and my key advice to all dentists is to think before you speak
and patients will pick up on your verbal and non-verbal communication before you speak
think about what you're going to say a separated instrument sounds a lot better than a broken file
and how patients hear and perceive things are very important so don't sit there shaking whilst
you're communicating it to your patient you have to have some sort of confidence
that you've explained this already to them it's an adverse outcome this is how we're going to
manage your adverse outcome and this is the effect it's going to have on your treatment
hi everyone i'm super excited to be joined today by dr dige to talk about patient communication
dr ditch is all about high quality endodontic treatment and has a massive passion for teaching
his work has led up to evo endo an endodontic clinic for referring dentists and the center for
endodontic learning for early career dentists thank you so much for joining me today dr dave
thank you so that was a great introduction hopefully i live up to everything that
you said so we've got lots of questions about communication and we'll get straight into it so
first one is why is communication so important in dentistry honestly my belief is simply that
if you can understand your patients values and expectations and you can manage them then
you will get more predictable results and outcomes and happy patients and the fundamental key to that
is communication and if you can ask the right questions at the right time you will understand
your patients that much better and how do you go about explaining certain treatment options to a
patient for example treatment options i guess with everything is fundamentally explaining to them the
value of the treatment what are you trying to achieve and what value does that treatment give
to them so instead of saying to him that you're going to have a crown for example i'd say mrs
smith you need a crown the benefits of this crown are it's going to protect your tooth it's going to
restore the functionality of the two so you'll be able to chew on it and also we'll be able to make
that tooth more lifelike in appearance is that something you would like instead of saying to
them you need a crown because a patient won't understand the value of what you're trying to
deliver and also explaining them to them the risks and benefits of treatments that you're carrying
out so that we fundamentally get informed consent from the patient which is the key to long-term
success and when we're explaining these things to the patient do you think we should be giving
statistics um when explaining these options or do you think patients don't appreciate that i think
statistics are important i think if patients get an idea of longevity of a restoration then
you can manage their expectations and statistics come into play if you are doing a treatment that
is unpredictable or you're questioning whether you should be carrying out that treatment first of all
if you're unsure about whether a treatment should or shouldn't be carried out you should
ask yourself are you going to be carrying it out and secondly if the treatment is unpredictable i
don't know why we shy away from communicating that if you're unsure what the statistics suggest that
the outcomes for this treatment option are not as good as others the patient should be aware of it
so for example with me when it comes to reroot canal treatments it's very important that i
give the patients a statistical background what are the likelihoods of success so if i were to
explain that to a patient i normally say to him again mrs smith so mr smith would you be upset if
i said to you there was only an 80 chance of us saving this too and actually the key is let the
patient answer the questions and not you answering those answering those questions for them because
some patients might be okay with 80 percent whereas another patient might think 80 that's
rubbish though right whereas if we can actually understand that if they're happy with 80 and the
treatment works they're going to love you forever if that treatment doesn't work well it was a 20
that didn't work and they will actually appreciate that you said that to them at the beginning
and like we talk about having a plan before you carry out the process it's the same with
communication communication is a part of your planning let the patient understand what that
treatment is being done and why it's being carried out and when you're giving out these
statistics to the patients is it as simple as finding a study and getting some numbers from
them or are there some numbers that you usually go with judge your patient if it's the sort
of patient that likes statistical information and is asking you very detailed questions get
detailed with your responses so if a patient's asking me very precise and intricate questions
and my actual communication to them is going to be very precise very intricate giving them details
of papers and studies if it's the sort of patient that's just asking you simple questions and you're
giving complicated answers back you're going to lose them and then actually you have to actually
ask does your patient understand what treatment you're carrying out and moving on from the kind of
patient understanding things do you think patients really understand x-rays should we go through the
x-rays with them my opinion the more information you give them okay that is going to have an
influence on their treatment yes it's worthwhile so for something like root canal treatment if the
x-ray is going to help you explain the treatment to them and what you're carrying out do it
but if it's of no benefit then why okay so for endodontics for me for example i would go through
an x-ray with a patient the reason why is i can explain to them the potential challenges that may
we may have during treatment and also discuss with them what effect that may have out on or may have
on outcome and definitely incest where they're heavily compromised or broken down so i think it's
very important that you show an x-ray why they normally say a picture speaks a thousand words
okay an x-ray is one form of a picture i wish i could encourage all dentists
to take some photos okay it doesn't necessarily have to be the most
swankiest pictures around on an slr camera but a picture speaks to a thousand words if you want to
tell someone something show them show them and they'll understand whereas if you just tell them
they don't know what a do composite is though they definitely don't know what a do composite is
that's great advice and how do you talk to the patient when something has gone wrong for example
you've perforated a tooth or you've broken a file planning is being prepared okay so for me though
they should already have known that actually that there is a potential for that to occur so when
we talked about earlier risks and benefits to our patients that would have already been discussed so
if it's an adverse outcome and they're not finding out about it the first time their reaction can be
managed okay and my key advice to all dentists is think before you speak and patients will pick up
on your verbal and non-verbal communication before you speak think about what you're gonna say okay
instead of a broken file a separate instrument sounds a lot better than a broken file
and how patients hear and perceive things are very important so don't sit there shaking whilst
you're communicating it to your patient you have to have some sort of confidence
that you've explained this already to them it's an adverse outcome this is how we're going to
manage your adverse outcome and this is the effect it's going to have on your treatment
and that way your patients shouldn't it shouldn't come to it as a shock to them
yes in some patients they react badly to it and then it's how you manage that situation
going forward and in that case if a patient does turn out to be difficult and responds badly how
would you manage it that way i guess it's managing people's emotions and understanding their emotions
okay a natural reaction sometimes as you start mirroring their emotions so if they're upset
and you start getting upset there's two people getting upset which isn't very good
um my answer to is always remain calm and relaxed control your mind if something's
gone wrong you have to think to yourself how am i now gonna best manage this so for me it is if
something's gone wrong i have to provide them with the information that's gonna make it better
and you have to ask yourself the question am i the best person to manage this problem and in some
cases it may be that you need to refer along to a specialist or in other cases you may be no look
i can still handle this but i need to be able to exude confidence to this person and not show fit
and remember don't fear things going wrong before they actually happen so i believe in positivity i
don't even think about proactive instruments or perforations because i actually just concentrate
on what i'm actually doing only fear something when it happens not before it happens so
just with them give them all the information one two make sure they're aware of their options
okay and three understand why they're upset and be caring okay no one can be angry at someone that
cares okay if you show them care attention and detail no one can be angry at you if you're very
blase about something going wrong then you're not going to get a positive response back and
let's say before you've even started any treatment or you're just talking to the patient and you want
to deliver some bad news for example you need to have this tooth extracted um are there any rules
that you have or any ways that you go about it delivering bad news to a patient when it comes
to an unrestorable tooth i guess it comes down to explanations i guess it's explaining to them
why that tooth is unrestorable before actually telling them it's unwritten so for me i take a
picture i take a radiograph and off a picture i would say mrs smith can you see this
can you see how little toother is left can you see this there's not a lot of bone on this x-ray
showing that there's enough bone to support this tooth so having looked at these things do
you think it would be wise for us to say this to i don't actually say the answer so the patient says
no i think it's better we take this out mr aurora or if they go well i still want you to give it a
go i really want you to give it a go i value saving my team i'd say i share your values mr
smith but if i said to you that two's not going to be there in 12 months time and you've paid
x sum of money would you be upset because that's the question you really need to ask you need to
ask them are they going to be upset if they paid a certain amount of treatment and it doesn't work
and if the patient's like yeah of course i would well then take it out no i wouldn't well this is
really unpredictable and actually in my hands i don't think it's going to work and if you
actually don't think it's going to work do not do any treatment that you do not think is going to
work that is a recipe for disaster and if it's a may work explain it to the patient this is
unpredictable dentistry i'm not sure if it may or may not work because of x y and z as i have shown
you and this is what we're gonna do would you be happy that's it that's a really good answer and in
general when you're discussing treatment options with patients how would you deal with one that
responds that's too expensive i just think the patient first has to value you okay and you've got
to be confident in your prices first of all and if you fully believe that what you charge is the
right fee you're going to exclude confidence to your patient and they'll value and understand that
this guy knows what he's doing or two if they say it's too expensive you have to show to them value
in the treatment you're going to carry out now a good comparison that i sometimes use i'll go mrs
smith you want to have an implant on an implant it's going to cost you two and a half thousand
pounds the benefits of the implant like this this this this this this and ask them the question do
you value this and if they say they don't value serving a tooth and they don't value it it's too
expensive for them but if they say yeah i do want it but it's still too expensive then give them a
comparison the human brain loves comparisons and give them a comparison that they'd understand
so for example if they drove an expensive car my comparison would be mr smith but you're happy to
drive a mercedes that costs 25 30 000 and you only use it for 40 minutes a day or an hour a
day or two hours a day i'm asking you to spend two and a half thousand pounds on your tooth that's a
part of your or an implant that's a part of your body that is going to be used all day every day
for the foreseeable future now do you value this treatment and it fundamentally will come
down to whether the patient values it and don't try and enforce your values onto the patient's
values the patient may not value it and they may actually genuinely believe you're too expensive
and you're not the right dentist to see and for me when it comes to prices there are no discounts so
i don't do i will give you this much off if you do this because that is a future conversation
you're going to carry on having perfect thank you so much dr ditch and are there any final comments
that you want to make in terms of patient communication or any final tips that you have
i would just say perceived value make sure the patients understand what they're having done
the value of the treatment and understand their emotions related to that if you can understand the
patient's feelings related to the treatment you'll need a very happier dentistry life thank you so
much dr dij and thank you for coming on to our youtube channel today and are there any ways that
our viewers can learn more about this kind of teaching yeah it's evolinda my whole belief is i
want to inspire people to learn and grow and in my particular field that's endodontics and if you're
keen to learn more about endodontics then i would visit the website which is evowindo dot co dot uk
and we'll get future dates up on there perfect thank you so much for coming on
today dr ditch and thank you guys for watching we'll see you guys in the next video thank you