Tips: From The Chair, David Clow

In the Foxhole Together: the Dentist-Patient Collaboration

My first two columns for the McKenzie Newsletter spoke from a patient’s perspective about what we ought to expect from each other as we develop our collaboration. It’s remarkable that we need to articulate all this as though we’re negotiating a peace treaty; after all, we really do need one another, even if we don’t necessarily want each other. Let’s face it, some days all you get are the patients who’d rather be somewhere else, and I’d venture to guess that if you line up a few of those days back to back, you’d rather be somewhere else too – but that shouldn’t happen! Ultimately, we’re on the same side and we need and want the same things. We have common purposes and common enemies. To fight together, we need to understand each other. But as I asked last time, how do we communicate all this with each other?

Fighting Our Mutual Enemies
My biggest enemy is systemic illness. It’s yours too, because in the end that’s what your work helps me to fight. A typical patient like me is pushing back against incipient serious illness all the time. My mouth is an incubator for microorganisms that start them. If I take reasonable care of it, the illnesses they can cause are kept more or less at bay. If I don’t do the basics - brushing, flossing, rinsing, and regular checkups - then I’m leaving myself wide open for an invasion of problems I need not have.

How many of your patients understand this? How many of them don’t exercise reasonable care? Have you ever taken a moment during a regular appointment to help a patient get the big picture that you can see when you look to their mouth? A compliment to me about good work or a suggestion about improvement might make a big difference. Yes, I know, sometimes the advice is unwelcome. But you don’t need to proselytize. Just a few words, a little encouragement and a reassurance that you’re there for me, will go a very long way. My enemy has a few allies helping in its cause. If systemic illness is out to get me, its friends are helping: Fear and Denial. I can’t fight them by myself, and neither can you. We can beat them if we work together.

Fighting Fear and Denial
Fear thrives on silence. What you don’t communicate, I don’t learn, and what I don’t know is the dark corner where fear lives. If you don’t talk with me, fear does, whispering all kinds of evil distortions and exaggerations about what you’re doing. Fear might suggest to me that your good efforts aren’t worthwhile. Fear might whisper to me that I can do without you, that anything I suffer out of your chair is better than any suffering I endure in your chair. Fear will tell me that your drills are bludgeons and your syringes daggers. Fear will lie to me and make me feel it’s my only protector, when really it’s protecting the pathogens in my mouth.

Fear’s cousin is Denial. Denial will tell me that Fear isn’t there at all, and that those fearful undertones are just my own healthy self-preservation and skepticism. It will tell me that I’m invulnerable. My bad habits won’t catch up with me. My neglect won’t matter. I won’t get sick, it’ll say, just because I don’t take care of my mouth.

Winning over Fear and Denial

Of course, Fear and Denial are really worried about the short term pain and suffering that happens in a dental chair. They have no view at all of the long term; they don’t want to look there. You can help me here, and help yourself too, by guiding me to look ahead, beyond this hour, beyond the fear and denial I brought in to this appointment. What happens in your chair in this appointment has consequences I want. It’s more than a repair or a cleaning. It’s an investment in my overall health. I might not understand that, but you do.

I may have spent a lifetime in the company of Fear and Denial by the time I see you. They might be sitting in the chair with me. But as influential as they’ve been, you have advantages over them. You have experience, training, reason, and caring. They aren’t as strong as you are, and certainly not as strong as we can be together. If you talk with me, that is when we fight as one.

Next column, I’m going to talk about where that happens and about what can be, for us both, the best part of the appointment: the Golden Five Minutes.

On behalf of McKenzie Management, David Clow consults with dental professionals on practice culture, case acceptance, and patient expectations. He can be reached at davidclow@mckenziemgmt.com

David Clow is a writer/consultant for Fortune 100 companies. His book, A Few Words from the Chair, is the first book written by a patient for dental professionals and students and is available here.

Forward this article to a friend.