On the Science of Influence

Build your relationships first….then your dentistry. ~ Bob Barkley

On the Science of Influence

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Based on the concepts of  Kevin Hogan, PSY. D

(Adapted and generously shared by Bill Lockhard, Jr. DDS)

Trust is essential to influence. People buy what they need from people who understand what they want. People are buying you and because of you, if they trust you. If they don’t, nothing has a chance to happen. Trust begins when credibility and reliability are established. You are the messenger; your likeability is the silver bullet. People are influenced by caring and empathetic people with similar values. When people sense genuine interest and concern for their welfare, they are likely to develop long-term relationships that will create win-win situations. Trust breeds loyalty. It is hard to switch from someone or something you trust completely. In fact, it’s almost impossible to change true loyalty because the stress of change would be enormous. Help the patient see you as someone who cares about them, and you will dramatically increase the probability of treatment plan acceptance.

Develop patient ownership of their problems and solutions early. There is greater ownership of the decision to accept treatment if the patient writes things down as he/she participates in the diagnosis and treatment plan process. Place something of yours into the hands of the patient, such as a diagnostic model of optimum treatment. When patients possess something, they perceive it to be more valuable than they did immediately prior to owning it. Once people own their actions or once people own something they value, their behavior and attitudes both begin to change.

Decisions are emotional, not just logical. Most people fail to influence others because they attempt to communicate with the sole intention of having the other person make a logical decision. They fail to realize that the unconscious brain (limbic brain) decides. The conscious mind, mostly composed of cortex, justifies the emotional decision to make that decision make sense. Take advantage of the brain’s organization and keep the client to your right when shaking hands, sitting and communicating. This accesses more of the left side of the brain for both of you, and allows you both to relax and perform more analytically.

First and last impressions matter. What happens first in some experience, event, or situation alters our perceptions of everything that follows. What happens last in some experience, event, or situation is extremely important in our perceptions and beliefs. People remember peak experiences and how the event ends, and then they generalize the ending back to the entire life of the experience. People want to have pleasant experiences. Make every effort to exceed their expectations.

Help people resolve their options quickly. Too many choices are confusing, and they don’t know which to choose. Be prepared to direct people to the optimum choice for them. People crave direction. Pointing out any negative aspects of your proposal makes you appear far more trustworthy, and it allows the patient to be set at ease as you are doing “their” job of finding the drawbacks of the proposal.

Compare expected results of action and non-action. People want to comply if they can see a way to not regret the action. They want to avoid making a bad (losing) decision. The best thing to do is look at what happens if they do and if they don’t comply. Looking at both sides increases the chance of compliance. The phobia of losing is tough to get past without at least acknowledging and examining the possible outcomes. The unknown is rarely a better option, in the mind of the patient, than the status quo, unless the status quo is enormously painful. When people are comfortable, there is little reason to change.

Create a realistic picture of what the patient will lose if they do not accept the treatment plan. Loss aversion is more pronounced for income than leisure. Losing the opportunity to travel is not as powerful as losing income. This means that money will have greater influence on a treatment decision than time. If you use the fear of losing money as a motivator for treatment, include a step-by-step set of instructions for compliance so the patient feels empowered to take action to avoid regret.

Help people go into the future and imagine in detail enjoying the benefits of their new oral health and attractive smile. Having people imagine the future is a powerful tool for gaining compliance. If you paint a realistic, positive future, there is an excellent chance that people will respond appropriately

Never let patients feel stupid about their past mistakes. People want leadership approval. All people need to feel wanted and part of a group. They want your appreciation and approval. Make sure they know that any intelligent person would have done the same thing if they were presented with a similar situation, for example, not knowing in the past about their real oral health circumstances. If you show even an unconscious body language cue that the person did make a foolish mistake, the natural tendency will be to feel defensive and that generates a “no” response.

Understand that at any moment, people are on the pendulum between the conscious mind response and their feelings, which are probably all over the map, trying to make sense of your proposal. There is ample evidence revealing that the closer one comes to a goal or an objective (in this case making a decision), the more likely one is to experience regret, which is the fear and anxiety of making the wrong decision. When people say, “I’ll think about it,” they don’t feel right in at least one way. They can’t quantify it because it is a feeling—but they are oscillating back and forth until it stops in the middle with “I don’t know” or “maybe.” Many times, a person’s conscious mind will analyze your proposal and make a rational decision to accept it, followed by a flood of anticipated regret. They say yes but feel no.

Ask the closing question after positive responses to three trial closing questions. Trial closing questions ask for a positive opinion. Closing questions ask for a decision. Do not offer someone a financial inducement to accept treatment (5% discount for cash).

When you get the decision you want from them, it is time to stop talking and move along. It is very important to always reassure the person that he/she made a wise decision. If you get a ‘no’ answer, understand that once someone passes on an opportunity, they are likely to decide that way in the future as well.

 

Trial Closing Questions:    “Does that make sense to you?”

“Would you like to protect the back teeth so you can continue to eat popcorn?”         “Is this how you want your smile to look?”     “Would you like your lower denture to be comfortable and not fall out when you eat?”

 

 

Are You Talking About Benefits or BENEFITS?

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I’m tired of talking about insurance benefits. So much is being said today about “changes in health care,” but the conversation really tends to be more about changes in insurance benefits. I think the time is right for those of us in dentistry to lead the way into a different conversation; a conversation about health.

We have a lot to learn about health; a lot to explore with our patients. Beyond education there is a place for authentic dialogue; an exchange of ideas in which there is learning on both sides. Beyond a mechanistic model of health is a true understanding of vitality, of what it means to thrive. This kind of conversation requires that we set aside our bias about know what is “best” for our patients.  It requires that we suspend assumptions; that we let go judgment; that we find in our hearts compassion — for fellow travelers on the road to health.

I’m not suggesting we ignore the realities of dental insurance in our lives and in the lives of our patients. I’m not idealizing the desire our patients have for health, or the possibilities they are able to see for themselves. I am keenly aware how important is to pay attention to the productivity and profitability of a dental practice. I just believe that we are at an important transition in regard to health care, and we can either “wait and see” how it turns out, or we can participate in shaping it.

I’d like to suggest a formula for health, both the health of your patients, and the health of your practice:

CSJ + PO + FF + MOP = Health

The first part of the equation has to do with Care, Skill, and Judgment. This refers to all aspects of how you care for your patients. We have a responsibility to develop skills in helping patients choose health as well as in delivering excellent technical dentistry. Success depends on clinical excellence and our capacity for understanding, patience and compassion. Our care, skill, and judgment make up the first, essential part of the formula for health.

The next part of the equation has to do with agreement on Preferred Outcomes. Our best homecare suggestions and treatment recommendations are meaningless unless we are moving toward mutually agreed upon outcomes. It creates the context for every choice we ask patients to make and every option they ask us to offer them. We can learn to help patients shape their preferred outcome by helping them see what Dr. Bob Barkly referred to as their “probable future” and their “possible future.” Without the context of a preferred outcome they cannot be fully informed of the implications of their choices.

Another element to factor into the equation is a Fair Fee. There are a number of ways to determine a fair fee. It can be based on your overhead, on comparables in your community, on time, on skill level, on degree of difficulty, etc. You must choose how a fair fee will be determined in your practice, but it should be based on solid principles which allow you to deliver the quality of care to which you hold yourself accountable. It is one of the most truly unique aspects of your practice. The degree to which you own the fairness of your process has everything to do with your ability to offer your work proudly and to stand behind your work.

The final piece of the equation has to do with Method Of Payment. This part of the process includes, for example: cash or credit card, payment plans, insurance reimbursement, and loans from wealthy relatives. It is an appropriate part of the equation, but it is not a part of the Fair Fee. They are two separate elements. Only when you have that clarity can you accept your fee graciously, or choose to appropriately adjust it, or decide to waive it completely.

If you choose to accept a credit card payment, you understand it is discounted by the fee you pay the credit card company. If you choose to accept what an insurance company decides is appropriate you do the same. That does not change what you have determined to be a fair fee. When you choose to accept something other than your fair fee you must consider the effect of that decision on the care, skill and judgment you will bring to the case; the outcomes to which your patient aspires; and the practice standards to which you hold yourself accountable. You may want review one or more of those elements to choose your course of action. You may want to consult your patient on any of those elements for their input, choices, and understanding.

The sum total of the formula is Health. Healthy choices by your patients must be freely chosen and fully informed, and that is true regarding your choices for your practice. They should not be in conflict with each other. One should support the other. We do not support healthy choice by hiding, protecting, ignoring, avoiding, and always taking the easy way out. Health is a choice and it is a worthy goal.

When I work with groups with this formula we explore each element in depth in terms of the part we can play in each part of the process. Where can we influence? Where might we be impeding the process? What are the possibilities we may not be seeing? Where are the opportunities we may be missing, the options we may not have considered? I hope you will enjoy exploring, asking questions, seeing new possibilities. I hope you and your patients can learn to celebrate the benefits of a healthy life. I hope you will become a part of a new conversation; a conversation about health.

Mary Osborne, RDH

 

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What a great forum for sharing the wisdom we have been privileged to gain from those who came before us. Hearing that wisdom expressed in the language of today is so important. ~ Mary Osborne

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