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Belle DuCharme, CDPMA
Instructor/Consultant
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Successful Patient Communication
By Belle DuCharme, CDPMA

Dorothy Leeds said, “When you know how to ask the right questions, you can talk to anyone about anything.” Questions allow you to find out about other people, assist in keeping the conversation going and direct the conversation to where you want it to go. To better understand your patients and their wants and needs, questions can clarify what you don’t understand and demonstrate your interest and curiosity in the patient’s issues. A well thought-out question can stimulate thought and convey appreciation for the patient’s input.

Open-ended questions start a process of information gathering that can take time, but offer the clinician an opportunity to get to know the patient. So often dentists and hygienists are pushed to stay on schedule and have trained themselves to ask close-ended questions that bring the conversation to a stop. If your practice is scheduled on a “clinical time in the chair” only with no added time for conversation with the patient, then you will feel the stress when the patient has questions that you don’t have time to answer.

Close-ended questions are designed to be answered with one word, usually yes or noThis keeps you in control, but that is not the key to treatment acceptance. In that arena the patient needs to feel they are in control. Close-ended questions start with “Do you…”, “Did you…”,”Are you…”, or “Have you…”  Using this approach you will be able to gain the basic truths, but sometimes you will come off as an interrogator. Questions such as “Have you seen a dentist recently?”  or “Do you floss daily?” are important, but they can be taken as punitive. Instead, try “When you saw your previous dentist what were you told about how often you should see him/her?” or “When you floss, are you having difficulty getting between any teeth?”

Open-ended questions start with Who, What, When, Why, Where or How. Some people can talk quite a long time, and that is why it’s important to use another question to direct the conversation. Asking too many questions can make a person feel uncomfortable and can kill the genuine exchange you are trying to achieve. Balancing questions with statements and adding humor when necessary are the skills of a good chair-side manner. During this exchange, be sure to not answer your own questions. Some people will think before answering or take a pause. This should not be a time where you rush them through their thoughts. 

Asking “why” questions can be good at establishing a motive for behavior, but at times is intrusive and aggressive. People often feel obligated to answer a “why” question because the alternative is “I’d rather not say” - which is often more uncomfortable than answering the question. For instance, if the patient is not wearing their bruxism appliance, the obvious thing to say would be, “Jack, why aren’t you wearing your bruxism appliance?” Perhaps a better open-ended question would be, “Jack, how is the bruxism appliance working for you? What have you noticed about it that has benefitted you?”

Sometimes in the exchange between the doctor and the patient there may be questions that are too personal, intrusive or rude. No one is obliged to answer questions like that and the best line of defense is to redirect the conversation back to dentistry. “I will have to give that some thought, let’s get back to your current dental situation.” 

Taking the time to get to know your patients involves foresight and planning. When scheduling a new patient, be sure that the chair-time includes the necessary talk-time, unless you intend to move the patient into another room. Have a pre-planned set of open-ended questions that you would like to ask the patient. If the patient has filled out the patient information form ahead of time, you can access that information to formulate your questions. 

Recall appointments that include the examination should also include a planned open-ended question. When the patient is known to you and your team, this becomes easier and pleasant. “How was your trip to Europe?” “Where did you last play golf?” “What have you cooked in your gourmet cooking class?”

When patients sense that you are truly interested in them as people, not just a set of teeth, the level of communication improves as does the trust in your practice.

If you would like more information on McKenzie Management’sTraining Programs  to improve the performance of your team, email training@mckenziemgmt.com

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