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


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We all fall victim to distractions, and as a consequence, we fail to do things we intended to do almost every single day. This problem is so timeless that philosophers like Socrates and Aristotle coined a word for it: Akrasia.

Akrasia is our state of being when we act against our better judgment by not following through…by getting side-tracked…by getting distracted by a shiny new object…a sales pitch…or an email or text. Our mind moves off goal, and we linger in the weeds of waisted time, waisted money, or waisted energy.

One explanation for why akrasia causes so much disruption in our lives has to do with what behavioral economists call “time inconsistency”, which is an academic way of saying the our minds value immediate rewards more than future rewards.

When we make plans for ourselves, like setting a goal to spend more time getting to know our new patients on an emotional level, we are making plans for our future self. Bob Barkley called this type of thinking “future focusing”. And when we think of the future in this way, it is easy for us to see the value in making changes…because changes to OUR behavior can affectively influence patient’s behavior, which in turn increases the likelihood that they will trust more…open up more…share their motivations and fears more, and thus move more toward successful collaboration with us.

But too often when the opportunity comes to make these behavioral adjustments with patients we are short on time, distracted by what is happening in another room, or the text message just received.

Subsequently, when it comes time to make a favorable behavioral change, we are no longer making a choice about our preferred future with patients, rather one based on our present feelings- stressed, distracted, confused, worried…and our focus suddenly shifts from centering our attention on what is in the patient’s long-term best interest to what is in our immediate best interest.

Akrasia kicks in and our behavior is hijacked by our emotions. We undercut ourselves and then under-serve our patients.

How can we avoid this from happening? How do we avoid akrasia undercutting our best intentions? By creating systems and scheduling structures which allow us completely uninterrupted time with our patients. By creating environments which are safe, quiet, distraction-free and conducive for listening, observing, and understanding how others feel, moment-by-moment.

On a theoretical level, this sounds easy, but on an application level it requires self-discipline and a dedication made by all Care Team Members to consider that time to be sacred – and to never be violated except in an emergency.

This one decision…to make relationship-building your top priority…is the key to the success of this practice model. And protecting it from the daily affects of akrasia are therefore key as well.

Bob Barkley put it another way, “Build your relationships first -then your dentistry.”

Paul A Henny, DDS

Thought Experiments LLC, © 2017

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