Wednesday, June 18, 2014

Doctor means educator.

One of the primary roles of a dentist, dental hygienist or dental assistant is to educate patients about the conditions in their mouth and what can be done about them.  Some people feel that they have to "Sell dentistry".  I just don't buy that philosophy.  Years ago I worked as a door to door salesman selling water softeners and to be honest I stunk.  I'm just not a good salesman.  What I am good at is education, and I enjoy it.  This is one of the reasons that I love dentistry because I don't have to sell things, I just need to educate.  If I do a good job of education then patients will most often choose what is best for them and their budget.

This is the way that I like to educate my patients.  I like to really do a good job at the start listening to them describe what is going on in their mouth both now and historically.  The patient lives with their mouth day in and day out and they know more about it than I ever will.  I talk with them upright, at eye level and really listen to what they have to say.  I ask questions that give them a chance to talk.  Good questions start with phrases like "Tell me about…." or "Could you explain to me…." etc.  This invites answers that give you great information.  Yes No questions are of limited value.

The next step is to get great records.  I need to have data available to make intelligent decisions.  Great radiographs, photographs, perio probings, gum recession measurements, a record of all existing work, models if needed and maybe even bite registrations or transfers to mount the models on an articulator.  Whatever I see is necessary to really look at the whole person.  I also like to know about their dental history and what their goals are in my practice.  When we have all that information we are really ready to start.

I love co-diagnosis.  I start by telling the patient that we are going to review all their records together and that I am just going to talk out loud about what I am observing.  I invite them to stop me at any point if they have questions and I will do my best to answer them.  Then I begin looking with them.  I explain what I am looking for and I point out the things that I observe, both the good and the bad.  If they have had great work done in the past I point that out.   If I see something that isn't right I tell them that too.  I might start out saying "I notice that….."  "May I tell you about how that could be improved?"  Most of the time people are happy to hear about their options.  For example, I might say, "I noticed that your front teeth are crowded.  May I tell you about some of your options for improving that?"  I am always surprised at how often people will tell me that they have been going to the dentist for years and that the dentist never mentioned that they could do something about it.  Somewhere in this discussion I like to bring up what will likely happen if they don't do anything and what they might expect if we were to treat the condition.  This should be an honest appraisal not a sales pitch.

In our office we have a monitor directly in front of every chair.  This is where we view most of our images.  We use an intramural camera for part of this.  I love to freeze an image and talk to them about what I am observing and answer their questions.  By the way, I have owned a lot of intra oral cameras over the years.  The first one I bought cost me nearly $20,000 with the monitors and printer.  The intra oral camera I have now cost me about $120 on eBay, straight from China.  At that price I put one in every room.  Frankly, I like it as well as any camera I have owned.

By the time we are done most patients feel that they know more about their mouth than they have ever known in their lives.  I sit them up and give them a synopsis of what we talked about and what treatment options are available to them.  We answer questions and begin to form a treatment plan based on what they need and want to do.  Larger treatment plans we may invite them back at a later time so that I have time to formulate an overall treatment plan and prepare needed visual aids.  Simpler plans we will compile that same day.

Education is easy, enjoyable and allows you to provide your patients comprehensive care.  The word doctor literally means educator.  Perhaps we should do more to live up to that title.

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