Getting to Yes

Nov. 1, 2010
Last month, I shared how our behavior toward patients is often based on the assumptions we have formed about them.

Frank M. Spear, DDS, MSD

For more on this topic, go to and search using the following key words: behavior, notions, continuing education, self-confidence, action, Dr. Frank Spear.

Last month, I shared how our BEHAVIOR toward patients is often based on the assumptions we have formed about them. For example, "This patient has only sought reactionary care or very basic proactive care in the past, so that's all we should expect and offer them in the future."

Our preformed notions limit us as clinicians and prevent our patients from seeing their possibilities. Shedding these beliefs and treating every patient encounter as a new opportunity to discover who the patient is and what he or she really seeks is a great first step toward finding the patients we want in our practice. But it is by no means the end of our efforts.

As the knowledge and skills of dentists develop and become more focused through continuing education, our competence and self-confidence grow. As this growth occurs, we begin to see new possibilities for helping patients with treatment options that we never saw or discussed before.

This all sounds great, so what's the challenge? It is translating what we see as clinicians into understanding and action by the patient.

Educating patients is absolutely necessary if we want them to accept more discretionary and regenerative care. For many dentists, though, education equates to presenting clinical findings, delivering a treatment plan, and assuming that the patient hearing the findings will understand and desire the plan.

We think, "How could a patient who has come to the office, sat through the exam, and listened patiently to the findings, not follow the logic and take action?" It's simple.

Logic is not what leads people to act; the information must satisfy a why. Knowing does not lead to action unless it is combined with an understanding of the consequences of no action. That ownership of condition and consequence is the why that leads patients to desire the possibility of treatment.

Helping patients to become aware of their unseen problems, understand the consequences if the problems aren't addressed, and see the benefits of treatment are the key steps in motivating patients to choose treatment. Notice I said the benefits of treatment, not the treatment plan.

The treatment plan is a critical step in treatment, but when it is presented before the patient has understanding and ownership of his or her problems and solutions, it can lead to a very frustrating "No" for the clinician.

For myself, the treatment plan is not presented until the patient is aware of the problems in his or her mouth, understands the consequences if no treatment is chosen, and has heard how treatment can change the prognosis. Once patients have experienced the why, then we can show them the how.

We are creating a why moment for the patient at his or her level of understanding and comprehension. But the reality is that, even when we follow the problems-consequences-solution protocol and achieve patient awareness, there is no guarantee that the patient will accept treatment and take action.

Different patients have very different values about their teeth and dentistry. Sometimes what seems so logical to us in our practices has no context whatsoever for patients, who have no value for dental care.

But if we don't educate our patients about their problems, inform them about the consequences, and tell them about the benefits and possibilities of treatment, I can guarantee they won't take action unless they feel or see the problem on their own.

All of us on the Spear Education faculty - Gregg Kinzer, Gary DeWood, Lee Ann Brady, Bob Winter, and I -work diligently with dentists and their teams to help them further develop their observation and diagnosis skills.

We prepare dentists to answer patients' questions, arm them with tools and techniques to follow through with appropriate treatment, and help them find the confidence to interact with patients throughout the process. We work incredibly hard at Spear Education to help dentists find a way to have their patients experience those precious why moments.

As the founder and director of Spear Education, Dr. Frank Spear continues to be recognized as one of the premier educators in esthetic and restorative dentistry in the world today. He and long-time practice partner, Dr. Greggory Kinzer, maintain a private practice in Seattle, limited to esthetics and fixed prosthodontics. Dr. Spear can be reached through

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