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Practice Sabotage: How We Make Patients Lie To Us (Yes, It's Our Fault)

Picture this scenario. I feel like I’m getting on very well with my patient. We seem to like each other. I’ve spent a lot of time explaining my extensive treatment plan. They seem to be quite interested in proceeding with treatment on the surface, but in reality, they’re really not that interested.

What’s going on?

Polite Evasion

The patient has no significant discomfort, and has been like that for many years.

This treatment was our idea, not theirs; what they’d really like to say "I'm not interested in your proposal", but that's really tough to say. It feels rude.

So, what do people do to get out of sticky situation like this. How do we save face? We all use a technique called polite evasion.

Think back to your childhood when you nagged your parent for a new toy and got the response: "We'll talk about it later" or "ask your mother". You now know that really just means “I’d like to say no, but I don't want to argue now, so I’m going to dodge the question and hope you forget about it”.

When a patient use polite evasion, it sounds like:

How often have you heard those lines? Did you realise it was polite evasion?

The Most Common Response from a Dentist

When dentists hear these objections, it’s a natural reaction to attempt to handle this as a genuine objection. WRONG!

The attempts will generally fail because the objection isn’t real, it’s just an attempt to escape the discomfort of saying 'no'.

Why Patients Resist Treatment

You could easily come to the conclusion that the problem is cost. In reality, however, the most common reason patients resist treatment is that they are actually just not very concerned. They think that their situation is stable. After all, in their minds, it has been like this for a long time and it isn't hurting, so why spend a whole lot of money to alter the status quo?

Status Quo Bias

Social scientists have researched one of the most common human biases - The Status Quo Bias. People tend to stay with the status quo even if it is clearly the wrong choice. So, we need to use our knowledge of human biases to guide the patient into making better choices.

The bias we can employ is the pain avoidance bias. Avoiding pain is more powerful than pleasure seeking.

How To Motivate Your Patient

When Dentists discuss treatment options they often focus on the benefits. However, the more powerful motivators are related to the consequences of not having treatment. The Damaging Outcome of the Condition. (DOC)

If the concern is in place, then all you have to do is get out of the way. A concerned patient just wants one thing from you: a solution.

To be quite certain that the patient is clear about the DOC, just get them to tell you the problem. You could say something like “I’m curious to hear your perspective of what you think is happening to your (tooth) and what you think might happen if nothing is done

If they can explain it to you, they understand. If they can’t explain it correctly, then you can help them. If they are clear about the DOC, and they don’t want to proceed, there is nothing you can do to change their minds, so let it go.

This is all you need to do.

The Problem With Elaborate Treatment Plans

Some dentists go to great lengths preparing very elaborate treatment plan proposals.

Paradoxically, the more elaborate the proposal, the more Polite Evasion can be triggered. The patient now feels terribly guilty saying no. If the fee is not high, they might be ‘guilted’ into saying yes. But sometimes this patient will just leave, never return and not respond to any calls. They are too embarrassed to face you because you went to so much trouble.

Focus Your Communications On The Damaging Outcome Of The Condition

Do not mention solution options until you are certain they can verbalize the DOC. I’m serious. Don’t talk at the patient. If you explain something to a patient make sure you have them explain it back to you. If you that’s the only thing you learn from this article your treatment acceptance will skyrocket. Good luck.

By Dr. Brett Taylor