Understanding and managing the inquisitive patient

Summary : According to a recent survey by Septodont, one of the more challenging day-to-day experiences for a dentist is the inquisitive patient. Too long spent answering questions means that appointments run over, other patients are kept waiting, and schedules are thrown into chaos. During the pandemic, with schedules – and budgets – stretched to breaking point, this presents even more of a challenge. When every minute counts, we discuss how dentists can keep their inquisitive patients satisfied and their schedules running smoothly.

When does curiosity become a problem?

Asking questions is not necessarily a problem in itself. In fact, as a dentist, you know that questions give you the opportunity to: 

• Involve the patient in their care. 
• Help them to understand their treatment. 
• Establish informed consent. 
• Manage their expectations. 
• Improve patient satisfaction and retention. 

However, there are some patients whose curiosity you just can’t seem to satisfy. You sense that they’re looking for an answer that you can’t give them. Or that they’re asking one question but they really want to ask another. Or that they simply don’t know what to ask to get the information they need. Sometimes, it may even seem as if the patient is challenging you. That’s when curiosity can become a problem. 

Your time with the patient is limited. You want your patient to feel comfortable enough to raise questions, but not to the extent that it dominates or disrupts their treatment. To deliver a high standard of care – not just to them, but also to the patients after them – how can you strike the ideal balance? 

Understanding the inquisitive patient

Patients ask excessive questions for a variety of reasons. Some simply haven’t been given enough information about their treatment, or don’t understand the information they’ve been given. Others are motivated by fear or uncertainty, and they usually fall into one of three categories. 

The anxious inquirer

This patient asks questions due to anxiety about dental treatment. 36% of people in the UK are believed to suffer from dental fear or anxiety, and a further 12% have a dental phobia, so you may run into this patient often. Asking questions can be a way for them to understand the unknown, mentally prepare for a treatment, or even stall for time.

Look out for questions relating to pain, duration of treatment, and recovery time in particular, as these can all be major sources of anxiety. Another hallmark is that the patient may not seem to be reassured by your answers. You might notice that each answer prompts another question, or that the patient circles back to a topic of concern that you’ve previously addressed. 

The control seeker

In a previous article, we discussed an interesting piece of research about the loss of personal control many patients feel in dental and other healthcare settings. This can happen at various touchpoints throughout the patient journey, such as scheduling an appointment around other commitments or having to wait a long time for treatment. At each point, the patient is doing something they’d prefer not to do but perceives that they have no choice if they want to be treated. That’s nobody’s fault, of course, but it can still take an emotional toll on the patient. 

By the time the patient reaches you, they may have accumulated any number of these “micro-threats” to their personal autonomy. Now, facing the biggest threat yet – a potentially uncomfortable or even painful treatment – some patients react by becoming inquisitive or even challenging. They may ask questions as a way to boost their confidence, re-assert their control, or gain a sense that they’re having treatment on “their own terms”. 

Check out our article about “managing patient expectations: the threat perspective“.

The overinformed patient

In the digital age, our patients can find an abundance of information about oral health and dental care with just a few clicks. Many do just that, but it can create problems in the chair. 

When a patient looks for information online, the best-case scenario is that they read accurate — but unnuanced — information intended to give patients a broad, simplified overview. The worst-case scenario is that they’re exposed to misinformation, ranging from innocent mistakes to deliberate fear campaigns. 

In either case, this can lead some patients to reach incorrect conclusions or form unrealistic expectations around their dental care. When your assessment, diagnosis, or treatment plan doesn’t align with their beliefs or expectations, you might face a barrage of questions as they try to understand why. 

Managing the inquisitive patient

1. Pre-educate your patients 

If you don’t already, provide every patient with detailed information prior to an appointment. 

For each treatment, create a standard template with a description of the procedure, why it’s necessary, what outcomes should be expected, and what will happen on the day. You can also include a list of relevant FAQs and point your patient to additional learning resources like articles or videos. When a patient is scheduled, they can be given all the information they need quickly and easily. 

For anxious and control-seeking patients, knowing exactly what to expect can help to ease their concerns and give them back a sense of control. Meanwhile, overinformed patients can be directed to accurate and reliable sources of information, reducing potential conflict in the chair. 

2. “Pre-assure” your patients

This pre-education stage is also a golden opportunity to reassure the patient before anxiety has a chance to take root. In our article Why topical anesthetics go hand-in-hand with patient (and professional) satisfaction, we discuss how pain is the number-one driver of anxiety in dental patients. It’s not just the experience of pain; research shows us that the mere anticipation of pain can be just as traumatic as the pain itself, and it can make the actual pain feel more intense.   

The first step to addressing this is to implement a comprehensive pain management system, focused on keeping your patients as comfortable as possible at every stage of treatment. Septodont can help you to achieve this with our portfolio of world-leading dental pain management products, including the highest-quality pre-injection topicals, injectable anesthetics, and lower-deflection needles. 

The second step is to tell your patients all about it at the earliest opportunity! As soon as they schedule an appointment, let them know all the steps you’ll be taking to keep them comfortable, e.g. topical anesthetic to make injections pain-free. By “pre-assuring” your patient, you’ll stop anxieties in their tracks and gain a reputation as a dentist who truly goes the extra mile. 

3. Give your patients a nudge

Don’t be tempted to drop your resources and pain management plans in an email or hand over a brochure and simply hope your patients read them! Plenty won’t so offer a gentle nudge. For example, have your reception staff say:

“I’ve scheduled your appointment and I’m going to send you an email to confirm. I’m also including some important details about your treatment and some questions other patients often ask about it. Will you read through that information and let me know if you have any questions that haven’t been answered?”

The question is key. Believe it or not, soliciting that one little “yes” is a tried-and-tested trick that marketers have been using for decades. People are more likely to read the information simply because they’ve made a verbal commitment to do so. 

If the material doesn’t answer their questions, you can delegate any further questions to a member of the dental team prior to the appointment. And for those who still don’t read it…

4. Make use of waiting room time

Give the patient a copy of your FAQs to review while they wait and ask them to write down any additional questions they want to ask during the appointment. 

This has several time-saving benefits: 

• As they bring their questions to mind, they may find the material has answered many of them. 
• You can get down to any unanswered questions quickly and efficiently. 
• The patient is more likely to stick to a pre-written list, instead of going off on tangents. 
• The patient is less likely to interrupt the treatment with questions they forgot to ask.  

5. Define question time

At the very beginning of the appointment, set clear expectations and boundaries around question time. For example:

“I’m going to start by talking you through what we’ll be doing today, and then we’ll have about x minutes to go over any questions you might have. Then we’ll start the treatment, and you’ll have the chance to ask some more questions afterward. Does that sound ok to you?”

Again, solicit the yes, and reiterate the agreed time when you hand over to your patient for questions. If your patient is still asking towards the end, remind them of the time limit and give them the chance to prioritize their most pressing questions:  

“We’re coming up to the end of our x minutes and we’ll have to move onto the treatment shortly. What’s the most important thing you need to know before we get started?”

6. Answer questions transparently 

During question time, be as open and forthcoming as possible with your answers. Research shows that if a patient perceives you to be shutting them down, avoiding their questions, or answering inadequately, they can double down on their efforts to assert control, i.e. ask even more questions. And if your patient is already skeptical or suspicious of the profession, this will only reinforce their fears and encourage them to keep challenging you. 

Try to acknowledge any concerns your patient is showing, even if they’re based on misinformation. The fear or uncertainty is still very real to them, so empathize with the underlying concern, offer reassurance, and answer their questions transparently. (And whatever you do, never dismiss them or try to pull rank!)

By investing a little time to make your patient feel heard, respected, and understood, you can show them that there’s no need to assert control or dominate the appointment. 

7. Know when (and how) to draw the line

What do you do when this isn’t enough? When an anxious patient keeps on circling or does an overinformed patient keeps on challenging? If you feel you’ve answered the best you can but the questions keep coming, it’s time to put the ball in their court – compassionately, of course.  

For an anxious patient, this may look like: 

“I can see how worried you are about the treatment. It’s very safe, but I understand that it can still be scary. Would you like to give it a try, or would you like to leave this for another time?”

For an overinformed patient, it may look like: 

“It’s important to me that you’re comfortable with the treatment plan but it seems you’re feeling conflicted. Would you like to go ahead, or do you need to go away and think about it some more?” 

Most patients don’t want to be in the chair, but they also don’t want to go away without having their problem solved. This is a simple way to give them back a sense of personal control, while subtly letting them know that question time must come to an end. When faced with this call to action, the majority of patients resolve to move forward. 

8. Delegate the debrief

Without a thorough debrief, the inquisitive patient will often call back with their questions later on. Rather than pushing the problem down the road, think about who else in your office is qualified to carry out this task. 

Consider delegating the debrief to your assistant or another member of the dental team. They will be able to explain the findings, talk the patient through paperwork and home-care instructions, and answer any further questions they may have. Meanwhile, you can move on to the next patient and keep your schedule running smoothly.