I hope you are doing well. Let me restate the purpose of this podcast because it comes out every 4-6 weeks or so. And as a format, I talk longer per session than I do with the Perio Patient Podcast because you, who are listening to this, I assume are interested in this topic professionally. You are a student or practicing dentist or dental hygienist – which I think should give you more incentive to see if there is something here you can put into practice immediately within patient care. Patients listen for a different reason, so I try to make those episodes shorter and a bit more frequent, on topics related to dentistry that hopefully keep them engaged with wanting to interact with our profession at a reasonable and healthy interval. That, to me, would be their benefit for listening.
So, now, the purpose of this podcast is to talk about topics I think are important to the practice of comprehensive dentistry – not in general terms of course, because I don’t have that as my personal area of expertise, but as comprehensive dentistry intersects with periodontics and the management of periodontal patients. By doing this, my hope is to enable these dental practices to receive periodontal patients back following active therapy provided elsewhere and pick up management with confidence. To me, this is a win, win, win with the patients winning the most because they are back with their family dental team and will continue to have high-quality periodontal support. It’s a win for your office obviously because patients are back with you without necessarily having to alternate, except when to do so would be better for the patient as well as you and your team. And it’s a win for me, because I can focus on the procedures I was trained within my specialty to perform and can allow dental hygienists to shine with the great skills they have to care for this unique group of patients effectively and efficiently.
And while I am in this review mode, let me re-explain what I mean by comprehensive dentistry and how it differs at least in my mind from general dentistry. These are my terms – how I define things.
I was a general dentist when I graduated from dental school and started my career in the Air Force first taking a General Practice Residency followed by a four-year assignment as a general dentist overseas. These were important years for me because they were incredibly worthwhile to my professional formation as a periodontist in that they allowed me to understand my focused role in a larger context which I had already for a number of years, personally experienced.
It’s just human nature – which I have a lot of personally – to consider people with different roles I have never lived to be thinking and acting in ways that I think make sense but have nothing to do with reality. But because I have been a general dentist I can understand what I would want my periodontist to do to help me with the problems I was facing. For one thing, if I refer a patient out, I don’t want to lose them. I want them back sooner than later. Also, it would be nice if, when they returned, they were motivated to be better patients than perhaps they were when I referred them out. In other words, I’m very interested in how the patient feels towards me and dentistry in general for having been referred. Obviously, there are limitations to this having to do with individual personalities, but at least I want them happy for having been sent and happy to return. And to the extent possible and practical, I would like these patients to stay in my practice – so if my hygiene team is able and willing to support these patients, that would be great.
So, what is the difference between a general dentist and a comprehensive dentist? Again, these are my terms, so blame me only, if you disagree. A general dentist understands dentistry from their own perspective only. A comprehensive dentist has a broader vision and philosophy that is focused on providing the highest quality care regardless who the particular provider might be – and they are willing to step into the leadership role, be the quarterback, if you will, and oversee the patient’s care in general. As a retired military officer, I appreciate the importance of the General in charge.
Here are some practical attributes of comprehensive dentists. They are comfortable communicating with physicians as well as specialists, not as inferiors, but as colleagues and patient-advocates. Another good analogy to describe the comprehensive dentist within dental care for patients is that they, with the patient are the hub of the wheel. All others, to include periodontists like me and dental hygienists are spokes of the wheel. This is not an ego trip. It is the reality of what is best for patient’s when it comes to their dental care.
Young dentists, and I was one once, are easily intimidated because graduation from dental school may still be very fresh in their minds. Within that context, they were the low people on the totem pole. Graduation may change this a little, but it still may seem that specialists are somehow like their instructors in dental school. Comprehensive dentists have experienced managing their patient care long enough to establish good rapport with specialists and hopefully have found a spirit of cooperation different from dental school. They have continued in their training and have developed a deeper understanding of treatment planning moving from what they did at first in dental school – which was to understand individual teeth, procedures and subjects – to now being able to draw all of this together and better focus beyond a tooth, beyond even teeth, beyond even the oral cavity, beyond medical assessments, and actually get to the point where they see people again – who happen to have mouths and who may need their help. This is a very different approach to patient care, but critical, because people are not typodonts. Here’s something else, as people shed their dental school experiences, they find they no longer have to know everything about everything. That isn’t their job. They need to know enough to ask good questions and put together good treatment plans even when necessary, they are asking specialists to provide input to make the plans even better. The team approach to care is always a better more practical manner of providing quality dental care over the super-dentist model who attempts to do everything themselves.
So, my title for this episode is “To help others you need two things.”
Here’s the situation or context for what I would like to share with you. You are a practitioner of some sort and someone comes to you for help. It’s the new patient you haven’t met who comes with a problem or more they may or may not know about. They are coming to you because you are a healthcare provider that fits with the kind of problem they think they have. I’m keeping it vague because the topic is broad and general in nature. This means, who ever you are, this is useful to you.
There are two things you need in your way of thinking in order to communicate effectively, and we can define the word “effectively” to mean that your communication will most likely be received well and will then move in a good direction toward solving their own particular problem or problems. The solution might be allowing you to provide them some form of treatment or it might be enabling you to give advice or make recommendations.
It isn’t selling them something in the sense that the goal is to get people to buy something. It is helping them and may or may not result in a patient-doctor or patient-hygienist relationship then being established.
So now, of the two things you need in order to help someone, the first one is… are you ready for this? You need to be like them.
Regardless, how you may feel or think about my recommendation, if your objective is to help someone else, this is what you first need.
This may seem obvious or easy. It isn’t. We are talking about a stranger. Someone you do not yet know. And worse? They have a problem or many – and they want you to help them. Also, we are talking about your time. We all have many things on our minds all the time and now this person is stepping in to ask for your undivided attention. To be frank, I often feel a bit annoyed at the thought.
We, generally and automatically like people who like us, or are like us, and we generally are not sure what we think about people we just meet. To be more honest. There are many people we encounter who we either do not like or don’t have an opinion about how we feel about them one way or another. We are indifferent. Distracted. Somewhere else. But what I am saying here, if you want to help people, you can’t start by either not liking them or being neutral about the matter. You have to like them. I am saying this has to be our strong position backed up by our actions, no matter what.
Now, allow me to compound the problem even further within the dental setting. It is not uncommon for someone to come in with fear, or a bad attitude already ready for a fight. It is not uncommon for someone to resent the fact they have to be where they are in the first place. Some of these behaviors can be rationalized based on their prior history, but the truth of the matter is we can’t know everything about strangers, and won’t learn everything fast enough for us to necessarily like them quickly – if we are going to base how we feel about them as a reflection of how they behave. I hope this is sounding more challenging to you than it might have at first, because it is.
The first thing every patient needs from us, is the sense that we like them. We are relaxed. We smile. We greet them in an upbeat warm way. If they cannot get this sense that we are happy they have come, then in all likelihood, we will not be able to help them much if at all going forward.
Well this brings us to the obvious and good question: How can we like people before we even know them?
My answer is we have to be totally comfortable with ourselves first. We have to like ourselves enough to be comfortable within a situation where we are not in complete control. We have to see ourselves in them and understand what it is like to be the stranger in an unfamiliar place, to have problems that are personal and possibly embarrassing, to be afraid – and in spite of all our feelings we have at least had the courage to come see someone we don’t know with the hope they might be able to help.
Empathy is understanding how someone else might be feeling. It isn’t sympathy in that we feel sorry for someone, because that isn’t helpful. Empathy is not only helpful, but necessary, and it involves being connected to our own humanity most of all. So, when I meet a new patient for the first time, I need to have a comfortable balanced feeling in myself. I’m not needy to be liked by them for example. I’m not trying to win their approval. I’m also not trying to be aloof and protect myself from possible negative looks or words from them. I want to be able to be engaged. So again, I want to project the idea that I like them – but, because I don’t yet really know them, I substitute what I don’t know about them specifically with what I know about myself as a person being in a similar situation.
This isn’t always easy. If I’m having a good day – perhaps I just came out of an encounter with someone else who complimented me and I’m feeling happy, then it might be easy to reflect this in this new encounter – but that’s unpredictable.
What if I just came out of a difficult encounter with someone, or I just learned some personal bad news? Will I allow this to care over to this new encounter with a new patient?
What I am describing here is a skill actually – the ability to step into a new encounter with someone and block out other distractions in order to concentrate of this new person. And when I put effort into doing this, what does it look like? Another way to put this is how do I psych up to make sure that I am in-the-moment with this new person – because if I am not, then I will not be able to do what it is I am here to do and the reason they have come to see me – and that is to help them with whatever their problem might be. To me, I focus on liking them automatically, habitually.
You know it’s funny, but often I have information about someone I have not yet met. Perhaps there has been a problem scheduling them on the phone. Perhaps they have cancelled and rescheduled – and this has been inconvenient – even in some ways it has resulted in me thinking that this person will be a drain to the practice financially. If people don’t show up for their appointments or they are difficult on the phone and all the rest, it is easy to be annoyed with them before I have even met them. And let’s say that they are just what I feared – even then, how useful will it be to go in with any chip on my own shoulder? But beyond this, if you can relate by thinking of similar stories in your own life, where you have been preconditioned not to like someone before ever meeting them, is it not true with you, as it has been so often with me, that the vast majority of the time, the result of the meeting is actually a positive one? It’s weird, but I usually feel better about who they are after meeting them than I expected. Not always, but way more often than I expect.
The second thing we need is to know something useful that can be of benefit to the one in need.
We need a skill set. We need what we have trained so long to have for those who need dental treatment.
In this way, we can’t be the same as the one who comes to see us. We have to be different.
So, put the two things we need to be able to help someone and we then can see the tension between the two.
In fact, the two things we need in order to be able to help others are opposites.
We need to relate and be different at the same time.
We have to understand well enough through empathy, but we also have to apply what we have learned in our training and prior experiences to the problems at hand.
I remember a biology professor in college who wanted to relate better with students and he would open his house up for Bible studies. I went to a Christian college. I should have appreciated his efforts to show kindness but found I had trouble with this because he also had the reputation of not being a very good teacher. I didn’t take any of his classes so didn’t know this first-hand, and yet I did not find myself particularly appreciative of his efforts to invite college students over to his home. This bothered me about myself for years. Why was I so judgmental? — until I came to realize that what I really needed from the professor most was to be a good professor, not a buddy I really couldn’t relate to. It isn’t that we could not have been friends, but that would have to develop slowly over time as he was able to help me with what I most needed — which at that time was to learn and pass biology. I took biology from a professor other students thought was great and he was. I learned and enjoyed the subject – but never really got to know this professor personally. But I left with high regards and recommended his class to others. I guess you could say the good professor liked me well enough to work hard to teach a class that would benefit me. That’s how he showed it. Plus, his teaching style was calm and I never sensed he was putting me down because I didn’t know as much as he did.
So, to be able to help people we have to like them as people and be good at what we do.
How do we build trust in a dental office? By working hard to like the others working there alongside us and working skillfully on behalf of patients who need our help. When patients step into this as the office environment, it builds trust.
One thing that has helped me keep my sanity in dentistry has been to clearly, on the front end, explain my role and responsibilities as well as the patient’s role and responsibilities when it comes to helping them achieve and maintain dental health. I refer you to the video on my website – dryoungperiodontics.com I call A Tooth Has Four Parts to hear how this sounds.
But this isn’t where you necessarily need to start. In other words, I’m not at this point advocating coming up with a good speech. Instead I am recommending that if you are just starting out professionally, which may mean you are still in school, or if you are experiencing frustration, even depression, and are thinking of quitting and finding something else to do that you first write this down and look at it often.
If you want to stay sane in dentistry write the following down and review it often:
I have two jobs and the patient has two jobs. None of these jobs can be shared by the other.
My two jobs are (1) to like patients and (2) to treat them well.
Patients willr benefit from doing their two jobs which are (1) daily homecare and (2) appointment management. Should they decide to take care of themselves, I will take no credit. It was their choice to comply with the recommendations, not mine.
I hope this has been helpful. Feel free to take what you like and leave the rest. Also feel free to leave comments below.
Subscribe to get notifications as I produce future episodes. As I said, it’s usually about every month or so. My more frequent postings are going out on the Perio Patient Podcast. They are shorter usually in length and are on subjects I think we as patients might find interesting. My next episode there is about wearing face masks.
Thanks for listening.