It’s neat to image a tooth and prepare a crown while the patient waits. But anyone else willing to spend money can do that, too. Except for me having to figure out how something else works, there’s nothing wrong with high tech, nothing at all. But I contend that any dentist who believes the key to outstanding achievement is having the latest gewgaws is journeying down a primrose path leading to debt and disappointment.
Overlook this quintessential fact at your peril. Dental success is and always has been, dependent upon creating positive relationships. Plus, working with and on people you like, who appreciate you in return, makes practicing more pleasant and productive.
Critical to achieving the excellent communication skills that forge these interpersonal bonds is understanding that: “If you must speak, ask a question.” Active listening is paramount, but queries allow one to direct and control a conversation while avoiding the potential misunderstandings and conflict that declarative statements can create.
Although for weal or woe, dentists must eventually speak. When it comes to patient interactions, staff members are more important than doctors, if for no other reason than they outnumber us. So focusing on our teammates, let’s have the first illustration of this concept involving the peculiar situation that is the job interview.
My practice asked applicants to hand-deliver resumes. Whoever greeted the applicant filled out a standardized form describing the potential employee in a situation which – unlike a formal interview – where everyone is well dressed, on their best behavior and frantically searching for the answers they think you want to hear. The person is relaxed and unaware of scrutiny. Appearance, smile, friendliness, use of language are all evaluated; the final inquiry being, “Would you recommend hiring this individual?” Several times the message has been, “You don’t need to know why, but we don’t want them here.”
Not trained in the art of hiring, few dentists become optimally prepared, choosing to trust their instincts or fly by the seat of their pants. Nothing is more foundational to practice triumph than surrounding oneself with the right people. The interview is where that blessed event occurs. Thus, becoming educated and fully prepared for these opportunities becomes a priority for those driven to succeed. (Few circumstances are more fraught with peril than when one believes that because he or she knows a lot about one thing, like dentistry, they understand everything. Proverbs warn that “Pride goeth before destruction,” and lists of victims of financial fraud incidents are usually replete with doctors’ names.)
Interviews tend to be awkward for both parties, and since few are comfortable with silence, doctors can tend to babble. But the point of this exercise is to evaluate and identify the best candidate, and their communication ability is an essential component. So, peruse the resume and ask what you must to clarify, but you already know what you think, so bene nota: shut up and encourage them to talk by controlling and directing the conversation with questions.
My 20-question form, developed decades ago, is continually updated, in part because of changing labor laws. Along with recording responses, I note smile, ease of discourse, vocabulary, tone, and energy. Usually forced to interview after work or on my day off, the hiring process can spread out, so I summarize my impressions as soon as an applicant leaves. I’m loath to depend on memory, and recency bias does exist.
Despite being time-consuming, I always held semiannual individual performance assessments for which the employee and I completed identical forms in advance. After exchanging papers and discussing our comments, we’d agree on one goal for them to accomplish over the following six months and record it on the report. We’d both sign the document, place it in the employee’s file and review it in six months.
This alone is a valuable undertaking, but meeting one-on-one behind closed doors creates a tremendous opportunity for dentists wise enough to ask questions. How do they perceive the state of the office? Are problems developing? Are there personal concerns? Suggestions? The doctor who can limit comments to, “I see, uh-huh, tell me more,” may discover what everyone has been whispering about and interdict a problem. Often teammates had wished to address these issues but lacked a private, safe and receptive venue.
Asking questions is particularly important when dealing with a disgruntled patient. The nature of our work is such that even clinical perfection (if such exists) does not guarantee the desired outcome, so disappointments are unavoidable. Imagine (or more likely remember) a scenario where you’d placed a deep restoration. Near midnight the patient awoke in great pain. After trying everything to gain relief, they called your office at 5 a.m. and related their tale of woe.
(The closest I ever came to getting punched occurred during a similar situation. The patient was furious that we hadn’t returned his 5 a.m. call until 8 a.m. Perhaps I was a bit flippant when I said our office policy stated that when no one was here, we didn’t answer the phone. Anyway, if worst had come to worst, I’m almost positive my chairside could have taken him.)
Listen to the patient’s story. Take notes, offer concerned looks and head nods as you let them fully vent. They will eventually quit talking, and you’ll get a turn. Assume this patient is a real white knuckler who hadn’t seen a dentist in years and proved extremely challenging to treat. You didn’t cause the tooth to break down. You’d shown him on the x-ray how close the damage was to the nerve. But these are declarative statements, and although they may be as accurate, they sound like excuses, which can lead to contention and blame. Don’t risk it. Instead, ask whatever clinical question necessary to clarify the problem, then assure the sufferer that you are on their side and will stop the pain.
Why dentists graduate unprepared in skills essential to economic survival, let alone triumph, is a topic that has perplexed me for decades. But one must understand and accept this reality. Every practitioner who wishes to excel must identify and correct these crucial deficiencies, of which lacking communication excellence is but one. So, after enduring a near-decade of expensive and arduous education, the bad news is that you still aren’t done. The good news is that this is merely the finishing kick at the end of a marathon, and the bounty available to the warriors determined to battle to the end is extraordinary. Chuang Tzu opined, “Great truths do not take hold of the masses.” Sadly, there won’t be a crowd at the finish line as few will complete this vital effort.
To those who do, I wish you Godspeed.