Uncategorized – Page 11

“Know Your Patient” Through Managing Cognative Distortions

Posted on February 6, 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:

We ask our friends for advice.

We observe other people’s behavior.

We seek-out and read testimonials.

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 are functioning 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.

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 opens the door to all kinds of moral arguments about marketing that our profession has struggled with since the 1970’s. I will leave probing that issue for another day, but suffice it to say, it is an issue full of moral fog.

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. The “race to the bottom” is real, and rooted in loss aversion. Establishing a brand expectation for quality is challenging but essential for health-centered / relationship-based dentistry.

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 mind are the most relevant. For instance, when people think of Delta Dental they think of saving money, not that the policy is limited to $1000.00 a year, highly restricted, and that the company has no particular interest in their health.

And finally, patients often come to us with a ‘confirmation bias’, which refers to their tendency to search for -and favor- information that confirms their beliefs, while simultaneously ignoring or devaluing information that contradicts their beliefs. An example of this when a patient believes that all dentists will hurt them, or that any dentist who is not on their insurance plan is shady and likely to 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 patients expectations toward more successful treatment outcomes.

L.D. Pankey put it another way, Know your patient.”

Paul A Henny, DDS

Know Thyself

Posted on February 3, 2017

The Ancient Greek aphorism “know thyself” is one of the Delphic Maxims inscribed on the ancient Temple of Apollo.

Dr. Pankey referenced this aphorism because self-awareness is key to our ability to stand apart from our patients and form healthy and effective interpersonal boundaries.

This ability to “stand apart” not only affects our attitudes, it also affects our behaviors. Additionally, it greatly influences how we see our patients and the world that surrounds THEM.

In fact, until we take into account how we see ourselves, we will be unable to understand how our patients see and feel about themselves and what the dental issues they are experiencing mean to them.

A lack of self-awareness causes us to function more on assumption than reality, and this in turn causes us to project our prospective onto our patient’s behavior and then fool ourselves into thinking that we are being objective.

These assumption-laden relationships significantly limit our potential to positively influence and relate effectively with our patients. And this limited ability to relate to our patients on a deeper level easily leads to misunderstandings, the devaluing of recommendations, deferral to insurance companies, and even to open conflict.

Bob Barkley’s Co-discovery method is the pathway to “knowing our patients” as well as allowing our patients -over time- to know us on a philosophical level.

And it is the practice philosophy which moves people toward health, or keeps them stalemated in dependency.

Knowing yourself leads to knowing your patient which allows you to optimally apply your knowledge. And isn’t that your Mission?

Multi-tasking Skills Overrated?

Posted on February 2, 2017

Linguists tell us that the word ‘priority’ came into the English language in the 1400’s. And at that time, there was no plural version…there was no such thing as “priorities”.

Only in the faster-paced world of the 1900’s did the word ‘priorities’ enter our lexicon, with the implication that we can do two or more things just as well -and at the same time.

But it’s a lie.

Neuroscience now tells us that it is neurologically impossible to concentrate on multiple tasks simultaneously, much-the-less do them all well.

So, what happens in reality is that the brain is forced to switch back and forth very quickly from one task to the next. And that there is a price for doing so.

Have you ever met a fine artist, musician, or master furniture maker who was juggling five different tasks at the same time?

I didn’t think so.

Multitasking forces the brain to pay a psychological toll every time it interrupts one task to focus attention on another task. Neuroscientists call this toll the “switching cost”, and it is paid in the denominations of stress and degraded outcomes.

An interesting study in the International Journal of Information Management found that the average person checks email once every five minutes, and that it takes 64 seconds on average to fully resume focus on the previous task.

Relate this truth to a dentist performing multiple hygiene checks while jumping between two active treatment rooms.

Easy disorientation…

Leading to more technical and judgement errors…

Leading to more unhappy patients,

And ultimately, to more and more stress.

It also means that we waste a lot of opportunities for right brain creative time, as switching forces us to stay in an analytical left brain mode.

And we wonder why we are less happy!

All this attempted multitasking didn’t hit the mainstream until the 1970’s, when computers -promising to simplify our lives – entered the workplace. Before that, no one claimed that they were “good multi-taskers”.

Today, people wear the term like a badge of honor. But its a rationalization, not reality. What it really means, is that they have a high stress tolerance and can get a lot of things done at a “good enough” level quickly.

Comprehensive, health-centered, relationship-based dentistry is complex. It takes uninterrupted focus, and extended right-brain functioning. Consequently, “switching cost” is the enemy. And “switching cost” is what high-volume multi-op insurance-centered dentistry is all about.

So we have a choice, to pursue the volume and the money, and accept the toll of distraction, stress, lower quality outcomes, and less happiness.

Or, we can pursue truly helping relationships with our patients, and enjoy our profession more while providing more and better care on fewer and more appreciative people.

The choice is ours to make.

Paul A. Henny, DDS

The Problem with Multi-tasking

Posted on February 2, 2017

Linguists tell us that the word ‘priority’ came into the English language in the 1400’s. And at that time, there was no plural version…there was no such thing as “priorities”.

Only in the faster-paced world of the 1900’s did the word ‘priorities’ enter our lexicon, with the implication that we can do two or more things just as well -and at the same time.

But it’s a lie.

Neuroscience now tells us that it is neurologically impossible to concentrate on multiple tasks simultaneously, much-the-less do them all well.

So, what happens in reality is that the brain is forced to switch back and forth very quickly from one task to the next. And that there is a price for doing so.

Have you ever met a fine artist, musician, or master furniture maker who was juggling five different tasks at the same time?

I didn’t think so.

Relate this truth to a dentist performing multiple hygiene checks while jumping between two active treatment rooms.

Easy disorientation…

Leading to more technical and judgement errors…

Leading to more unhappy patients,

And ultimately, to more and more stress.

It also means that we waste a lot of opportunities for right brain creative time, as switching forces us to stay in an analytical left brain mode.

And we wonder why we are less happy!

So we have a choice, to pursue the volume and the money, and accept the toll of distraction, stress, lower quality outcomes, and less happiness.

Or, we can pursue truly helping relationships with our patients, and enjoy our profession more while providing more and better care on fewer and more appreciative people.

The choice is ours to make.

Paul A. Henny, DDS

Perception & Expectations Drive Behavior

Posted on January 31, 2017

Perhaps one of the most challenging aspects of dentistry, and life in general, is that things are often not what they appear to be – particularly in the beginning.

And this truth naturally includes our perception of others and their intentions and agendas. Studies tell us that we form opinions about others within the first eight seconds of first meeting them, from there, we seek to confirm our initial perception.

In other words, we use confirmation bias to color in the details around our initial psychological sketch to then draw a conclusion which is likely to be in alignment with way we want to see things.

And that is an elaborate way of saying that we use rationalizations to explain the world around us to ourselves more often than we use our self-discipline and resourcefulness to uncover the real truth – particularly with regard to how OTHERS perceive it.

New patients who come to us full of memories, assumptions, and biases as well. So, the formation of a new relationship with a person is much like a dance with a stranger and somewhat forced together by circumstance. And that dance may be harmonious because what they are expecting is what is happening, or it may be an uncomfortable and even threatening herky-jerky experience…an experience that they can not wait to end.

The goal for us then, is to facilitate the former and avoid the later, as the later is counter-productive with regard to successful collaboration.

In other words, if the very nature of our relationship with another person is uncomfortable, what is the likelihood of them making good decisions for themselves? And what therefore is the likelihood of that person making a decision which leads toward a higher level of health and a lower level of putting their health at risk?

How do we do that?

One word – marketing.

Marketing? The manipulative vehicle which is the very scourge of our capitalistic society?

Yep – that marketing.

You see, marketing has nothing to do with ethics, although it may or may not be ethical. It may lead a person toward a good choice or a bad choice. And that is because marketing is about image and expectation management.

In the world of dentistry, we have thousands of opportunities to create images and shape expectations. We also have thousands of opportunities to ignore those opportunities or even to undercut them.

So yes, dentistry’s perception problem is of our own making, and therefore only ours to solve.

And because we – collectively speaking – have failed so miserably at conveying a health-centered message about dentistry ( instead we convey that it is about things – implants, teeth cleaning, saving money, veneers, etc.) that most people fail to perceive dentistry as having much of anything to do with their total health.

As Pogo infamously said, “I have met the enemy and the enemy is us.”

We can change the direction of our profession as it careens toward corporate consolidation and depersonalizations only by changing the public’s perception of it.

And that is what co-discovery can do. Bob Barkley had that figured out fifty years ago. Why didn’t we listen?

Paul A Henny, DDS

Too Busy can be Too Unproductive

Posted on January 30, 2017

There is a common mistake which often happens to us without our realization of it. And it relates to the difference between staying ‘busy’, and our focusing on being ‘affective’…and I mean ‘affective’ in the sense that our actions positively influence the emotions of others…that they cause others to feel BETTER about themselves in our presence.

‘Busy’ on the other hand, is undefined. It can be productive or unproductive, hence it can advance the purpose of our practice, or it can impair it.

‘Busy’ is often running from one room to the next all day long trying to be as thorough as possible under very limited time constraints, while simultaneously being ‘nice’ to people.

But that’s not ‘affective’, and therefore that’s NOT advancing the vision, even though we are doing our very best under the circumstances.

‘Busy’ is often related to our internal need to feel like we are making progress…carefully checking the boxes…keeping all of the ducks in a row. It also is sometimes a clever way to avoid criticism…after all, being ‘nice’ yields few confrontations, and all we need to do is tell people what we think they want to hear… to “frame” our message in such a way that they can’t see our production agenda, or even our indifference.

So why do we want to be ‘affective’ anyway? Don’t the interactions become too unpredictable if we have to deal each person on an emotional level? And won’t emotional-level conversations lead toward something we can’t control…and therefore cause an out-of-control schedule? And if we can’t control our schedule, how can we stay busy?

Do you see the trap impregnated into this kind of circular logic?

The central key to becoming a health-centered / relationship – based dentist is to learn how to work with people as individuals instead of just bodies delivering teeth and gums to us, and about which we want to make a profit.

Dr. Pankey famously said, “I never saw a tooth walk into my office”, and he meant that if we do not find a way to become more ‘affective’ with people, we will likely never be able to influence them enough to cause them to make better choices about their health…and that they will therefore never move “above the line”.

Think about it, ‘busy’ might not be everything that it’s cracked up to be. Becoming more affective with people is where the real health-centered game is played. And that ‘game’ can only thrive through a Vision-driven Mission, faithfully executed every single day.

Now, THAT’S a good kind of ‘busy’!

Paul A Henny, DDS

Accurate or Not, Schemas Drive Behavior

Posted on January 26, 2017

Chances are high that you have never heard of Fredric Bartlett, but in 1932 he conducted one of the most famous cognitive psychology studies of all time at Cambridge University.

The experiment involved Bartlett reciting a Native American folk tale called “The War of the Ghosts” to a number of participants. Next, he followed-up by asking the participants to repeat the story back to him several times over a twelve month period.

What Bartlett discovered was that both the content and quality of the story degraded substantially over time, as each person adapted the story to fit their own world view and beliefs. This process included each person altering the story content as well as its theme and emphasis.

In other words, each person changed the story to become more meaningful to themself based on their biases and memories.

Psychologists tell us that this reinterpretation process is influenced by a “schema”, where preconceived notions are used to interpret what is currently being experienced. Schemas therefore are naturally self-validating whether they are accurate or not.

More importantly, schemas tend to be sticky and resilient to change – even in the face of contradictory information.

In dentistry, we face the schema phenomenon almost every day, as new patients walk in our door with preconceived notions about what dentistry can and can not do to help them, as well as how it is accomplished.

Schemas then represent our patient’s beliefs about us and our purpose. And if we fail to create a safe and helpful learning opportunity for our patients to challenge the validity of their schemas, they will proceed along with their misconceptions and distorted assumptions.

And this is likely why Mrs. Smith flies into an unexpected rant at the front desk, or cocks her head oddly when you tell her she has a new dental problem. Assumptions set up tension when challenged, and tension triggers stress which sometimes leads to confrontation – all attempts to defend a sticky and resilient schema.

Bob Barkley understood all of this, even though the term “schema” was not widely used in his time. He understood people on a very deep level, and consequently developed the co-discovery process to break through and break down each patient’s distorted beliefs about dentistry and replace them with the truth, facts, and helpful information based on his philosophy of practice.

On a psychological level, co-discovery facilitates the replacement of old schemas with a new updated and relevant perspective of dentistry and the value of dental care. And from there a patient can much more easily choose to become more healthy.

Paul A Henny, DDS

The Philosophical Paradox

Posted on January 25, 2017

Life is full of paradoxes, seemingly self-contradictory statements or situations which ultimately are found to be true – and the practice of dentistry is no exception.

One of my most favored paradoxes of late is the fact that every relationship-based / health-centered practice must develop a written Philosophy Statement, which can critically function as the practice’s constitution.

Bob Barkley said, that creating and writing this Statement represented the single most important thing that a truly patient-centered practice can do.

But therein lies paradox #1:

Even though writing a Philosophy Statement is essential, it is only valuable if it is a “living” document created by individuals who truly believe in what it represents. In other words, a Philosophy Statement is a SYMBOLIC representation of how the team feels, and consequently what they are willing to struggle to attain (including how they chose to live). And because a Philosophy Statement is symbolic, the words themselves are somewhat meaningless – particularly to others except through their EXPERIENCING of what they mean.

And this is where we left brain-leaning dentists can easily get hung up, as most of us have been enculturated in the behavioralist tradition, where we believe that people are reactionary, or should predictably respond to our logic.

This mindset, particularly when recently empowered by a a largely emotion-derived Philosophy Statement, causes us to want to tell the world and recite it to our new patients like the Gettysburg Address.

But at that moment, it is wise to pause and recall the truism, “No one is more dangerous than the newly anointed”, as too often in those situations, what we intend with our actions is often perceived very differently.

So this brings us to paradox #2:

“I learned that the less I told my patients about my philosophy of dentistry, and what I could do for them, the more interested the patients became in really thinking about themselves and accepting responsibility for there health.” – Robert F. Barkley

So the less we tell patients -the more they learn IF we create an optimal environment for that learning to occur. And the less we tell patients about OUR philosophy (but instead focus on allowing them to experience it), the more the the patient will “acquire a philosophy of their own” which is in greater alignment with their clarifying values.

And it is through problem ownership that the desire for a preferred future emerges, along with the will to see it through.

Paul A Henny, DDS

The Toxicity of PPO’s on Health-centered Dentistry

Posted on January 24, 2017

Dentists who are contractually involved with insurance today are fully aware of the shift toward PPO style plans, which restrict patient access to dentists of choice, as well as restrict dentists under contract from referring to specialists of choice.

In and of themselves, these restrictions would be manageable if it were not for the substantial reductions in fee code compensation, where in some cases, that compensation drops from payments in the range of 82% of “reasonable and customary” rates down to 58%.

One does not need an MBA or a degree in accounting to see that a broadly experienced compensation drop of 24% devastates profitability, which then forces upon the practice changes in business structure and climate to survive.

This external force – the shift from indemnity plans to PPO plans- is affecting the dental profession more than any other trend, as it demands a ramped-up economy-of-scale approach to dental practice. In other words, it is forcing the dental profession to become industrialized, where patients become “units” and workers become day laborers.

With all of the focus on maximizing productivity and reducing costs, while maximizing profitability, the discussion of health is easily lost, with the dentist and team are reduced to being repair workers laboring under a remedial philosophy, and with patients who are often dissatisfied with both the outcome and their experience.

This trend line was noticed early by Bob Barkley in 1972 when he said, “Dental service corporations play a very critical role nationwide since they can stymie progress in prevention…Somehow service corporations acquire a marked distrust for the honesty of dentists and use this as a reason for holding back on their preventive teaching programs. One prominent dentist-executive of a large corporation declared that to pay for such teaching would be an open invitation to fraud.”

So there we have it- the core of the problem, the fact that dental insurance has everything to do with money and is only peripherally associated with health. And that the contractual relationship between the dentist and service corporation is founded on distrust. Consequently, a more dysfunctional relationship could not be designed or advanced.

Paul A Henny, DDS

You Can’t Do it Alone

Posted on January 19, 2017

As mentioned on many occasions, the creation and maintenance of a truly Relationship-based / Health-centered practice is founded first on clarified values, a clear Mission, and a compelling Vision which the leader can then effectively convey to the staff. But having a “staff” is not nearly enough to succeed, as one must have a mission-focused Care Team…and the Mission must be one which they have helped to co-define and write. Subsequently, it is a Mission that they “own”.

On a behavioral level, who are these people, and what do they look like? This question was nicely addressed recently on a dental blog, where the question was posed, “What do top performers in a dental practice look like?” The responses were quite instructive:

“They’re not clock in/clock out people. They work to better the practice and do the best they can. They look for ways to improve systems and think outside of the box. They treat the practice like it’s theirs.”

“They either have great work ethic and drive. It can be spotted a mile away and immediately. Its rare. So many people don’t value, appreciate or take care of their OWN belongings. Those are the people who won’t value yours. These are also the people who are lazy and disrespectful.”

“Goals are something in these people that the others don’t possess. These people’s lives don’t revolve around how hard they work/or the amount of effort they put forth around bribes (bonus systems.) They would do it without. These are the ‘keepers’.”

“They are people who pour their heart and soul into a practice as if it were their own. They have a natural born drive for success and achievement, so your success is their success, and they have pride in all they do. They don’t quit until the job is done.”

“I say that high performers look professional, they sound articulate, and they leave people feeling complete. They look like they got dressed with intention, they sound professional, they leave people feeling like they’ve been heard.”

“The way they do anything is the way they do everything – with purpose, passion, precision and joy.”

So if you had a team full of people like the ones described above, how well do you think your practice would be doing right now? And how well would they accommodate to the daily challenges of practice? How would your patients feel when interacting with people like this? And how would you feel about going into work each day, knowing that these folks would be there to greet you and help you in any way that they possibly could?

Obviously, the behavioral composition of the team matters quite significantly, and the good news today is that there are predictable methods and means (through proper interviewing techniques and testing) to find these kinds people, lead them, and form them into a powerful and caring Team.

So what are you waiting for?

Paul A Henny DDS

“Know Your Patient” Through Managing Cognative Distortions

Category: Uncategorized

“Know Your Patient” Through Managing Cognative Distortions

Posted on February 6, 2017

Know Thyself

Posted on February 3, 2017

Multi-tasking Skills Overrated?

Posted on February 2, 2017

The Problem with Multi-tasking

Posted on February 2, 2017

Perception & Expectations Drive Behavior

Posted on January 31, 2017

Too Busy can be Too Unproductive

Posted on January 30, 2017

Accurate or Not, Schemas Drive Behavior

Posted on January 26, 2017

The Philosophical Paradox

Posted on January 25, 2017

The Toxicity of PPO’s on Health-centered Dentistry

Posted on January 24, 2017

You Can’t Do it Alone

Posted on January 19, 2017

Home Testimonial

Great Forum

CODISCOVERY BLOG

CODISCOVERY IS VISONEERING.

FAILURE AND SUCCESS ARE TWO SIDES OF THE SAME C...

Remember: Everything is Relative.

Failure and success are two sides of the same c...

Get Involved with the
Bob Barkley Study Club Now!

“Know Your Patient” Through Managing Cognative Distortions

Posted on February 6, 2017

Posted on February 3, 2017

Posted on February 2, 2017

Posted on February 2, 2017

Posted on January 31, 2017

Posted on January 30, 2017

Posted on January 26, 2017

Posted on January 25, 2017

Posted on January 24, 2017

Posted on January 19, 2017

Home Testimonial

Great Forum

CODISCOVERY BLOG

Get Involved with theBob Barkley Study Club Now!

Get Involved with the
Bob Barkley Study Club Now!