Posted on June 29, 2017

We all want to get along and be liked. We also want to make good decisions, so when we make decisions regarding issues that we know little about, we often use a cognitive-social approach by asking our friends for advice, observing other people’s behavior, or seeking out and reading testimonials.

In the world of the social sciences, this cognitive-social approach, is known as “social proof” or “informational social influence”.

Psychologists tell us that we make assumptions about most things via a rather incomplete fact-gathering process often tainted with bias. And sometimes this process may even be completely devoid of facts.

We see this phenomenon frequently in dentistry, as patients enter our practices with all kinds of preconceived notions picked up from their social environment, or through experience – and how much of it is true is unique to the individual.

Some patients function off of ‘survivorship bias’, which is based on our tendency to assume marketplace “winners” are those who are most visible. In other words, in the popularity contest of life, less visible and better options are often not even considered. A current example of this is the growing public assumption that every “all on four” case is successful long-term, and every patient is happy with the outcome. This distorted perception has been created by some very clever and persistent marketing which conveniently skips past potential down-sides.

As a marketing executive friend of mine once told me, “If you are not in the top three of top-of-mind, you may as well not exist.” This marketing truth can open the door to all kinds of moral arguments regarding marketing, and about which our profession has struggled with for over fourty years. I will leave the probing of this issue for another day, but suffice it to say that the “marketing issue” is full of moral fog, and if marketing is not done in a principle-centered fashion, it can lead to some very undesirable outcomes for patients and consequently the reputation of dentistry as a profession.

Our patients also have a tendency for what psychologists call “loss aversion”, which refers to our tendency to strongly prefer avoiding losses over acquiring gains. In other words, we have a psychological tendency to seek out bargains instead of quality, unless a strongly assertive argument and expectation is established for the later. Consequently, the “race to the bottom” with regard to viewing dentistry as a price-sensitive commodity by the public is real, and it is rooted in loss aversion. Hence, establishing a brand expectation for quality is a challenging but essential step for health-centered / relationship-based dentists.

Our patients are also influenced by what is known as the ‘availability heuristic’, which is a little mental glitch in our heads which causes us to assume that the first things which come to our minds are the most relevant to us. For instance, when people think of Delta Dental they think of saving money, and not that the policy is limited to $1000.00 a year, is highly restricted, or that dental “insurance” is really a defined benefit plan which has nothing to do with their overall dental health.

And finally, many of our patients often come to us with a ‘confirmation bias’, which refers to their tendency to search for -and favor- information which confirms their beliefs, while simultaneously ignoring or devaluing information that contradicts those beliefs. An example of this is seen when a patient comes to us believing that all dentists will hurt them, or that any dentist who is not on their insurance plan will take advantage of them financially.

You can easily see from this brief discussion, that the psycho-social nature of our relationships with patients before, during, and after treatment is complex and potentially full of cognitive distortions which can lead to undesirable behavior and poor decision-making. Consequently, successful helping relationships emerge only when we are aware of where potential distortions may lie and tactfully manage our patient’s expectations toward more successful treatment outcomes through collaborative relationship-building, and co-discovery.

L.D. Pankey put it another way, “Know your patient”, because it is the only pathway to health-centered outcomes in patients with complex needs.

Paul A Henny, DDS

Thought Experiments, LLC © 2017

Read more at www.codiscovery.com

Posted on April 3, 2017

Most of us are familiar with Dr. Pankey’s “Cross of Dentistry”, which stated that spiritual (happiness & fulfillment) and material reward (financial prosperity and security) is an outcome of a developmental process requiring us to “Know Ourselves”, “Know Your Patients”, “Know Your Work”, and to “Apply Your Knowledge”.

Today, let’s focus on “knowing our patients”, as it is the key to more successful learning on their part, and this in turn is key to their movement toward better decision-making and ultimately a higher level of more predictable health.

The more we know our patients on both a physical and emotional level, the more effective teachers we become. Know little about a patient, and often we will be trying to teach things which they are not ready to learn, already know, or perhaps understand better than us (particularly the “why” behind their previous decisions).

Also of critical importance is how our patients perceive how we feel about them. Do they feel valued, or so they feel ashamed? Do they feel competent or incompetent at caring for themselves? And how much of our behavior towards them influences that perception?

The more our patients feel truly valued, the more they feel that we think they are interesting and extraordinary people, and the more they will be open to listening to us, as they will afford us the same esteem.

And their enhanced listening makes our teaching both more timely and effective. Simply put, the more appropriate our teaching, based on our knowledge of them, the more eager they will be to learn from us.

The more patients learn, the more they grow in their ability to assume responsibility for the direction of their future dental health. And that is the fertile ground from which successful, collaborative relations emerge.

Charles Sorensen said, “I believe that the Mission of a health-centered dentist is to help the patient reclaim or enhance their self-esteem, not claim straighter teeth, whiter teeth, or a better bite. They need to help each person to feel better about themselves…to be glad to smile, to be able to make friends more easily, to get a better job, to be a better lover, to be a better parent, and to be a better friend.”

And how can we possibly facilitate that through dentistry without knowing them well?

Paul A Henny, DDS

Thought Experiments LLC, ©2017

Read more at www.codiscovery.com

Posted on March 7, 2017

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