Chapter 33 Communication
Unless the dental professional adequately and accurately communicates with the patient, it will be impossible to discuss his or her treatment needs. Patients come to the dental office with wants, and dentists have an obligation to review what their needs are. If the dentist cannot communicate accurately and adequately with the patient, it will not be possible to convert those wants into needs.
Communication is probably more relevant to esthetic dentistry than other areas in that patients are now more aware of what can be done esthetically for their smile. They come to the dental office and say, “I want this smile,” often showing photographs from magazines. The dental professional then must translate that into a determination of how to satisfy the patient’s want in a way that will mesh with the patient’s actual needs. One of the most attractive things about a person is his or her smile; the ultimate fashion accessory is an attractive smile (Figure 33-1). Communication is essential so that the dentist understands what the patient wants and the patient understands what he or she needs and what the dentist can do.
Patient communication has changed with the increased demand for esthetic procedures. Typically patients used to come to the dentist for either routine continuing care or for procedures that were urgently needed and/or reparative in nature. Today, they come for elective procedures. Dentists’ communication must be fine-tuned to be able to address the specific needs relevant to esthetic demands.
Several words can be used in verbal and written communications that will encourage patients to seek esthetic dental procedures (Box 33-1). For example, when talking with a patient about whitening, it is easy to use many of these words to help the patient better understand about the procedure, as follows:
Box 33.1 Key Words for Patient Communications
“Mr Smith, we have a new and easy way to whiten and brighten your teeth. The advantage of this process is that you will have a beautiful smile and the results will be wonderful for you. The benefit is that you will have a more youthful appearance and a healthier smile. We can do this for you in a safe and proven way.”
The telephone is often the first chance that the dental office has to interact with the patient. The telephone can be considered the first line of offense. Patients typically call the office first rather than walk in. When the patient calls, the dental office has about 20 to 40 seconds to make the individual feel warm, welcome, and comfortable and to sense that this is the best possible office to satisfy his or her needs.
How one answers the telephone creates the initial impression for the patient or prospective patient. The person answering the telephone should maintain a very upbeat voice that indicates that the person is smiling and happy to have received this call (Figure 33-2). An appropriate beginning is to say:
(From Finkbeiner BL, Finkbeiner CA: Practice management for the dental team, ed 7, St Louis, 2011, Mosby Elsevier.)
Once the initial introduction or salutation has been made, an information-gathering process begins. One of the first pieces of information to collect from a caller is the person’s name. Once the telephone respondent has the caller’s name, he or she should begin to use that name in the rest of the conversation with that individual. The exchange may be as follows:
The rule of thumb is typically that if the caller is perceived to be older than the respondent, always use “Mr,” “Mrs,” “Ms,” “Dr,” or whatever the formal title of that person is. If the caller is perceived to be younger, it is probably acceptable to use the caller’s first name. When the respondent is not sure, the first thing to ask after ascertaining the caller’s name is “May I call you [caller’s first name]?”
Once the respondent has identified the caller and used his or her name, it is necessary to try to find out why the caller has contacted the office. Often when a patient or prospective patient calls the office, he or she will volunteer the reason for the call up front. If the caller says, “I broke a crown,” the next obligation is to gather information from him or her relative to what the immediate need is. The first and foremost question to ask is “Are you in pain?” As healthcare providers who truly care about patients, dental professionals need to ascertain whether or not the patient is in pain and how quickly the patient can come into the office to address that problem. The caller may also report that a tooth is sensitive when something hot or cold is eaten. Regardless of the symptoms reported, the dental office respondent encapsulates the caller’s reason in a response and assures the caller that the situation should not be a problem and that the office can make him or her very comfortable. The call should end with a reassurance, such as “We look forward to seeing you in our office so that we can help you.”
If the patient is not in pain, a series of questions can be asked to gather more information. This includes asking when it was that the individual last saw the dentist. A new patient will never have seen the dentist but often will have been referred by a current patient. People tend to refer people similar to themselves. Type A patients are referred by type As, type Bs by type Bs, and so on. If the referring patient has always been a good patient and someone who has received esthetic treatment, the respondent may have a sense of why this prospective patient has elected to call this office. Another way to find out that someone has chosen this office through a referral is to ask, “Who may we thank for referring you to our office?” This helps build a relationship with the prospective patient and sends the message that (1) this office likes referrals and (2) it thanks those who refer others.
When the caller says he or she is in pain, the easiest way to determine whether the situation is an emergency is to ask the caller, “How soon can you be here?” If the caller cannot come until after work is finished for the day, it may not be an emergency. If the caller can come in right away, this is likely an emergency and every effort should be made to accommodate the caller and relieve the pain. After that, a more formal appointment can be made during which a more complete treatment can be developed.
Once it has been determined that the caller will be coming to the office, the respondent should ask whether the patient has ever been told to take medication before seeing the dentist. This does not mean taking a full medical history, but an affirmative answer to the simple question alerts the dental office that premedication is required.
Other information to discuss includes transportation information, parking availability, and directions. All of this information helps the dental office to better handle potential or established patients who call in.
The attitude of the person answering the phone is essential to good telephone communication. If the caller perceives that the person on the other end of the phone line is not paying attention, is not receptive to what the caller is saying, or sounds grumpy or bothered by the call, he or she forms a negative opinion of the rest of the office. It is important to greet each caller with a positive attitude in a very upbeat voice that conveys a sincere desire to help the caller and make a connection. The caller then knows this is the best possible office to help resolve his or her dental problem.
The person answering the telephone should be able to engage the caller in conversation relative to the caller’s desires. For example, the prospective patient might be concerned about the color of his or her teeth, and the dental team member answering the phone should be well versed and comfortable in discussing the treatments available to whiten and brighten teeth. If the patient is concerned about cracked or chipped teeth, the respondent should be able to discuss in broad terms treatment options such as porcelain veneers or crowns. Keep in mind, though, that a diagnosis cannot and should not be made over the phone. The person answering the phone should be clear that he or she is speaking in generalities and it is only the doctor who can fully assess the patient’s needs when he or she visits. The patient will then be informed of possible treatments before any services are performed.
Following up with the patient after making the initial appointment is a second important step. If the situation is not of an urgent nature, the follow-up call would probably be made the day before the appointment. A typical call would be as follows:
“Mr Smith, it was great talking with you the other day. If you recall, we have an appointment time set aside for you tomorrow at 2:00. We look forward to having you here with us. Is there anything I can help you with to make your visit a little easier? Do you need directions to our office? May I tell you, if you’re coming by car, where parking is available? You indicated that you need to take medications before the appointment; please remember to do that.”
The first visit with the dentist and staff is critical in establishing a relationship. It has been said that it takes 5 minutes for the patient to know whether he or she will be in the dental office for the next 15 years, and 15 years to figure out if he or she has been in the right office. If a new patient, Mr Smith, is coming in, the person at the front desk should be prepared to stand up and greet Mr Smith when he walks through the door. An appropriate greeting would be:
In addition, when the morning staff meeting is held, everyone should be made aware of who the new patient is and how many new patients are coming in that day. Then everyone should try to greet each new patient by name and welcome him or her to the office. That first contact is critical in securing a positive relationship with the patient.
In establishing rapport with the patient, the acronym FORM is useful. This stands for family, occupation, recreation, and motivation. Using that acronym provides points of conversation that will help you build a relationship with the patient.
People also enjoy talking about their recreation, or what they like to do for fun. The dental assistant could ask the patient what he or she likes to do in their spare time. It is important to be able to discuss subjects like this with the patient.
With this approach, the dentist has indicated that although the office staff members know why the patient is here, they are seeking further information about what the patient would like to accomplish in this visit.
Typically the patient is told what to expect either on the phone, depending on the length of the conversation, or at the initial visit. First, it is important to meet with the patient, whether this is done by the dentist or the staff. With a new patient, the current procedure is to take full face and intra-oral photographs (Figure 33-3, A to C). Also, study impressions and models of the teeth may be made (Figure 33-3, D), and there may be a need for radiographs (Figure 33-3, E to I). Depending on how the staff and office are set up, a complete diagnostic work-up may be performed. Some of these tasks are handled by the dentist; some fall to the dental hygienist or auxiliary staff. The patient is fully informed of everything that will be done before the initial visit.
Depending on the time available from the initial phone call to the appointment time, it is a nice touch to send the prospective patient a note, preferably handwritten. This initial packet should also contain directions to the office, where parking is available for the office, and what bus, train, or subway station is closest to the office, as appropriate. The note could say:
It was great talking to you on the phone and I really look forward to seeing you at your appointment next Tuesday at 2 pm. I’ve enclosed an appointment reminder card as well as directions to our office. I’ve included a health history form that you can fill out in advance, as well as one of our recent newsletters.
Sending a health history form (Figure 33-4) to the patient in advance does two things: (1) it allows the patient to fill the form out at home with access to all his or her medications so they can be recorded accurately, and (2) it gives the patie/>