Make the Fearful Patient Your Biggest Fan
What are your biggest fears? Insects? Rodents? Hanging from an airplane over open water? Being buried alive? A few years ago, the so-called reality show FEAR FACTOR exploited peoples’ fears, and contestants would actually volunteer to participate in this game of public traumatization for a mere $50,000. Fortunately, dental phobia was not ever featured on this program, but as dentists discover early on in their careers, many patients can be very anxious about the dental experience. There are varying levels of fear, but when fear reaches the point that it is irrational and causes the patient to avoid treatment, it becomes a phobia.
Patients who are extremely phobic typically have a history of negative dental experiences. However, those experiences aren’t necessarily painful. In many cases, anxious patients are as much or more afraid of embarrassment than they are of pain. They may start avoiding the dentist because of a painful experience, but they also often realize they need to return to the dentist. However, they can’t bring themselves to do so because they are afraid they will be scolded and belittled for their neglect.
In other cases, fears are learned vicariously through parents, family members, and friends. They may hear about Aunt Mary’s horrible experience 20 years ago and decide to take ownership of that incident almost as if it were their own. Typically there is not just one reason why people become fearful - it tends to be a cumulative effect.
Managing the anxious or phobic patient can be almost as difficult for the dentist as the experience is for the patient. Dentists frequently are targets of comments such as, “Don’t take this personally, but I really don’t like dentists” from patients, friends, or even family members. In other cases, it’s the question, “Why did you become a dentist?” as if such a decision surely must be the result of some early life trauma or closeted desire to engage in tortuous activities. Anxious patients are a common source of stress for dentists who receive very little training in managing and caring for them.
One of the most critical steps a dentist can take in handling an anxious or phobic patient is to listen to them. The fears of the patient will be as individualized and unique as the patient themselves. Taking extra care and time to build a relationship with the patient first and address their dental needs second is vital. It’s a process of gaining and keeping the patient’s trust. Give patients the opportunity to talk about their fears. Ask them if they have had any negative experiences in the past, if they have concerns about dental treatment, injections, anesthesia, or drilling. The answers to those questions can be every bit as important as the routine health history questions posed. Not only will the patient’s stress level go down, so too will the doctor’s.
Many anxious or phobic patients feel very helpless in the dental chair and this can be particularly traumatic. Helping them to feel that they have some control is critical. The most common approach is to establish a signaling system in which the doctor will stop if the patient raises their hand for any reason - perhaps to ask a question or because they might want to rinse. The key is to ease their fears by emphasizing they have more control of their circumstances.
In addition, it is vital that team members are sensitized to the special needs of this type of patient. Putting the patient at ease the moment they walk in the door will go a long way in improving the entire experience. Dental teams should tune into the patient’s body language such as breathing rates, perspiration, whether or not the patient is unusually quiet or particularly boisterous. How is the patient holding their body? Are they gripping their hands? Do you see muscle tension?
Dentists and dental teams that take the time to get to know and understand fearful patients often find that they become some of the most loyal patients in the practice as well as the doctor’s greatest source for patient referrals.
Next week, build long-term positive relationships with all your patients.
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