Wheat buns

Iwas looking in my pantry tonight and came across a totally useless item. My wife bought whole wheat hamburger buns.

I was looking in my pantry tonight and came across a totally useless item. My wife bought whole wheat hamburger buns. I imagine there are people somewhere who prefer whole wheat buns, but I don’t know any of them. I grant you that whole grain breads are healthier than white bread. If I were really all that concerned about my health, I wouldn’t be eating a hamburger in the first place.

The really painful thought is that my wife thinks I look like someone who needs more fiber in his diet. Whole wheat hamburger buns are something I don’t really want, but they are probably good for me. Intellectually, I know these buns are good for me and that they taste just fine, but when I go to the store, I do not buy them. Emotionally, I feel like an old codger who needs more fiber when I buy them.

In dentistry, we provide many services that people don’t really want. If we better understand how people make decisions, we will be able to influence more people to accept our services. Unfortunately, most dental schools have taught us the wrong way to go about this. We are taught that the key to case acceptance is patient education, while the reality is that case acceptance is driven by the patient’s emotional connection to the treatment plan.

There are three steps to improving our patients’ emotional acceptance of their treatment plans. The first step is to understand how patients make decisions. The formula for the decision-making process is F + R = D. This means people use facts plus their reasoning to make the decision. The interesting point is that 90 percent of a decision is based on emotional reasoning and only 10 percent is influenced by facts. In fact, we most often use facts to rationalize or support our reasoning. This is exactly what happens when you discuss a procedure with a patient, and the patient suddenly latches on to a single point as the justification for avoiding treatment.

This happened to me recently. A patient walked in with an infected, partially impacted, lower third molar. Of course, he had been referred for extraction many times. Even though I explained that the infection could become life-threatening, the patient adamantly refused to have an immediate extraction because he would not be completely recovered in time for his trip to Las Vegas later that week.

Once you understand how emotions influence the decision process, you can move on to Step 2, which is to develop systems that allow you to uncover your patient’s emotional motivators and concerns. The main system involved here is the preclinical interview. If I had asked the right question of the patient planning the Vegas vacation before I began to discuss treatment, I would have understood how to motivate him to accept this very necessary treatment. If you ask the right question, you can craft a response that will support the patient’s emotional needs.

In dental school, we are taught to “educate” our patients. Unfortunately, we pattern our patients’ education after our own dental education. It has been estimated that as first-year dental students, we must increase our vocabulary by 13,000 words. Most of us use these dental terms all the time, even though they have almost no emotional impact on patients. While we absolutely must educate our patients, they will not hear us unless they first hear that we will support their emotional needs. The technique for this is to present treatment using the format of benefit + procedure + features.

For my patient who delayed the extraction, the treatment presentation should have gone something like this: “So that we can be certain your trip will not be disrupted, we need to see if we can get this tooth extracted today.” Once you get some agreement on the course of action, you can then describe the features of the treatment and provide the proper patient education.

The emotional motivators and concerns of patients always fall into just a few categories. Usually, people are motivated by pain, fear, health, money, image, or time. We must ask the proper questions and understand our patients’ motivators if we want to influence them to accept treatment. Often, the obvious motivator does not really resonate with an individual. That is why we must ask. In the wheat bun example, the motivators were health and image. My patient was concerned with pain and time. If you understand the decision process, discover the proper motivator, and support the emotional motivator with the proper verbal skills, your treatment plan acceptance will skyrocket.

Dr. Michael Gradeless, a 1980 graduate of Indiana University, practices preventive dentistry in Indianapolis with an emphasis on cosmetics and implants. He is an adjunct faculty member at Indiana University, where he teaches the Pride Institute university curriculum of dental management. He also is the editor for the Indiana Dental Association. Contact him at (317) 841-3130 or e-mail drmike44@aol.com.

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