The patient-provider relationship: How to “be curious, not judgmental”
I’ll be the first to admit that I’ve judged patients when I've had a busy day or come into the office with a bad attitude. As dental professionals, a significant portion of our job relies on building relationships and making patients comfortable with the treatment we’re recommending. But how do we handle situations when they decline our professional opinion or—even worse—get disgruntled and request to see a different provider? Do we immediately judge this patient or try to understand where they’re coming from?
Where patients’ reactions come from
Patient behaviors are determined by several factors, including attitudes, beliefs, social norms, and perceived control.1 This begs the question of how we, as providers, can be better stewards of curiosity rather than judgment when it comes to patient care.
Trust and rapport
Dentistry prioritizes treatment outcomes, practice deliverables, advancements in technology, and other modalities to improve provider performance and efficiency. Although these factors are critical to providing cutting-edge care, what about patient-provider relationships? Those built on trust and rapport not only alleviate anxiety and distress but enhance a patient’s involvement in decisions about their care.2
Engaging patients is partially dependent on the dental team’s communication skills and ability to build rapport, but curating a trusting relationship is more than just making a patient comfortable in the chair.2 Knowing what motivates and concerns patients makes them truly feel heard. This helps the provider facilitate better conversations about dental treatment and make each appointment individualized.
Motivations and concerns
Motivations are energy and persistence that directs behaviors, whereas concerns are what worry or make someone anxious.3,4 Motivations may fluctuate on a case-by-case basis—or over time. Patients may be motivated by their health, esthetics, or prevention. They may be worried about finances, time, scheduling, or pain.
In situations where the provider doesn’t have a true understanding of a patient’s reason for seeking dental care, or why the patient is worried about a procedure, it can be easy to pass judgment. To mollify this, it’s important to ask open-ended questions, provide reassurance, involve patients in the appointment by showing them images and demonstrations, and communicate in a way that’s aligned with a patient’s oral health literacy. Doing these things not only builds trust but offers insights into patient motivators and concerns.2
Building value
When building value in dental care, it’s critical to understand what drives and concerns a patient. For example, patients motivated by prevention are going to prioritize their oral health and make routine oral hygiene visits. However, if a provider thought a patient motivated by prevention was motivated by esthetics instead, the patient may be more likely to decline treatment as they may not see value in the recommendation. Relying on curiosity and giving patients the opportunity to ask questions—while making sure they comprehend the information you provide them—will prevent objections to treatment recommendations.5
In addition to building value in treatment rendered, value can also come from the provider and where care is received. One study evaluated 724 participants and what they consider when choosing their dentist. Twenty-two percent of respondents favored dentist’s competence, 20% looked to recommendations made by someone they knew, and 19% valued overall quality of the dental care services provided. Participants’ satisfaction with dental services received was also evaluated, with 93% agreeing that communication with their dentist had been easy.6
Thus, if a patient values the dental services rendered, they are more willing to recommend their provider to someone else. Effective communication that considers one’s oral health literacy and cultural competency is another critical component to avoid judgmental language and behaviors.2 Understanding what a patient values in their care may boost curiosity around patient behaviors and decisions rather than judging a patient for disagreeing with their dentist. Ultimately, the provider is responsible for serving as a patient’s teammate and supporting their specific needs.
Conclusion
Being curious and not judgmental seems like a simple concept, but the patient-provider relationship is complex. Although providers are typically very busy, feeling as though time slips through their fingers some days, taking time to build trust and rapport beyond a patient’s personal life helps foster a constructive relationship where the patient values the treatment being rendered. Staying curious and finding avenues to understand a patient’s motivators and concerns may mean the difference between their acceptance or refusal of a treatment recommendation.
References
-
Arnett MC, Eagle IT. Motivational interviewing: dentists’ role in patient behavior change. Decisions in Dentistry. April 4, 2022. https://decisionsindentistry.com/article/motivational-interviewing-dentists-role-patient-behavior-change/
-
Dang BN, Westbrook RA, Njue SM, Giordano TP. Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study. BMC Medical Education. 2017;17(32):1-10. doi:10.1186/s12909-017-0868-5
-
Gillam D, Yusuf H. Brief motivational interviewing in dental practice. Dent J (Basel). 2019;7(2):51. doi:10.3390/dj7020051
-
Hosseini F, Masoudi N, Mohammadi AE, Sadat Z. Scoping review on the concept of patient motivation and practical tools to assess it. Iran J Nurs Midwifery Res. 2021;26(1):1-10. doi:10.4103/ijnmr.IJNMR_15_20
-
How to create value for your dental practice. Progressive Dental Marketing. https://www.progressivedentalmarketing.com/dental-marketing/how-to-create-value/
-
Ungureanu MI, Mocean F. What do patients take into account when they choose their dentist? Implications for quality improvement. Patient Prefer Adherence. 2015;9:1715-1720. doi:10.2147/PPA.S94310
Annie Walters, MSDH, RDH, attended Northern Arizona University, where she spent time caring for individuals in Guatemala and Indian Health Service. She has a special interest in advancing access to care for individuals with specialized health-care needs. She’s a member of ADHA, and received her MS from the University of New Mexico, where she developed a chairside resource for RDHs to use for patients with specialized needs. She practices in Flagstaff, Arizona, and serves as part-time faculty at her alma mater. Contact her at [email protected].
