Rapport, Detective and Discovery
Rapport, Detective and Discovery
Rapport, Detective and Discovery
What is the most common error in case presentation?
If you knew this, can you see how it could help you?
You already know it; you just forget sometimes in the melee of everyday practice.
So what is this error and how can you be reminded?
Here is the hint: whose eyes are looking at the appointment? What point of view must you assume to begin any patient relationship?
That's right your patient's viewpoint the one she patient brings to the appointment. What is on her mind? What is she thinking? What worries her? What are her problems from her point of view?
What is on her mind?
So that was easy, right?
Well, maybe notbecause most dentists skip over this and assume that they know.
Here is a typical scenario. A patient completes the new patient paperwork. Your staff reviews it briefly and then you get it. After a quick once over, you meet the patient, review the information provided by the chart forms and start. Not bad. Just not great.
If you are more adept, you'll get the chief complaint and ask a few questions about it. Virtually all dentists accept the first and possibly the second answer given. This is better. You did ask for the chief complaint. This at least begins to establish some rapport with your patient. This works better when you lead your next words to reflect how your next steps are going to address the issues or issues the patient mentioned."
So what is the problem?
You haven't yet reached and understood what the emotional driver is for your patient.
Admittedly, for the check-up, " doesn't need much work" patient, it is probable that the emotional component of the visit is far lighter. A mistake is made when all patients are treated equally. Just as you must customize your treatment plans, you must also customize your interview process to match the logical and emotional need of your patient. The key word there is emotional.
Frankly, most dentists are pretty good with the logical part, but fail miserably when getting to the emotional heart of the matter.
You have a built in advantage that can be squandered unless you keep yourself emotionally aware. That advantage is the authority position you hold as a dentist.
You have a patient questionnaire that can ask virtually any question! Sure, it must pertain to the issues at hand, but still; have you designed yours to help get to the emotional heart of the matter? What could you ask that you don't presently?
Now I am not saying it is always easy. It is not.
Many patients are quite protective of these importances.
Some will blurt it all out; maybe one in fifty.
The rest play a game of verbal decoys at varying depths. Some play this "game" at high levels almost as a test of your capacities. Thank goodness, not many do this.
Most need to know that you are listening to them in a way that no other dentist has. This is especially true of the patient comes with prior bad experiences.
What you must create and maintain is rapport.
Rapport comes from feeling understood and from agreement with the patient's viewpoints and values.
Even if the patient is wrong, you must acknowledge what she says as being accepted and understood. Save your disagreements for the editorial pages of the ADA Journal.
Only when the patient feels accepted, understood and significant can you begin the process of guiding the patient where she must be led. This means you start by getting in tune and resonating with what is important to her. This is what rapport really means.
From this point, you can then begin to take your patient down the persuasion pathway.
But what if your patient is hiding this vital information?! How can you know what is important to her indirectly?
This does require that your sensitive side is turned on, with your emotional antennae at maximum reception
Here are some ways to "ask" or uncover indirectly:
Stories she tells. What a patient will tell you through her stories portrays what is important. The more stories she tells, the more you can discover.
Questions she asks. Her questions will often tell volumes about her attitudes and points of view. Too few questions and too many questions are both bad indicators.
Circumstances that brought her to you and the ones she lives with everyday. Was she referred? Did you find you through your web site? What position does she hold you in? Are there socio-economic factors? What background influences does she live with?
Complaints she voices. These can be a fount of knowledge, if carefully understood. I used the term "carefully understood" because the complaints are often a mask that covers what is really even more important. What feelings are revealed? What type of words does she use? What does her facial expressions, body language and eyes belie?
Tone of voice. What does her tone of voice reveal? Is she bored, fearful, excited, or desperate?
Word choices. What type of words does she use? Does she speak using words that indicate visual, auditory or kinesthetic preference?
Problem solver or goal seeker? Most patients are trying to solve a problem; some are working to achieve a goal. Some are working on both. Note the words that she uses to describe: are they moving towards a goal or away from a problem? Once you know the direction she is headed, you can structure your word choices to match. This step helps keep rapport in place and increase it.
What have you noticed about these seven items? What do they require from you?
LISTENING.
Listening like your practice depends on it because it does, if you want to make a difference.
PAYING ATTENTION. Giving her your undivided attention for those brief minutes where you are focused on her.
MAKING HER FEEL IMPORTANT. Give her the acknowledgement and praise she deserves during interview process.
The bigger the problems you are helping to solve, the bigger your rapport must be BEFORE you present a plan of care.
If you aren't feeling connected and in good communication before you present, you should either into good communication and connection at the start of the presentation or postpone any significant presentation. Present only a portion of the plan to begin. Then after succeeding with that, then go on to the rest of it. Even then, a presentation can go awry unless you continue to build rapport after getting a yes.
Building and maintaining rapport is one facet of private care practice that never goes way.
Becoming the best you can be requires a significant commitment to understanding people and getting in tune with how they think, what they feel and what they value. Are you up to the task?
How else can you know without listening, paying attention to the reactions of your patients and observing how they communicate?
This is a life long journey but what other choice you have? Why not enjoy the trip?
Best,
Charley
Copyright Charles W Martin 2010
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