“Know Your Patient” Through Managing Cognative Distortions

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

“Know Your Patient” Through Managing Cognative Distortions

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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

Thought Experiments, LLC © 2017

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