Practicing under the influence

Nov. 1, 2000
You`ve heard this all your career and it`s true: "Inform before you perform." Patients need to know what`s going on. But be aware that "inform before you perform" is a consent issue, not an influencing technique. Don`t confuse consent and influence. Early in our careers, we didn`t know about influencing patients. When patients accepted treatment, we assumed they said yes because of the information we provided them.

Paul Homoly, DDS

"Knock, knock."

"Who`s there?"

"Lena."

"Lena who?"

"Lena little closer and let me tell you about influence."

You`ve heard this all your career and it`s true: "Inform before you perform." Patients need to know what`s going on. But be aware that "inform before you perform" is a consent issue, not an influencing technique. Don`t confuse consent and influence. Early in our careers, we didn`t know about influencing patients. When patients accepted treatment, we assumed they said yes because of the information we provided them.

Where we get into trouble is when we think that if a little informing sells low-fee, single-tooth dentistry, then a lot of informing should work when offering complete-care reconstructive dentistry. Put another way, the principle holds: The more you perform, the more you should inform. But this is not the way complete-care dentistry works. Complete care requires more influence than information.

Patient education, consent, and influence overlap. Consent is the information that outlines the benefits, risks, and alternatives to care. Patient education provides instruction for patients to maintain dental health. Influence means motivating the patient to appreciate and want the benefits of care.

Patient education, consent, and influence include elements of each, but they also have individual strengths: consent informs, education instructs, influence motivates. When dentists don`t understand how to influence, they substitute information and instruction and hope these elements will influence patients to accept complete care. Instruction and information are not substitutes for influence, just as influence is not a substitute for instruction or information.

Let me sell you the solution

In many of my clients` offices, adult patient education has evolved into a selling technique. The education process creates deficits. To remove those deficits, there`s a price. In Dentists: An Endangered Species, I termed this process: "You`ve got a problem, let me sell you the solution."

Imagine walking into a fitness facility that offers fitness and diet-screening for a reasonable fee. You`d like to be fit, so you decide to do it. The young, hard-body saleswoman takes you through the fitness and examination process and lets you know you`ve got some real problems. You sense her disappointment when you can do only two pull-ups. You catch a certain edge in her tone of voice as she measures your body fat.

You hope the torture is over, but then she sits you down in front of a videotape. For 15 minutes, you watch young athletes flex their muscles, all the while she reminds you that this is not you. The saleswoman takes a picture of you in your gym trunks. Then, she uses a computer-imaging program to remove your love handles and tuck your tummy. "This is how a healthy body looks. Now what are you going to do about it?" chides Miss Hardbody.

Would you feel better or worse about yourself after this experience? Would this process raise your fitness IQ and make you want to be more fit? How would you feel about the saleswoman? Would you be ready to plunk down your money to shut her up?

It seems that too much of dental patient education is a sales tool that degrades patients to create deficits that weren`t there when the patient walked into the office. Then, we hope patients will open their wallets just to shut us up!

To sell complete dentistry to your patients, you need to influence them. Dentists are trained in consent issues and patient education, but most of us are not trained in influence. Consequently, we offer a lot of information and education ... and hope it will influence our patients to accept complete dentistry.

Most case presentations I see for complete dentistry are exaggerated forms of consent. However, a lot of consent does not equal influence. Informed consent and patient education are issues that appeal to our patients` logic; influence appeals to their emotions. Case acceptance for complete dentistry requires both.

Dr. 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 e-mail at [email protected]. Visit his Web site at www.paulhomoly.com.

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