Patient communication: In modern dentistry, in addition to professional competence, communication with patients is of great importance. Effective communication makes it possible to understand patients’ concerns, provide them with relevant information and involve them in decisions. It is important to understand clinical, social and emotional needs and to be able to adapt to them. In this article, MDT Marie Witt addresses the changes that characterise “today’s patients”. Based on her experience, she describes how her work has changed because she focuses on a well-founded communication concept when talking to patients. The experienced master dental technician shares her expertise.
MDT Marie Witt
The patient in the age of medialization differs in many ways from the patient of earlier times. As digital communication and media consumption change (e.g. through social networks), people orient themselves and adapt. This has an influence on the dental and dental technical work and the handling of the patient, e.g. during information or counselling interviews, patient consultation…
Patient communication: changes and the “patient of today”
Todays patients are better informed; it is initially an open question whether the knowledge is always technically correct. Patients actively inform themselves regarding treatment options and alternatives. dr Google is the new encyclopedia; here the patient can find almost everything. Depending on how meticulously researched, the information is more or less productive. Patients today often have higher aesthetic demands, e.g. shaped by “role models” in social media. In addition, a large number of patients attach great importance to health prevention, e.g. healthy nutrition, sport, work-life balance, dental prophylaxis, etc.
And even if a lot has changed, one thing is still the same: the patient’s fear or discomfort when visiting the dentist’s office. In 2002, the DGZMK (German Society for Dentistry, Oral Medicine and Maxillofacial Medicine) spoke of only 20% of patients who were not afraid; this number is unlikely to have changed significantly. This means that 60% to 80% of people associate a visit to the dentist with anxiety.
These are by no means all the challenges that patients present to us in the dental practice and dental laboratory. There are also, for example, “aesthetics patients” who would like to have their new smile fulfilled. In addition, the patients are to be differentiated in their decision-making authority. Many consciously make their own decisions; others don’t want or can’t do this and need our help. And in parallel to the changes in patients, dentistry has also evolved, today it is significantly more minimally invasive than it was a few years ago.
The new aesthetic dentistry
The self-determined “patient of today”
From my own professional experience, I know that patients in everyday work – both in the dental practice and in the dental laboratory – demand our full attention. This is not always easy. Because not only clinically, but also emotionally, we encounter patients with very different concerns: fear of a treatment, high aesthetic demands, functional problems and the resulting complex complaints, the desire for straight and/or lighter teeth, toothache, dissatisfaction with an existing restoration, etc .- the list is long.
Squaring the circle or how we manage to take into account the challenges in the consultation or information session and also be efficient. The solution: make those affected involved. Human dignity, means having the right to choose.
Patient communication: breaking new ground
The “patient of today” therefore demands a higher level of attention. This is associated with a change of perspective in patient communication. The medical literature is there. And it’s not a potpourri of phrases; Rather, it is about psychologically sound communication models that not only sound good in theory, but are practically applicable. These not only provide us with linguistic finesse, but also convey concrete skills in order to adapt flexibly and individually to the conversation with the patient.
Integrate concepts efficiently
We need a communication concept for the patient consultation in addition to clinical and technical work concepts. In order to understand patients during conversation and respond to them in a suitable manner, it is important to know the basic facts of communication. The communication square according to Schulz von Thun and the typology of the patient according to the Riemann- Thomann model bring individual communication to the point. This creates an understanding of how conflicts can be avoided in patient discussions.
When I think about it, one thing has become clear to me personally in the many discussions with patients over the past few years: If we don’t understand the patient’s emotional history, it will be difficult for us to understand their dental history. The emotional and dental stories are inextricably linked and should be heard. Many patients have a keen sense of whether we are listening or whether we are pretending to be listening.
Would you counsel yourself the way you counsel your patients? An example is the active passive body language that the patient intuitively pays attention to. This thesis comes from the specialist literature on the subject of “conversational skills”.
Efficiency and good conversation skills are not mutually exclusive, quite the opposite.
Basics for an efficient patient consultation
The time for a consultation is limited in everyday practice and laboratory work. But it happens again and again that patients cannot follow our explanations and ask the same questions several times. First of all: Efficiency and good conversation skills are not mutually exclusive, quite the opposite. A good conversation structure is based on time management. But how do we properly conduct an efficient conversation? The first step is to set the framework for the discussion. Where can I talk to the patient undisturbed. In the dental practice, this can be the treatment room. In the dental laboratory, the conversation should take place in a separate room; a place where we can be undisturbed with the patient. The next step is the basics, the interview techniques. For many, the topic is new. It was for me too. But once applied, I suddenly noticed a real change in the patient. The fact is that the patient had not changed, it is simply that our communication had improved. A confidential basis is created. “Tools” for this are solid discussion techniques, such as e.g. E.g.: active listening, motivating conversation, meta-communication, and of course empathy for the other person.
When I think about it, one thing has become clear to me personally in the many discussions with patients over the past few years: If we don’t understand the patient’s emotional history, it will be difficult for us to understand his dental history. The emotional and dental stories are inextricably linked and should be heard. Many patients have a keen sense of whether we are listening or whether we are pretending to be listening.
The result of good patient communication
Based on the information collected, the patient either makes a decision themselves or feels that a competent team is helping them and that a decision is being made in their interest. In turn the patient gains trust. We speak of “shared decision-making” or “participatory decision-making”. We used to try not to make any decisions for the patient. We avoided making a decision for the patient or with them. Because we did not want to hear: “You didn’t understand me correctly. That’s not what I had in mind.”
What I wasn’t aware of at the time: there are different types of patients and each type requires a different level of communication. Today it is clear to me that the conduct of conversations and the establishment of communication always depend on the type of patient and that one should get involved with it. Because in order to be able to successfully complete a restorative therapy, the cooperation of the patient is essential.
Dr Ellen Langer, Professor of Psychology at Harvard University, writes on the subject of decision-making: “People want a reason for their actions.” A simple “because…” is necessary and often sufficient. The patient then shows a cooperative behavior within the framework of the therapy: compliance. In addition, the focus is also on the cooperation and co-responsibility of the patient: adherence.
Last but not least
“Change your perspective of the patient” … that’s the headline of the article. A few years ago, I personally realized how important it is for my work and patient communication to understand the patient’s perspective. Dental technology is a medical trade. We are not machines, we have emotions. And this is exactly what we need when we work with and on people; “Fellow men”. Situations often arise in which nagging and dissatisfied patients sit in front of us. You may know this; there is this one patient case that has stuck in your mind for years. Here the spiral of the negatively escalating way of communicating with each other was the reason why the restorative therapy could not be completed or could only be completed unsatisfactorily.
Use the opportunity for a change of perspective! Break the vicious circle. Communication difficulties are not caused by an individual, but by the interaction of the people involved. In everyday life, we often only react to conflicts. However, it is better to act. I therefore prefer to take action myself, find out what has upset the patient and actively adapt to them.
What I wasn’t aware of at the time: there are different types of patients and each type requires a different level of communication. Today it is clear to me that the conduct of conversations and the establishment of communication always depend on the type of patient and that one should get involved with it. Because in order to be able to successfully complete a restorative therapy, the cooperation of the patient is essential.
Conclusion
It has become essential for me to be able to access well-founded communication concepts. These save us time in our everyday work. They allow a structured approach. Incorrect communication due to missing facts is minimized and valuable working time is saved. Tedious adjustments or new products can be reduced or almost eliminated. From today’s point of view, I would not want to do without my knowledge in the field of patient communication. And the patient? Of course not them either. The interpersonal trust is the reward for the effort and this is also communicated to the outside world. The word-of-mouth recommendation is a respectable side effect. Today we talk about marketing; To put it even better: the marketing of the modern age.
Author:
ZTM Marie-Luise Witt, smile@ztm-marie-witt.de
