Words of Wisdom from Jan Lazarus RDH

Every patient is different. Overcoming a patient’s obstacles to treatment may take some finesse. The diagnosis and treatment plan are typically the easier task. In this series, we have asked the experts from our Protocol Directory, to share their insight.

When Jan Lazarus RDH with The JP Institute was asked to address “Is it going to hurt?” her response included the following.

The simple response to “Is it going to hurt?” in most cases would be, “No, we plan to make you comfortable by providing any necessary numbing solutions. It looks like you have had numbing gel and local anesthetic in the past. How did that work for you?” Listen, and respond with empathy and reassurance. Then, explain that we continue to have updated products and techniques to ensure your comfort and we will make sure to review and discuss the best options for you. Continue to provide any additional details until they are comfortable with the customized plan being offered to keep them comfortable. “Please tell me about any other concerns you have” is only one example of an important open-ended question that helps a clinician understand and address patient concerns.

One approach for effective communication the JP Institute has taught over the years is to cover any potential issues, concerns, or objections prior to them becoming an obstacle. It is important to develop and embrace an effective case presentation that addresses any potential concerns and proactively offering valuable information early on in a discussion prior to the patient asking. There are several communication skills and techniques that should be considered, practiced, and implemented to assure that we are addressing our patients’ primary concerns. Most patients will need to be reassured that a particular procedure will not hurt. It is a good idea to begin with this reassurance as you describe any recommended procedure.

In our JP Institute Communication module, we coach a structured approach to address the most common objectives. This five-step process is “Down to a Science” and can be applied to various aspects of dentistry and life in general. The important note is that it works. We are all familiar with the fact that it is “not just what you say, but how you say it.”

Five-Step Process

  1. Pre-Diagnosis/Diagnosis – Thorough collection of all diagnostic data, photos, intra-oral camera images, radiographs, comprehensive periodontal charting, and salivary diagnostics. The doctor diagnosis or hygienist pre-diagnosis when appropriate, should be clear and concise using visuals as part of the educational process. In addition, integrate effective communication positions when speaking to patients. Here is the brief list of critical nonverbal communication that represents your true expression. Good eye contact, body posture, proper distance and physical position, facial expressions that represent an authentic concern, appropriate tone of voice, volume, voice inflection, listening, timing all with a smooth flow of speech. And, at the same time evaluating your patients’ body language and again listening and connecting with your patient!
  2. Discuss Specific Recommended Treatment Options – In addition to discussing details of the recommended procedure, this is also when you would proactively let your patient know that they can expect to be comfortable for this procedure and explain the different anesthetic options available in your practice. Then, engage in an interactive discussion using effective communication positions and open-ended questions to make sure you have heard and understood all your patients’ concerns about the anticipation of pain. As you discuss the recommended treatment use visuals for clarity.
  3. Discuss the Benefit and Value of Treatment – What kind of results/outcome to expect from the recommended procedure or treatment. Use visuals and before and after photos whenever possible. Explain why it is important for the patient to have the treatment, taking into consideration individual risk assessment, contributing factors, and total body health benefits. Always include oral and systemic benefits as it relates to patients’ individual systemic variables for both periodontal and restorative procedures
  4. Consequence(s) of not treating or following through with a recommended procedure. This should be discussed and documented for all recommendations and proposed treatment. Patients need to learn that in many cases the postponement of treatment can result in pain or discomfort. This is only one of the common consequences of not following through with recommended procedures.
  5. Closures and Hand Offs – The patient is given the opportunity to decline or accept treatment and offered appointment(s) in the schedule. This last step in the five-step process, after you have answered all their questions and addressed concerns, is to offer the patient an appointment for the recommended treatment.

By giving our patients accurate information in a confident caring way, creating relationships that build trust, patients are equipped with the information needed to weigh the benefits against the fear of pain, time, and money, and then make a decision. Just remember that how you say it is more than half of the message.

These Words of Wisdom are a small introduction to what JP Institute can bring to your practice. For information about The JP Institute, please visit our Protocol Directory page. For an in-person experience with Jan, she will be presenting at Collaboration Cures 2022. Join us in Arizona for AAOSH’s Annual Event September 15-17, 2022.

Jan Lazarus RDH
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