When To Draw A Line In The Sand With Patients

As I often say, there is way too much apologizing with patient conversations.  You don’t need to say you are sorry.  It’s not your fault for the state of their health or any other circumstance.

Obviously, that doesn’t mean you don’t care and aren’t prepared to help.  It is very meaningful to be empathetic with your patients by expressing genuine care and concern over their circumstances.  However, do not apologize for them and by default imply that it is your team’s, doctor’s, or practice’s fault because it removes responsibility from them.

And when you remove responsibility, you take away their own personal motivation to be committed to the outcome that is best for them.

For example, the wrong wording would sound like, “I’m sorry I have to tell you…”

Try rephrasing it by saying things like, “I’m so sorry that you are in pain but I’m really happy you are here so we can take care of you.”  

Or, “Goodness, I really wish you weren’t dealing with that sensitivity, the good news is we are going to do something about it.”  

Or, “It is a shame that you have had to suffer with less than ideal oral health for a long period of time, no one deserves that.  Today, though, we are going to help you get what you do deserve and that’s returning to strong, healthy, usable teeth.”

Everything can be reshaped to be empathetic (without accepting culpability), and coupled with the good news that you are here to help.  Acknowledge the issue, express sincere concern, and end with a positive solution.

Sometimes you have to take a more blunt approach when reframing doesn’t work or you have a patient that is a little bit of a tougher personality, seemingly indifferent or they might even make off handed comments about your motives.

Then the best thing to do is be straight with them about their problems and the benefits of taking care of them or consequences of doing nothing about them.  This comes across the most authentic and almost always results in the patient being willing to reconsider and see things differently.

Here are a couple additional ways to implement the reframing strategy with this more direct approach.  

To reposition yourself as their advocate and on the same team, try something like…

“You know Mr. or Mrs. Patient, I just want to tell you we have the exact same goals in mind here.  We want you to get healthy and to achieve what we know you deserve with complete and optimal health.  That said, it is very simple, we want to prevent you from having problems, spending money, or needing dentistry ever again.  That’s why… {insert treatment rational}” 

This works incredibly well because as soon as a patient gets skeptical about “do I really need it” or “that’s a lot of money” – you can swoop in and save them by letting them know you’re on the same mission.

And then you can ask them a challenge question such as, “You don’t want to wait until you lose your teeth to do something about it, now do you?”

Again, tough language but with aligning beliefs that help the patient to feel a sense of control over the decision while having the peace of mind that you are going to help them because you actually want the same thing for them.

Finally, there is the worst-case scenario where you can use a more advanced technique of a drawing a line in the sand.

You begin a sentence with, “I really feel like I’m letting you down because…” and you insert the consequence they are trying to avoid.

Then say, “Look it is your prerogative to do nothing and to stay the same.  It’s just my responsibility to make sure you understand what the consequences and results of that will be.” 

Always remember this all sounds better coming from you when you are talking to a live person that you have had back and forth discussion with already.  Slipping one of these sentences in whenever necessary is actually very easy and seamless.

You want to avoid sounding passive aggressive or guilt shaming but when said with love and a true desire to help, you will find that you instantly increase your credibility and rapport with the patient.  Patients will give themselves a chance to reconsider and it will lead to greater case acceptance.

It does all come down to your confidence in how you communicate, your conviction in the value of what you are doing, and knowing that you only help the people who say yes – which means sometimes they need to say no to something in order to say yes to something else.

And that’s exactly where we are headed next week.  

Play with these few slightly different communication tools to help motivate and connect with your patients.  Use your empathy not to actually give up on patients but instead to influence them in a more powerful way to take action on their health.

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