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Embracing the opportunity of ethical influencing

There was a time when it was considered reasonable for a dentist to adopt a didactic and paternalistic role. The patient was given a diagnosis followed by a recommended treatment plan, and they were expected to follow the dentist’s advice.’ But times have changed, and so have the patient’s mindset and their expectations.

They have greater access to more information (Dr Google); they have more choices (with many more dental practices); they have a greater need to be in control of their decision-making; and they’ve become wary of being told what to do and ‘allergic’ to being sold to. Dentists are caught between being expected to give an opinion as to the treatment required, whilst understanding that any attempt to talk the patient into treatment can easily damage the relationship irrevocably. Just because they see you as an expert in your field doesn’t mean they’ll blindly follow your recommendations.

All ethical clinicians care about their patient’s well-being and it’s entirely reasonable to want the patient to choose the most optimal treatment for the condition. However, the fact that most dental treatment is both discretionary and expensive, and yet most conditions are chronic and painless, makes the dentist’s job all the more challenging. Bridging the gap between what a patient wants (or what they think they need) and what the dentist thinks the patient needs, has become the hallmark of mastery in our industry. And great clinical skills alone are no longer enough to bridge that gap.

“The greatest ability in business is to get along with others and to influence their actions”  John Hancock

To influence: to have the capacity to have an effect on the behaviour or actions of someone.Some might suggest that dentists have an ethical necessity to influence their patients towards choosing optimal dentistry. At the very least, you have the choice to develop the skills to become an ‘ethical influencer’. To find a way to influence your patients to want appropriate treatment in such a way that can never damage the delicate and fickle clinician-patient relationship. One place to start might be the…

Two Rules of Ethical Dentistry

Primespeak has always been based on two ethical foundations:

  1. To offer patients treatment that you would have if you had their conditions (or what you would offer your partner or your parents)

  2. To offer treatment options regardless of the cost (in other words, without judgment around what they can or can’t afford).

Most dentists agree that following both rules would be an entirely ethical way to practise dentistry. Those who haven’t practised by these two rules and begin to do so, invariably experience an increase in case acceptance, merely because they’re providing more options than they might previously have offered. So if you don’t have the energy to read any further, you could stop right here and you’d still have some gold nuggets that on their own will make a big difference.

But if you’re still reading, you’ll also know that rarely (if ever), do any dentists practice these two rules 100% of the time. Why not? Because you’re human. And sometimes you just don’t have the energy, or the desire, or the communication skills, required. Knowing the two rules is the first step.Practicing them each day, with each patient, is the next step. And the more you practice them the more you’ll see that without a new communications paradigm to accompany these two rules, you may also get more rejection (again, merely because you’re offering more options). And more rejection will ultimately lead to abandoning or reversal of the rules.

A new communication paradigm

We’ve always maintained that Primespeak is a ‘rejection-proof’ communications approach. That doesn’t mean you’ll get 100% case acceptance 100% of the time, but it does mean that no matter what the patient chooses, they like you, trust you, and return to you. And that you can rest easy knowing that you’ve done your job. It’s a big call, but we stand by it.

Some might think that in order for it to be true, they’d need to use all the techniques, strategies and tools in the Primespeak toolbox, exactly as we present them.

In actuality, true mastery lies in:

  1. using the least number of tools in the Primespeak toolbox;

  2. knowing there’s a sequence, but not always needing to follow it to the letter;

  3. working with the counter-intuitive until it becomes intuitive;

  4. becoming comfortable with the uncomfortable;

  5. recognising that there are no scripts to follow, only concepts;

  6. acknowledging that trying anything new will feel clunky in the beginning;

  7. maintaining anything that currently works for you, even if it runs contrary to the Primespeak Approach;

  8. becoming aware of what you’re saying, how you’re saying it and the impact it’s having on your patients; being willing to change, amend and adapt any concepts to suit your needs and your style.

So what is this new communications paradigm and how does it differ from the standard Paradigm?

To begin with, consider that when we want to convince someone to buy or do something, it is intuitive to ‘talk-up’ the positive attributes of what we want them to buy or do. In sales training, this is known as benefit selling. All of us ‘benefit sell’ in one form or another everyday. And in dentistry, focusing on the solution is common because most dentists are hard-wired to determine the right solution for any oral health conditions they find. The issue with this however, is that in the absence of trust (between the dentist and the patient) and ownership (of the damaging results of the existing conditions), the most optimal solutions may fall on dear ears.

Primespeak is the antithesis of traditional sales techniques. One reason that Primespeak seems counter-intuitive is that we get better results by NOT benefit selling the optimum treatment.

Essentially, the Primespeak new patient exam goes through several broad stages of ethical influence and none of these stages has any benefit selling:

  1. The first stage has the dentist gather information from the patient and build rapport. There is no danger of the patient perceiving a sales agenda, provided that no mention is made of any particular treatment solutions for the patient’s condition.

  2. The second stage requires the transfer of information from the dentist to the patient before the clinical exam. Patients usually need a certain amount of dental education in order for them to be able to make intelligent decisions. The focus should be on the damaging results of an existing condition rather than the solution to a problem. This information should be woven into a conversation that is not specifically about this patient, but a general comment about what can happen with a particular condition. We have not done any benefit selling because we have still not talked about solutions.

  3. The third stage involves the patient overhearing a conversation between the from dentists and the DA. The language used is simple, descriptive and factual regarding what can be seen. Still, no mention is made regarding treatment.

  4. The fourth stage allows the patient to see images of their conditions and is involved in a conversation regarding what they can see. Still no mention of solutions, however the visible facts are indisputable. If we have created appropriate concern about the degenerative outcome of that particular condition, the patient is now ready to explore treatment options.

  5. The fifth stage involves going through thevarious options. By this stage, the patient has a deep level of trust with the dentist and a high level of ownership of the problems, so a conversation about the various options isnatural and appropriate. The patient can now make an informed decision, totally comfortable in knowing that the dentist will support whatever they choose, as long as the patient is aware of the pros and cons of each option. The absence of any recommendations removes any chance of rejection.

In Summary

Every dentist has a choice to embrace the opportunity to influence their patients to desire optimum oral health with strong ethical foundations. A deficiency in communications training results in a deficiency to reach the desired treatment outcomes. Primespeak provides dentists and their team powerful communications techniques, tools and strategies to add to their influencing toolbox and create a win-win outcome for themselves and for their patients.


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