By Paul Homoly, DDS
"Knock, knock."
"Who's there?"
"Armageddon."
"Armageddon who?"
"Armageddon out of here if you're gonna cry!
Many dentists become uncomfortable and are not sure what to do when a team member or patient starts to cry. Tears - your own and others - are part of the practice of dentistry. Knowing what to do when the tears start will make you a better dentist.
I remember speaking to a group of oral and maxillofacial surgeons, when one of them (a man, of course) asked the question, "What do you do when a patient begins to cry during case presentation? It really irritates me when this happens. I wish they'd just get to the point without all the emotion!"
My response was that crying is the point. We need to understand that emotion - and lots of it - accompanies the practice of dentistry. Expressing that emotion - whatever it is - is a choice that patients make. The question by the oral surgeon is revealing, because it suggests that crying is an unreasonable act and dealing with it is outside the job description of the dentist. Think about this: If you don't think patients should be able to cry about their dental health, then maybe you don't think your dentistry is as important as you say it is.
Standard of Caring
The best dentists and team members exhibit a high standard of caring. Standard of caring is an awareness of and competence in gracious, supportive, and constructive re sponses to strong patient emotions. Crying is one way that patients express emotion. Standard of caring in response to crying often requires that you get out from under your emotional hiding places.
Get in touch with how your patients feel. When you do, this often makes the most legitimate and constructive response easier. Let me be quick to add here that I'm not suggesting that you over-sympathize. This would disable you. I'm suggesting that if you want to practice on the leading edge when it comes to a high standard of care, then you must be on the leading edge of the standard of caring.
What to do
Here are a few insights on what to do when a patient cries:
1. Remain quiet and listen. Fight your urge to offer solutions. Don't minimize the patient's feelings by saying that there's nothing to cry about. If you don't want to upset your patients, don't disagree with how they say they feel.
2. Silently offer the patient tissues.
3. Appreciate the insight you're gaining about how your patient feels about his dental condition or situation. Emotions strong enough to bring on tears are emotions strong enough to make treatment impossible if left unacknowledged and unsupported. When you recognize and acknowledge the strong emotions associated with a patient's situation, you're very close to understanding how to best communicate the benefits of care. Clearly, communicating the benefits of care leads to case acceptance and relief of the patient's "disability."
4. Empathize and appropriately continue your conversation. Phrases like, "I'm sorry ellipse," "I understand ellipse," and "It must be difficult ellipse" are good lead-ins to empathetic dialogues. By letting the patient talk it out, he or she will feel more confident about you and be more willing to respect and accept care from you.
5. Your ability to respond and support patients during moments of tears foreshadows to them how you'll respond to future emotional events. Complete-care dentistry requires strong clinical and behavioral skills. If your repertoire of skills doesn't include emotional intelligence - empathy, rapport, and acceptance - many patients will not choose to accept your treatment recommendations. To you, their refusal of care looks like low dental IQ. To them, your narrow range of expressive capacity looks like low emotional IQ.
Many reasons exist for people to cry in the dental office. The best dentists have developed broad shoulders to support and nurture the inevitable emotional moments of dentistry. Become a good shoulder to cry on!
Dr. Paul Homoly coaches dental teams to implement reconstructive dentistry through his continuing-education workshops, private consulting, and seminars. This column is an excerpt from his new book, Isn't It Wonderful When Patients Say Yes? - Case Acceptance for Complete Dentistry. Dr. Homoly can be reached at (704) 342-4900 or via email at [email protected]. Visit his Web site at www.paulhomoly.com.
