Posted on May 21, 2013

Dr. James Otten:

One of the great joys of being in a health care practice is that we get to spend time getting to know and more importantly, understanding what’s going on in the lives of our patients. This week I had the opportunity to spend time with one of the newer members of our patient family whose spouse is undergoing some very difficult chemotherapy. Many years ago early in my practice, when I bought into the all too pervasive notion that “success” was hinged to how many patients I could see in a day, this kind of conversation would have never happened. Now I know that in fact if we are truly about health care this conversation is vital to our collective health. Let me tell you why.

Part of our conversation was about her experience with a specialty center for her husband’s care and how comforting it was to them that all professionals there exuded an attitude of caring coupled with a confidence or what we call “unconscious competence”. This, we discovered through our conversation, is no small distinction. What often gets talked about as “health care”, especially to our patients, is really just a menu of treatment options. In dentistry we often see this same reference to comprehensive care.  In fact, we wonder why we have a health system that spends enormous amounts of money and often has relatively poor outcomes? I would submit it’s because we’re only discussing treatment and as long as that’s what gets rewarded in the system, that’s what you’ll get more of, but as we know, treatment alone does not produce the best outcomes.

If however, you look at all the great health centers like Mayo, Cleveland, and Cooper Clinics, (and hopefully our practices) they don’t just provide great treatment but they care for people and to do so all have some fundamental characteristics: they work collaboratively, they focus on the whole person, they are constantly improving and they are a culture of compassionate people. Most of these can be learned with the exception of compassion. You can’t really teach compassion, but you sure can model it and build a culture of compassionate people.

I hope when our patients visit us they feel like this particular patient did and that these same qualities are a part of their everyday experience with us. We believe that lives are enriched by healthy smiles and that this can only be achieved through real health care. Care is a personalized experience that takes the time to know and understand our patients and how we can help them. This is not just semantics– care and compassion are more than just words. They have to be demonstrated by people who are always willing to do whatever it takes to help another, who go the extra mile and who constantly strive for excellence.

That conversation I had this week? Well I can only hope my patient was somehow comforted by being able to talk about the difficult time that she had been through. This is what healing is really about. I know that it also helps me to heal when the people we care for demonstrate the courage to face all the fears and anxieties that come with health challenges –whether it’s cancer or dental health. Last time I checked there was no code or procedural description for intentional listening or non-judgemental acceptance but these are as important as any part of a patient’s evaluation and plan. This is what comprehensive care is about.

I felt I was a “good” dentist back in the early days and looking back I think I was good but not great. Running from chair to chair I missed the most important part of the process—the patients story. Without it we are only guessing about what is appropriate and, when we guess, treatment is fragmented and outcomes are not what they could be. We are privileged to be a part of the lives of our patients that entrust us with their care not just procedures. We should be vigilant about thanking them for sharing their stories with us. They inspire us, they honor us with their trust and appreciation and they make us better practitioners and people.

Posted on April 16, 2013

 

T.J. Bolt, DDS

Contributing Writer 

Direction not intention leads to the destination.

There are two paths in dentistry:  Disease Care and Health Care.  These two paths could not be farther apart in their outcomes or what goes on in the journey.  There are three reasons that people lose their teeth.  They are: 

Tooth Decay, Gum Disease, and Bad Bite.  

Going down the disease care path is one that focuses on repair.  The dentist is putting out fires.  Many times he is shingling the house while the house is on fire.  If a patient stays down this path for any length of time by the time that they are in their 50’s and 60’s they find their mouth in a state of disrepair while going to the dentist every 6 months.  Why?  There is no agreement between the dentist and the patient on what the purpose of the relationship is.  There is no plan on where the patient wants to go.  There is usually no understanding of where the patient has been.  There is no focus on the causes of the problems the patient has.  There is no understanding of the cause of disease and what the patient is supposed to be doing when they are not in the office.  This is called a co-dependant relationship and this never leads to long-term health or a successful outcome.  It is reactionary.

Structure influences behavior, but behavior determines the results.

Health Care on the other hand is relationship based.  The doctor and the patient have met for some length of time answering and developing questions that will lead to a successful outcome.  This relationship is called interdependent in that there is agreed upon roles and values.  There is an understanding of why the relationship exists.  The questions that can be answered or at least they are in development are:  Where has the patient been?  Where are they now?  Where does the patient want to go?  How does the patient want to get there?   What role does each of us play in the process?  In other words there is a plan that is created based on the patients goals and objectives.  The patient and the doctor co-develop the plan so it is their plan.  The patient owns the problem, and understands the cause of the disease.  The patient understand that they are the cause of the problem and together with the help of their dental health coach and support team that they have a more certain future.  This is the path that helps create success.  It works every time.  This is creative and the energy is abundant.  There is an endpoint.

The prudent see danger and take refuge.  The simple keep going and suffer for it.  Pr27:12   For more information please visit my website www.drtjbolt.com or call 402-572-8000.