The dental nurse plays a vital role in facilitating the first crucial conversation, which can provide the best opportunity to get to know a new patient.
Buying dental treatment is a big decision for most of us. Not only do we need to feel reassured that the practice can deliver the treatment well, with minimal discomfort, but also – and, perhaps, more importantly – that we are going to achieve the outcome we want or desire.
Patients do not buy dental treatment. They buy what it does for them and how it makes them feel about themselves. It may be the ability to smile with confidence or eat without fear of sensitivity or fear of their teeth falling out. All we have to do is give the patient the opportunity to tell us how their teeth and mouth impacts their life. Our first face-to-face meeting with a new patient is, therefore, the perfect opportunity to start that process.
Building foundations
This meeting sets the tone of the relationship the practice is seeking to develop. Here is the opportunity to put the patient at ease and build a foundation of trust and confidence in the practice team. It is a chance to show that, together, the team can deliver the treatment outcomes the patient is seeking. The dental nurse or treatment coordinator has a vital role to play here in facilitating this first, crucial conversation that can provide the best opportunity to get to know the patient. This allows you to properly tailor the right treatment to their wants, needs, desires, requirements. Getting to know them is actually a lot easier than it might seem.
Smile checker
After the receptionist has warmly greeted the new patient – and replayed to the dental nurse any relevant information the patient has provided – this offers a good starting place for the first proper conversation, or the ‘Smile Checker’ or ‘Personal Dental Assessment’. Many practices have these. It is a simple form with a series of questions that asks the patient to tick ‘yes’ or ‘no’. Whatever guise these take, they provide an outline structure or prompt around which the dental nurse can start a conversation with the patient – and this can be returned to year on year. Engaging patients in conversation might seem like hard work but, with the use of this form – if only once a year – it can allow you to develop a relationship with your patients. Unfortunately, so many just end up being filed in the patient record, which is such a missed opportunity.
Opportunity
Once the patient has completed the form, the dental nurse can take them to a quiet area – an office or empty surgery – where the patient can feel comfortable sharing information and their feelings about their teeth. This offers the opportunity for the patient to expand on the answers they have given on the form and for the dental nurse to explore what lies behind them and to have a conversation about how the patient feels about their teeth and mouth; what outcomes they are looking for, and the options the practice can offer in terms of treatment and pricing.
Practice in managing this first conversation is essential. This doesn’t have to involve a formal training course but instead, by using other team members, it is possible to role play different scenarios to provide the dental nurse with the chance to develop personal style and technique. The most important element here is to practise the use of open questioning. By using the practice’s own form – and having another member of the team fill it in as if they were the patient – the dental nurse can explore a range of different scenarios. Playing out these situations in a safe environment can help the dental nurse find their own words and build their confidence with a range of patients, from the willing talker to the more reluctant or nervous. The more this can be practised, the more likely a comfortable conversational style will naturally develop.
Simple rules
The rules are simple; ask really good, open, patient-focused questions. Listen carefully to the answers and then ask another open question, relevant to the answer the patient gave. Offer information, as and when requested by the patient and always finish with a question. This way you will stay in control of the dialogue. When the meeting is complete, the dental nurse can hand over the patient to the dentist, summarising the discussion in front of the patient and replaying the information the patient has imparted.
If the dental nurse has done their job effectively, all the dentist will need to do is confirm the diagnosis and present treatment options from a clinical perspective. The success of this process is related to the consistency of approach. Team work can be very powerful using the same process each time a new patient contacts the practice, from first phone call through to ‘dentist-meets-patient’. Each team member sharing the conversations they have had with the patient at every stage also helps to maintain this level of communication. This approach is the foundation of effective, productive and profitable conversations, which provides a better experience and sustains a dental business. Through good first conversations, we can understand desired outcomes. Deliver these and a new patient will be much happier.
Good communication is an essential part of your role. Here, Dental Protection offers a few simple
steps to help ensure good practice.
The relationship with each patient is a very human and humane one that calls for understanding by both parties. At each stage of the professional relationship, the dental nurse must ensure the patient understands issues under discussion whether it is about:
- Explaining histories
- Agreeing treatment
- Raising concerns over outcome
- The making of a complaint.
Your skills must, therefore, include:
- Keeping control
- Promoting the right body language
- Listening
- Speaking.
Additional skills include:
- Correspondence
- Record keeping.
All have a role to play in communication and proper implementation should help control the situation for the benefit of the patient.
Non-verbal skills
Non-verbal skills relate to the image portrayed
to the patient and include:
- Patient expectation
- The physical proximity of the patient and
practitioner - The practitioner’s physical appearance,
manner and movement.
For some patients, such issues as appearance, facial posture (smile), movement, general body posture, gestures and the physical distance between the two parties can influence their interpretation of the information supplied. Whilst good communication skills are required at all stages of treatment, there are three fundamental areas that demand special attention.
1. History taking
The initial histories set the scene in which the patient will be investigated. They will also colour the subsequent treatment plan or plans presented to the patient. Similarly, at each stage of investigation or treatment an opportunity arises for the patient to give further input. Such input may be negative or positive but it can – and should – influence:
- Further consideration of investigation
- Diagnosis
- Treatment plan
- Treatment or follow up.
2. Consent
Consent is based on the patient being able to absorb information, to consider the information and to make a reasoned decision. It is important not to lead a patient to a decision and it is equally important that every effort is made to help the patient understand issues in order to properly seek the preferred options. Communication in consent, as elsewhere, is dependent on a feedback mechanism. For example:
- Is the patient able (competent) to hear the
discussion and make a meaningful decision? - If the answer is yes, can you pass on the
information in a way in which the patient can
understand? - Has the patient shown reasonable signs of
understanding the issues? (This may require
further questioning)? - Has proper weight been attached to each to
facilitate decision-making? - Have sequelae, cost and prognosis been
explained by the practising clinician? - Does the patient appear to understand?
- Is the patient individually empowered
to give authority on his or her behalf, for
example in the case of a child?
Only once all these considerations have been made can it be demonstrated that every effort has been made to communicate properly. Confidence can then be placed in the decision about treatment reached by the patient.
3. Record keeping
Records should support the verbal and written interchange between patient and dental hygienist or therapist and, where necessary for the best interests of the patient, between colleagues.
Remember….
When communication breaks down, it can often be the trigger of a patient complaint or claim. These dangers are magnified if both parties are speaking a different language. Even when speaking English, patients may have a different understanding of what a ‘familiar colloquial’ English phrase means. Remember, too, that front desk staff are often your ‘eyes and ears’ and it is important they understand their roles in feedback of information. That said, staff should consider that confidentiality in communication is a fundamental ethic and principle and nothing should be relayed to a third party (except in exceptional circumstances) without the patient’s permission.
This article was originally published in Dental Nursing Magazine and contains content by Simon Tucker and Dental Protection.
The dental nurse plays a vital role in facilitating the first crucial conversation, which can provide the best opportunity to get to know a new patient.
Buying dental treatment is a big decision for most of us. Not only do we need to feel reassured that the practice can deliver the treatment well, with minimal discomfort, but also – and, perhaps, more importantly – that we are going to achieve the outcome we want or desire.
Patients do not buy dental treatment. They buy what it does for them and how it makes them feel about themselves. It may be the ability to smile with confidence or eat without fear of sensitivity or fear of their teeth falling out. All we have to do is give the patient the opportunity to tell us how their teeth and mouth impacts their life. Our first face-to-face meeting with a new patient is, therefore, the perfect opportunity to start that process.
