Have you ever been chair side with a patient that has serious problems and struggled to get acceptance and said to yourself, “If this person knew what I know about what’s really going on in their mouth, they would not hesitate to get it treated today”?
That thought leads most dental professionals down a deceiving path. We mistakenly think that people make decisions because of what they “know.” Because of that misconception, it leads us to believe this dental half-truth: “Educate the patient and he/she will do what is in their best interest.” While there is some truth to that statement (because most people don’t make a decision out of ignorance), it is only part of the truth. If it were 100% true, there would not be any overweight physicians who smoke! They know better and yet they don’t do better. Why? Because there is something far more powerful at play than just what we know. The real truth is that we make decisions emotionally at first and then justify that emotional decision with logic. Even if that emotional decision is a split second gut reaction that only takes seconds, the brain usually follows that instinct and immediately begins to collect data to validate the initial reaction. So with that being the case, how do you combat the common new patient remark: “I just want my teeth cleaned”?
Want vs. Need
“I don’t want exam.”
“I don’t want X-rays.”
“I just want my teeth cleaned”.
Why do patients say these things? The problem rests in the scientific model, which lays out this sequence: Diagnose, create a treatment plan, present, and then treat. While that sequence might work for science, it flies in the face of everything we know about human psychology and decision-making. The reason people “just want a cleaning” is because they don’t want any more problems than they already have! Imagine going to get your local auto shop “to just get your oil changed” and the mechanic says, “While you’re here today we would like to do a complete and comprehensive analysis of all the systems in your car.” You would most likely grab your wallet and run! That’s not what you wanted—you just wanted your oil changed!
The fact remains: We do what we want to do, not always what we need to do. The scientist in you wants to do an exam so you can diagnose. Your patient just wants their teeth cleaned. So how do we marry these two divergent worlds?
Start by meeting the patient where he/she is and finding out what is really wanted. Everybody wants something. Even the most seemingly unmotivated patient is motivated to be unmotivated. So before you start pushing your scientific agenda, it might be wise to find out what their agenda is. If they just want their teeth cleaned, do you know why? Here are some specific questions you may ask:
“Different people have different reasons for getting their teeth cleaned, Mr. Patient. What is your most important reason?”
“What’s the most important thing to you about getting your teeth cleaned?”
Then, listen very carefully to what they say. Is it the feeling of having clean teeth? Peace of mind knowing they are doing what they are supposed to be doing? Or is it because they want to keep their teeth for as long as possible? If you ask the right questions and listen, there will always be something in what they say that will indicate what they really want. Remember, it’s not the cleaning they want. It is something that the cleaning will do for them that will lead to having a discussion about the bigger picture.
Helping Patients by Asking the Right Questions
My good friend and co-presenter of No More Hygiene: The Secrets of Modular Periodontal Therapy, Dr. Thomas Nabors saved the life of one of his patients by determining her why. Read on as Dr. Nabors shares his experience:
As our practice has made the journey from a teeth oriented practice to a body oriented practice, we have had some amazing people stories. Not patient stories as I think sometimes we loose perspective as healthcare providers by grouping people as patients. Patients are who we work on, or fix. Often, not having the time, or taking it to realize the person connected with our job. Or, perceived as procedures for the day as opposed to humans we can help.
As one of our hygienists found out, by paying attention to the person and not their oral cavity, a life was saved. “Sue” came to our practice as a new patient as she had not seen a dentist in a few years. Her health history read as many adult patients does, history of some type of cardiovascular problem she really can’t remember that she may have pre-medicated in the past for, a history of asthma, a history of high blood pressure for which she no longer takes medication for.
Rather than take that at face value and move on to dental history, more questions for Sue followed. The primary one was “Tell me more about that.” So, then we found out that Sue has been on disability for asthma for years. She had a history of radiating left arm pain that her primary care physician attributed to the asthma, and she was on different medication for high blood pressure that never really seemed to help. But, she did see her primary care physician regularly.
For us, the arm pain, the lack of asthma improvement, and the up and down blood pressure did not add up. Rather than proceed with dental care, we referred her to a cardiologist. Several weeks went by and out of nowhere, I got a call from a cardiac surgeon, who told me that Sue would have died on a heart stress test. She was in right heart failure and would have certainly passed away if she had stayed on the path she was on. He could not believe it was her dentist and dental team that got Sue to the right place and paid attention to the whole picture. He simply called to thank me and congratulate me for doing such a great job.
Sue spent months in therapy and, thankfully, is on the mend. She see us now as a patient and has referred patients to us with a simply message that they tell us when they come in: “We are coming here because you saved Sue’s life.”
So just remember this: People do things for their reasons, not your reasons, and behind that reason is a justification for how they feel about something that is very important to them. They are in your chair for a reason. Find out what that reason really is and how they feel about it. Then you can genuinely help them get what they want.
Steven J. Anderson is the founder of numerous dental organizations including The Total Patient Service Institute that specializes creating high performance, case acceptance dental teams. For dates and locations of the next Total Patient Service “Total Immersion” experience, log onto www.totalpatientservice.com or call 1-877-399-8677.