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