Situation:

You know you are telling patients what to do, it is not a conversation, and you aren’t getting the results you would like.

Desired Result:

Mutual trust, respect, and understanding.  Leading to more credibility, better relationships, and acceptance of care.

How To:

There are three basic modes of listening:

1. Competitive or Combative Listening happens when we are more interested in promoting our own point of view than in understanding or exploring someone else’s view. We either listen for openings to take the floor, or for flaws or weak points we can attack. As we pretend to pay attention we are impatiently waiting for an opening, so we can say what we know.  The other person does not feel heard or understood.
2. In Passive or Attentive Listening we are genuinely interested in hearing and understanding the other person’s point of view. We are attentive and passively listen. We assume that we heard and understand correctly but stay passive and do not verify it.  This can lead to assumptions, misunderstandings, and confusion.  It is important to clarify and verify so the other person knows you do understand.
3. Active or Reflective Listening is the single most useful and important listening skill. In active listening we are also genuinely interested in understanding what the other person is thinking, feeling, wanting or what the message means, and we are active in checking out our understanding before we respond with our own new message. We restate or paraphrase our understanding of their message and reflect it back to the sender for verification. This verification or feedback process is what distinguishes active listening and makes it effective.

Here are the keys:

First, listen without interrupting the speaker, pay close attention, do not let your mind wander.  Other people find this flattering and will think more highly of you and respond to your attentiveness by being more open.  You build trust and respect by listening, not by talking.

In addition to listening without interrupting, give the speaker a few verbal and non-verbal cues every now and then to indicate you are listening. Be active rather than passive. Indicate that you are totally engaged in the conversation.  This can be done through body language (nodding, eye contact, and leaning forward) as well as simple phrases such as, hmmm, really, tell me more…

The third key to effective listening is to question for clarification. Never assume that you understand what the person is saying or trying to say. Instead, ask, “Let me see if I understand you correctly” or “what I heard you say was…“ If you do not understand or don’t have it right, the speaker will correct you.

Finally, if you are not sure you understand the speaker or want further explanation, say “Can you explain that again?”  This is a powerful question.  It is almost impossible not to answer. When you ask, “Can you explain that again?” the other person cannot stop giving a more expansive, extensive answer.

Situation:

Doctor finds it difficult to get in the hygiene room, do an exam and stay on-time.

Desired Result:

The doctor and hygienist collaborate on the patient evaluation and co-diagnosis, resulting in a more thorough exam and a higher acceptance of treatment recommendations.

How To:

The doctor’s goal is to arrive in the hygiene operatory during the first 20–30 minutes of the patient appointment.  Do not wait until the last 10 minutes of the appointment or until the hygienist is completely done polishing.

It is very important that the doctor greets the patient with a “Nice to see you!” statement, not a “How are you?” question. Making a statement, rather than asking a question, allows the Doctor to have control of the conversation. For example, the doctor could start with “Good to see you Jim!” and ask the hygienist “How is Jim today?” (This is the cue for the hygiene handoff to begin. Doctor does not say “What did you find today?”) Wash and glove while the hygienist shares information, then sit in the Doctor chair. The Doctor evaluates the patient while the hygienist is speaking.  The hygienist is positioned to assist with air and water during the exam.

 

The exam begins with the hygienist making a positive comment about the patient’s homecare or visit.  The next step is to update the doctor on new personal information (so the patient does not repeat what they told the hygienist to the doctor, using valuable exam time). The hygienist reports her clinical findings as the doctor evaluates of the mouth.

Jane Hygienist: “Jim’s health history has been updated, his blood pressure reading was 124/79, his last set of radiographs was June of last year, we discussed taking a full mouth view at his next hygiene visit. The gum tissue is healthy, he has been flossing more.  We discussed that you might recommend a crown to replace the large rough and cracked filling on — 30.”  I did a shade check at his last hygiene visit and his color is changing slightly so we may want to consider whitening as well.”

Doctor: “Yes, I see your concern regarding — 30 and I agree with your analysis.  Jim, because I know you have a busy work schedule, I would hate for this tooth to break at an inopportune time. To avoid more complex and more expensive treatment, I recommend that we schedule for the crown on — 30, it is here on the lower right. The longer you wait, the more likely it is that you will need other, more expensive, treatment. Let’s get this taken care of while we can plan it. Jane can you print the picture and explain the crown procedure to Jim. If he wants to begin whitening get him set-up to do that before we begin the crown.  Jim, I would like to see you within the next month for that crown, I don’t want to wait too long.

Also taking the full mouth view x-rays at the next hygiene visit will allow us to check on how the new crown is doing, so let’s plan on that and for me to review those x-rays with Jim at the next hygiene visit.  Thanks Jane.  Good to see you Jim,” (this is the time to make a personal comment or reflect on the personal information the hygienist shared now that the exam/evaluation is complete).

Situation:

The dental assistant’s role in greeting and seating the patient.

Desired Result:

A patient greeting that is friendly, inviting and lowers any patient anxiety.

How To:

A warm greeting, a genuine smile and a courteous handshake are an important part of the dental visit.  This orchestrated opening sets the tone for the appointment, introduces the team member and encourages an open discussion of the patient’s expectations and fears.

• The dental assistant enters the reception area and walks up to the seated patient. The assistant looks the patient in the eyes, smiles and using the patient’s name, makes an introduction.

“Mrs. Jones, Hi my name is Kim, I am Dr. Adams dental assistant and I will be working with you today.” Shake the patient’s hand. “It is nice to meet / see you. Please follow me.” Make small talk. “Did you have any trouble finding the office or parking today?” or “The weather outside is frightful, are you staying dry today?”

• Escort the patient to the clinical area and seat the patient.  While making eye contact, the assistant says to the patient:

“Mrs. Jones, your chart shows that we are doing a crown on tooth — 2 today and a tooth colored filling on tooth — 3.  Do you have any questions about your treatment before we get started?”

• The patient may have a question or two which the assistant readily answers. Next, she makes the patient comfortable, offering relaxing music, a neck roll or lumbar support and a blanket. Now she can place the protective bib and applies a topical anesthetic to the treatment area.  When the doctor enters the operatory the assistant says:

“Dr. Adams, I have everything ready for the crown prep on tooth — 2 and the composite on tooth — 3, and Mrs. Jones is comfortable and ready to get started.”

• Then the doctor greets the patient, gives anesthesia, and returns in a few moments to begin the procedure.

Situation:

You want your patients to know you accept patient referrals (no, they just don’t know—many physicians and other healthcare offices are closed to new patients).

Desired Result:

To consistently attract quality new patients from other patients by asking for referrals.

How To:

In order to generate more patient referrals, focus on providing excellent customer service, a great patient experience and quality dental care.  Don’t be shy about pointing out the great care they received.  Help them know they made a good decision to go ahead with treatment and they will receive the results they are looking for (i.e. beautiful smile, long lasting restoration, conservative care etc…).

One effective method of asking for referrals is to “fish for compliments”. When a patient has a fabulous dental experience, ensure that you “get the word out” by asking them for a referral.

Here are the 5 steps:

1. Ask your patient an open-ended question that will lead to a compliment.
   “So what did you think of today’s visit?
2. Accept the compliment graciously and make a values statement about the practice.
   “I’m glad to hear that! We work very hard to make certain we keep our patients comfortable and relaxed. And you’re right, we do have fun!  I’m glad you enjoyed your visit with us.”
3. Transition Statement
   “Many people avoid dental visits out of fear. They don’t know a visit to the dentist can be enjoyable!”
4. Ask for the referral
   “If you know of anyone who might benefit from a visit to our office, please let them know about us. We’ll take great care of them!”
5. Thank the patient
   “Thank you again for the nice compliment, it’s nice to know we are doing a good job.”

Asking for referrals is not begging for patients. It is a subtle way to let patients know about the excellence you provide and how important they are to your practice. Start fishing for compliments and watch new patients call your office.