Essential communication strategies for a great dentist-patient relationship

Running a successful dental practice requires mastery of both dentistry and business. Communication skills can help the dentist excel in both arenas, and yet this “soft skill” is often seen as an afterthought in dental curriculums – if it’s featured at all. Here, we reflect on the value of communication skills in dental practice and explore key evidence-based communication strategies to elevate your dentist-patient relationships.

How communication skills can make or break the dental practice

In a recent Septodont survey, we asked dentists about their biggest day-to-day challenges in practice. No matter where they were located, who they treated, and how their patients funded their care, dentists consistently mentioned the same core challenges:

• Overrunning appointments and disrupted schedules.
• Non-compliance with treatment.
• Fearful, hostile, or difficult patients.
• The worry of formal complaints or litigation.

These challenges can all impact the patient’s quality of care and treatment outcomes. They can all impact the dentist’s work satisfaction and the clinic’s bottom line. And they can all be – at least partly – avoided or resolved by applying effective communication skills. 

Good communication between patient and dentist is associated with:

• More effective care. You are able to elicit the information you need to make an accurate diagnosis and plan the most appropriate treatment.
• Increased productivity. Your patient clearly understands their treatment, has realistic expectations, and allows you to complete your work in a timely and efficient manner. 
• Better patient compliance. The patient trusts your judgment, accepts your recommendations, and follows the treatment plan.
• Improved patient outcomes and satisfaction. Accurate diagnoses, effective treatment, and patient compliance lead to better oral health outcomes (and happier, healthier patients).
• Easier patient retention and recruitment. Satisfied patients come back, and they tell their friends and family about you too.
• Lower likelihood of complaints. According to Canada’s Nova Scotia Dental Association (NSDA), better communication could resolve 4 out of 5 complaints they receive.
• Lower risk of litigation. Evidence shows that miscommunication and misunderstanding – not clinical malpractice — are responsible for a considerable proportion of dental litigation.
• Communication techniques for better dentist-patient relationships. You’re no doubt familiar with basic communication skills like eye contact, open body language, positive tone, and active listening. Here, we’ll discuss some not-so-commonly applied strategies that can help you to build on those foundational skills and improve your dentist-patient relationships.

1.    Respect your patient’s time

Despite our best efforts, delays are a fact of life in the dental practice. Appointments take longer than expected, treatments don’t quite go as planned, emergencies come up… We can’t help this, but we can keep the patient in the loop.

Failing to acknowledge a waiting patient sends the message that your time is more valuable than theirs. Instead, you might approach the situation as follows:

• Be upfront with the patient about delays as soon as they arrive. This demonstrates mindfulness and respect for the patient’s time before annoyance can take root.
• Give the patient an expected wait time. Having an “endpoint” to which the patient can anchor, as opposed to an indefinite wait, reduces the cognitive discomfort of delays.
• Ask the patient if they’re ok to wait. They will almost always say yes, but asking them to explicitly consent gives them a sense of control. 

2.    Person first, patient second

Before you ask the patient about their oral health status, enquire about their general wellbeing and make a note of any personal circumstances or life occasions that stand out. Make a point of enquiring after these at the next visit, too.

It does add a minute or two to the visit, but this small gesture also communicates to the patient that they’re more than just a line on the practice balance sheet. It helps you to build an authentic relationship with the patient, one that they would be reluctant to lose and rebuild with another provider. It reinforces that you have their best interests at heart and makes it easier for them to trust your recommendations. Further, it provides a wealth of information on factors that could affect their oral health status and treatment success, e.g. risk factors, life/family stressors, or barriers to compliance. Patients often don’t realize that this kind of information is relevant, so it gives you the valuable insight you might not otherwise have.

3.    Set an agenda

When it’s time to talk treatment, set an agenda with the patient so that both of you can clearly communicate your goals and prioritize your concerns.  

In various clinical settings, this co-operative practice of agenda-setting has been shown to increase patient and clinician satisfaction, limit “hidden” or forgotten questions throughout the visit, and improve treatment outcomes. That contributes to efficient treatment, healthier patients, and a happier dentist.

Studies indicate that during this initial agenda-setting, clinicians have been shown to interrupt the patient within 18-23 seconds of their opening statements. Researchers caution that patients can perceive this as the clinician exerting control, and may disrupt the consultation at a later point with their unasked questions. For agenda-setting to be effective, it’s important that your patient gets the chance to be fully heard.

4.    Acknowledge your patient’s expertise

A successful dental consultation is a collaboration between two experts. While you are the undisputed expert on dental health, your patient is the expert on how dental treatment fits into their life. It’s important to acknowledge this and treat them as such.

For some patients, the best clinical course of action is not necessarily the best practical course of action. Actively solicit your patient’s expertise by enquiring as to how proposed treatments will work with their lifestyle, schedule, and family circumstances. Identify any concerns or barriers to compliance, and encourage your patient to work with you to find solutions and alternatives.

5.    Protect against empathy fatigue

Empathy is one of the most effective communication tools a dentist can use. However, you regularly see patients in a distressed, vulnerable state, and you have to contend with the knowledge that helping them might mean inflicting more pain. The emotional toll can leave dental professionals desensitized or indifferent to the patient’s experience.

This destructive coping mechanism is often referred to as “empathy/compassion fatigue”. Not only does it contribute to clinician burnout, but it also has a detrimental impact on the dentist-patient relationship. In fact, studies have found that empathy is so important to patients that they perceive lack of empathy to be responsible for many medical errors, and cite it as a major factor in their decision to sue for malpractice.

For the health of yourself, your patients, and your practice, it’s critical that you take steps to prevent or manage empathy fatigue and burnout. It may help to implement a comprehensive pain management program, reducing pain, fear, and anxiety in your patients and alleviating the emotional burden for you. Septodont can help you to achieve this with our portfolio of world-leading dental pain management products.

6.    Always make time for questions

Questions are an opportunity to involve the patient in their care, help them to understand their treatment, establish trust, and manage expectations. It’s important that you make time for – even encourage – questions and answer them openly and honestly.

Of course, we understand that it’s not ideal to have a patient asking excessive questions. To strike the right balance, read our article Understanding and Managing the Inquisitive Patient, where we discuss why some patients have a tendency to over-question, and how you can communicate with them successfully.

7.    Tailor to the needs of the patient

Effective communication involves adapting your style to the unique needs of each patient, but those needs can vary widely across different populations.

One study found that children respond best to empathy, detailed reasoning, and sensory communication, e.g. tactile and visual demonstrations. Another study found success with reflective listening, descriptive praise, and self-disclosing assertiveness (proactively sharing information about your own relevant feelings and experiences).

For senior patients, research supports an entirely different set of communication tactics. These include preparing an agenda (see #4), listening attentively, asking open-ended questions, and providing written instructions.

8.    Maintain communication and consent throughout

Even though you’ve explained the treatment beforehand, continue to explain what you’re doing throughout and why. Regularly check that your patient is still happy to carry on, using pre-established signals and waiting for affirmative consent before you proceed. These small gestures convey your respect for the patient and remind them that they’re in control of what may be a difficult experience.

9.    Finish on the same positive note

While the first impression colors the appointment, the last impression is what your patient will remember most. That means the final few minutes of the consultation are just as important as the first.

Resist the urge to hurry the patient along, even if you have a full waiting room! Give them your full attention, allow them to ask any final questions before concluding, and thank them for their time. If they need to arrange payment or follow-up, personally escort them out for handover to the reception team.

10.   Ensure consistency across the practice

A great experience with you can be completely overshadowed by a bad experience with another team member. Make sure that all of your staff uphold the same high standards of communication as you do, providing training and mentoring if necessary.