Posted on August 31, 2017

Bob Barkley is largely credited for bringing two terms into our profession’s lexicon: “Co-discovery” and “Co-diagnosis”.

And as a consequence, both terms are commonly seen in articles, books, and presentations focused on patient-centered care as well as during programs which teach comprehensive treatment planning and case acceptance.

Rarely however, do we see distinctions made between Co-discovery and Co-diagnosis, when in-fact these terms represent two distinctly different phases of a new patient process which have different objectives.

Today, let’s clarify the distinctions.

“Co-discovery” can simply and accurately be described as “learning with”. And Bob Barkley was extremely intentional about HOW he structured his new patient experience so that optimal “learning with” occurred each time.

Learning with what?

Bob intentionally created a new and unique experience for BOTH the new patient and himself, in which they -in real time – learned about not only what was wrong in a patient’s mouth, but also what was right…about what was healthy and what was pathological…about what was subjectively attractive and what was not…about what was functional and dysfunctional… and about what was trending toward becoming a problem.

But of equal importance, Bob and the patient were simultaneously learning about HOW THE PATIENT FELT ABOUT WHAT THEY WERE LEARNING AND WHAT IT MEANT TO THEM.

That’s Co-discovery… objective, subjective, AND emotional learning which happens in a safe, non-threatening, caring, constructive, and infinitely useful fashion.

Co-diagnosis on the other hand, is what happens AFTER co-discovery. It is the informed conversation focused around what the findings mean and what the implications are on the physical, functional, and emotional levels as well as what the patient wants to do about it -and when.

Bob Barkley was so committed to this process that he stated in his new patient brochure, “While it is important that a dentist diagnose your mouth, it is far more important that YOU diagnose it. The extent to which you understand your mouth determines your ability to plan for your future.”

Notice here that Bob is intentionally NOT taking ownership of the patient’s condition, or choices. In fact, he states his deeply held belief that patients can make better choices for themselves if WE give them a chance.*

So in the end, Co-discovery and Co-diagnosis are actually about fostering ownership, self-responsibility, and therefore facilitating the creation of healthy and effective emotional boundaries with our patients.

And Co-discovery and Co-diagnosis were the critical steps #1 and #2 in predictably making that happen.

Pretty impressive for 1972, wouldn’t you say?

Paul A Henny, DDS

* Bob Barkley also stated in his book Successful Preventive Dental Practices, “No greater risk of failure can be run than that of attempting to use traditional patient management procedures in a health oriented restorative practice. Examining and treating a patient’s mouth without prior attitudinal development is an error of omission for which the dentist pays handsomely with time, energy, stress, and money.”