When a Patient’s “NO” Really Means “YES”

Today, we are going to play a game.  It’s one your kids likely play (to your dismay).  It’s called The Opposite Game.

We’ve talked over the past couple weeks about patients who either resist treatment or maybe just take a little extra nudge to get them to the right decision for their health.

Last week, I shared with you last week some phrasing to draw a line in the sand with your patients.  Now, we’re going to attack it from a different angle.  

In the end, you’ll have a complete communication toolbox to use whenever you need to push your patients forward in the conversation.

One of the most powerful methods to building rapport with someone is finding common ground, something that you can both agree on.  Specific to your situation with your patients, you can find something that patient is willing to start or initiate or learn more about or be interested in.

While we want you to always go big picture and create a complete pathway to health with your patients, it doesn’t mean that every patient is going to get there the same way or that every patient will even agree to what they are willing to accept as optimal health; as each patient is unique.

While it is your responsibility to tell them how you can help them, diagnose them from optimal health back to their current state, and compare their mouths against your clinical philosophy, it’s also a fact that not every patient will simply agree to recommendations.

So, we have to have a back-up plan because we can’t accept them doing nothing and we can’t give up on them entirely.  Therefore, the alternative is to simply get them in motion in some way, shape, or form so we can find some common ground and they can feel a sense of positive progress.

One of the best ways to do that is to get them to say “no” to something instead of trying to force them to say “yes” to something.

If we are playing tug of war to get them to agree with you about whatever the topic is they might feel forced, pressured, lectured, or at a minimum they certainly will not feel like they arrived at the decision on their own.

Remember, that’s the whole ownership concept where a patient takes responsibility for their own health.  This is why, among many other reasons, you always talk with the patient using the photographs and x-rays as the props, you master the 3 P’s, and you get the patient engaged so they are owning their own current state of health as well as their future outcome they deserve.

Here’s where the Opposite Game comes in.  Instead of focusing on yes, let’s focus on no.  Instead of focusing on what they do want (or what you want them to want), focus on what they do not want and reverse your agreement around the other direction.

Here are a few easy examples of what they don’t want…

To pay a lot of money

To be in pain

To lose their teeth

To not be able to enjoy foods they love

To be self-conscious

To waste time

As a team, you should make up your own list specific to your practice and patients.

This means that we can take anything in our patient discussions and we can come back around from the opposite side… “So, Patient, we could go the delayed route where it will end up ‘costing’ [more on why and where you use that word versus avoiding another time] you a lot more, is that ok?”

The answer should “no” but depending on how you word it you might get a “yes” – but it’s all the same.  We got an affirmative response to something we can agree to.  

Then I can say, “Yes, I completely agree, which is why I am recommending you do [insert treatment] now to avoid having to pay more than you should if you wait.”

You can find common ground on what you and the patient want to avoid.  In this case, it is paying more than necessary.

It could be as simple as, “Would you like to wait and then do a root canal?”

Or, “There are a couple options, one where you would have to lose some teeth, is that your preference?” 

Or, “Well, we could do nothing about it and you’ll still have jaw pain, is that something you can tolerate long term?”

Or, “If we ignore the problem, it will affect your ability to eat, are there foods you are willing to give up?”

For this week’s Morning Huddle, I would encourage you to write out your list of what patients don’t want (essentially a list you and the patient will agree).  

Then practice which each other by playing The Opposite Game.  The objective is to ask a question where you get a “no” in order to default to a “yes” to something else.

Remember the most important part of this is not stopping at one question, you listen to their answer and use it as a bridge to the next question.  Keep this going until you get to the place where you both agree on a treatment.

You also want to begin with the end in mind in your questions and know that your goal is not just to meet your patient where they are, though that is where you start, it is to take your patient to where they deserve to be.

Using questions in different ways will always help you build rapport and find common ground.  Get your patients in motion by taking the opposite approach.

As we all know, there are two ways to see everything and while they appear to be the opposite they are really just different ways to arrive at the same objective: helping your patients take ownership of their health and make a decision that is in their best interest.

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