Its all a big game.

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

Its all a big game.

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Game Theory is defined as “the branch of mathematics concerned with the analysis of strategies for dealing with competitive situations where the outcome of a participant’s choice of action depends critically on the actions of other participants. Game theory has been applied to contexts in war, business, and biology.”

Game Theory is also highly relevant in the social sciences, hence on the interpersonal relationship level, and is also highly associated with our neurobiology.

In this context, we can think of every interaction with every person each day as a game…a game where each participant has goals and agendas. The “game” may be a simple as you want a Starbucks’ coffee and the Starbucks’ employee wants an exact amount of money in return. Or, it can be as complex as a patient wanting to feel better about themselves, but they have no idea how to accomplish it – hence, they are sitting across the table from you.

On a neurobiology level, games are mediated primarily by our dopamine “reward system.” When we “win” the substantia nigra and ventral tegmental area areas of our brain manufacture and release dopamine. “Win” several times, and you may develop a habit, or even an addiction.

Studies show that as this reward system matures around a specific action, such as drug addiction, it actually responds BEFORE the event in anticipation of the reward, hence the motivation to keep doing actions which are actually existential threats.

In other ways, this internal reward system is involved in encouraging us to eat or not, run every day- or not, or go to the dentist-or not.

Studies show that if we don’t “win” at least 30% of the time, we will start to “extinguish” the behavior. This means that when patients come to us and do not feel like they are “winning”…getting what they want out of their relationship with us, they will stop showing up, answering the phone, or even paying their bills.

On a personal level, dentists will stop doing comprehensive examinations on their patients when the case acceptance rates drop down to near the 33% mark.

So consider this: You are it, and it is you. Your biology drives your behavior and your behavior drives your biology – sometimes for the better and sometimes for worse.

The take-away here is that we need to become more aware of these truths and manage them in a more organized way which will increase our chances of reaching preferred outcomes…”winning”…and reduce our chance of “losing.”

Fine-tune our new patient processes, and we can create more win-win agreements. Fine-tune our relationships with others, and others -in increasing numbers- will want to continue playing the game with us, and therefore there will be more “winning” for both of us in the future. And do all of that well – over and over again – and we will have a growing practice and quite a prosperous future.

Paul A. Henny, DDS


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