What is trust and why does it matter in the relationship-based practice? 

Writer and public speaker Steven M. R. Covey says that trust is the one thing that changes everything. Trust lives at the intersection of competence and character. In other words, great skills alone are not enough because you might use them to benefit yourself and not your patient/client.

Trust in Relationships

Character alone is not enough because you might not be able to deliver great clinical results. When character and competence are both present, then what is possible within that professional relationship becomes different.

A strategy to establish and build high trust working relationships in a professional practice is equally as essential as developing high clinical competency. In fact, they are synergistic and will provide energy for one another.

Trust then is not just a philosophical construct. It is not just a means to bring your personal mission to life. It is also a critical business strategy in building a relationship-based professional practice. This is the face of the trust that lives between a dentist and their patient.

Strong Leadership

Much research has shown observable trust to be the number one factor in a patient’s decision to trust the practice as a whole and the dentist in particular. This is simply a measurable function of leadership and the culture that results when great leaders are at their best.

A high performing leader will have strong relating competencies, high integrity, courageous authenticity, self-awareness, and a focus on achievement. These competencies will attract like-minded team members, establishing a culture of respect, appreciation, accountability, and trust.

When this happens, trust will flow in both directions and be visible and experienced by all. This entire process is nonlinear. It is very interdependent and, by necessity, simultaneous. Much like each biochemical system in a cell is necessary for proper cellular function, each complex biochemical unit is also necessary for the other systems to form in the first place. Together, they ensure the entire cell functions properly.

Similarly, while the dynamics of respect, trust, appreciation, and accountability are essential ingredients to establish a healthy practice culture, they also rely on one another to sustain a successful system. They are necessary for the entire practice to function at its best.

Check out this article for quick and easy body language tips that develop trust! What’s your take on this oft-debated topic? 

Time is a major priority in the thriving dental practice. Balancing the need for comprehensive care with the efficiency necessary to get everything done in a day is a serious challenge. When it comes to periodontal assessments, the numbers today shockingly still show that a majority of offices are not routinely completing a perio exam.

It doesn’t have to be that way!

Implement a Quick Perio Screening

Consider making your life a lot easier while still improving patient care by offering periodontal screenings. An efficient screening that divides the mouth into scored sextants shouldn’t take more than a minute or two.

Your hygienists will appreciate the opportunity to show off their probing skills. They will be able to help patients recognize the signs of gingivitis and periodontal inflammation that may have gone unnoticed otherwise. If the patient scores high enough, then that will necessitate a full-mouth periodontal exam that includes full mouth probing furcation scoring and measuring muco-gingival attachment loss and recession.

This simple addition can lead to more dentistry in your practice and therefore higher production. That’s a boon for both patients and dentists, as the former improves their health and the latter is able to offer more complex treatment.

Periodontal disease is a sneaky, pervasive issue that can be detrimental to a patient’s entire health. Systemic diseases like atherosclerosis and diabetes have been associated with periodontitis. Gingivitis, while reversible, can still be exceedingly unpleasant and eventually lead to worsening periodontal health.

The way your hygienist educates patients about periodontal disease contributes to how patients understand the screening’s purpose. The hygienist must make it clear that you are checking for gingivitis and periodontitis because they can lead to pain and tooth loss. This would require much more invasive care in the long run.

Get our take on dental esthetics by reading this awesome Pankey blog here. Do you carry out perio screenings in your practice? We’re dying to know more, don’t be a stranger!

Providing healthier mouths to patients and doing more fulfilling dentistry (and making more money as a result) are admirable goals most practices have. I have written a couple of times about techniques that help us improve case acceptance: creating curiosity and co-discovery, listening, the learning ladder, and more.

This brief overview is an attempt to see the process as a journey for the patient and to consider their perspective:

Patient’s Journey: Eighteen Inches at a Time

It Starts in the Head

Patients first listen to the facts about dental care, their need and wants, issues or diseases that they have, and potential treatment solutions. Sadly, facts are not enough.

Developing great listening skills, caring, and trust help patients come to see you as their health advisor. This requires an eighteen-inch ‘Journey to the Heart’! It is there that caring and trust live. The emotional connection is very important in case acceptance. To ignore it is to minimize your success. But that too is not enough.

The patient must schedule, keep appointments, and pay for recommended treatment. This ‘Journey to the Wallet’ is the next eighteen-inch trip the patient must take. It is the execution of the plan from their perspective.

Valuing dental care and oral health is demonstrated by their checkbook and what they spend time and money on. Still not done?

The next eighteen-inches take us to a knee. Appreciation helps fulfill us as caregivers. Most rewards are best when they are balanced, financial, and behavioral: money and warm fuzzies, you get the idea. Money alone does not buy happiness (but it does help you enjoy your misery in some mighty fine places!).

The final journey takes us eighteen inches to the patient’s feet. When patients tell others about your practice and refer their friends, you have come full circle. This trust display is the ultimate compliment to you and your team.

Keep the Patient’s Perspective in Mind

Ask yourself the following and seek answers with your team to enhance patient health, your fulfillment, and mutual rewards:

·       Have you helped nurture movement toward the heart?

·       Did the patient accept and schedule treatment? If not, why not?

·       Were they able to pay with gratitude and appreciation? (borrowed from Dr. Pankey)

·       Did you ask for and receive referrals of their friends and family?

Remember, it’s a journey, not a destination. Enjoy the trip and check the map along the way. You, your team, and your patients will all be the better for it.

A journey is best measured in friends, rather than miles. -Tim Cahill

Referrals can be a real challenge, especially for those invested in building a strong relationship with their patients. It’s a bummer to let go of the many years you’ve put into developing a patient’s trust, but it happens all the time. You just have to make sure the trade-off goes as smoothly as possible.

Everyone has patients that move or need to leave their dental practice for whatever reason. As part of the service and care we have provided I like to give them a referral to an office where I know they will get the same level of care and quality.

Referring to Another Pankey Dentist

I may not know every dentist that has gone through Pankey, but I know a lot about them. I know they care passionately about dentistry based on their commitment to education and being the best dentist they can be. I also know they have learned the same approach to clinical care that I have and really understand how to connect with their patients. Many have created their own individualized, relationship-based practice.

One of the best resources I have for referrals to dentists in the Pankey family is the “Find a Dentist” link side banner on the Pankey.org website. I can type in their area code and find members of the Pankey Alumni association anywhere my patients are moving to. I use this resource all of the time.

I also know that I get patients referred by other Pankey dentists every month. That’s why when I look at the dues and fees I pay to belong to dental organizations, my Pankey alumni membership is the easiest one to pay. What I get back in rewards is a small cost to market my practice to other Pankey dentists looking for a new dental home for their patients.

What’s your favored referral process? Let us know! 

Trust is a central facet of human interaction, one that cannot be ignored in a dental or business setting. This blog reviews some interesting concepts on trust from Oxford professor Rachel Botsman: 

Trust: Known and Unknown

Botsman is a thought leader and significant contributor to the current conversation surrounding the role of trust in our personal and business relationships as well as our culture. She says that trust lives in the unique tension between our hopes and fears. It is about vulnerability and expectations.

Trust acts as the bridge between the known, where we are comfortable, and the unknown, where we are fearful. She defines trust as, “a confident relationship to the unknown.”

Similarly, when we enter into a relationship with a patient, there is a great deal unknown to them concerning their dental condition. They don’t necessarily sense what is required to establish good health, function, and esthetics.

A Relationship Strategy

According to Botsman, in developing our strategy of building high trust relationships, our goal should not be to build more trust. Our goal should be to become more trustworthy.

The established science of trustworthiness says that it requires high levels of competence, reliability, benevolence, and integrity in our life and practice to be present and experienced by others. Integrity, or aligning our intentions with our actions, is the most important.  

That same science says that real trust takes time and friction, at least some minimal friction, to establish. When a relationship is established seamlessly and instantly, there isn’t even the time and opportunity to ask the question: “Should I trust this person with something that is important to me?” That is the minimum amount of friction required.

Many organizations and a significant amount of behavioral research conclude that the strongest relationships are those that have experienced a problem and found a way to reconcile the issue. In other words, friction strengthened the relationship through solving the problem.

Have you listened to or read anything by Rachel Botsman? Join the conversation below … !

Listening is a skill everyone likes to talk about but very few actually know how to enact. It’s more challenging than we might think to really shut our mouths and pay attention without constantly interrupting or adding our two cents.

In my last blog, I talked about offering an empty presence and letting the person finish their story. Here, I cover other important listening skills. We should all make the effort to speak less and hear more.

Become a Truly Great Listener

Listen for Their Heart

Listen for the feelings behind the words. Can you hear voice fluctuations? Can you read their eyes? Feelings of regret, fear, grief, hope, etc.

Using the balloon symbolism, I picture a red balloon filling with their emotions as I listen for feelings. There is no higher form of communication than heartfelt, empathetic listening. The balloon symbolism may feel silly, but it will help.

You cannot be heard until the patient’s emotional bubble is deflated through your quiet confidence and empathetic understanding.

Ask Permission to Go Forward

When you ask for and receive permission to offer advice, you are much more likely to be heard. This is truly one of the most intuitive questions you can ever ask and does wonders for building rapport: “May I give you some initial thoughts?”  or “May I have permission to consider what you have told me and study possible solutions?” 

Once a person has given you permission, they are more likely to become a partner in solutions. 

There is no greater gift of healing, expression of love and builder of self-esteem we can offer those special people we care about most, including our family, friends, patients, co-workers, and community, than listening. Everyone wants to be heard.

How do you practice listening skills? Let us know in the comments section below!

Dr. Pankey had an advantage most of us do not that made him a world-class listener. Often labeled a disability, Dr. Pankey was hard of hearing. Because of this, he had to learn how to listen intently to his patients.

Dr. Pankey learned to listen for feeling over content. Listening is a skill that can be developed and improved. It requires intention and attention. One must practice! Here are a few tips that help:

Actionable Skills to Become a World-Class Listener

Offer Your Empty Presence

Most important of all is the intent to be present. Be here, nowhere else. Never enter a room without taking a deep belly breath to quiet the sympathetic, judgmental lizard brain and enhance the empathetic brain.

Empty presence is being fully available for the patient with no agenda, no busy talk going on in your mind, no judgment about what is said, no mental correcting or explaining chatter going on in your head for when you get a chance to talk.

I like to imagine an empty white balloon completely devoid of anything. My objective is to simply let the person fill it with their own thoughts and feelings. Really focus on what they say and how they say it and especially the feelings behind it. You are a gatherer of their information, not an explainer, corrector, teacher, or judge.

Let the Person Finish Their Story Without Interruption

Take a deep belly breath again once they have gone silent. What they just told you is simply what they first told you. There is probably more. When a person has finished their story, the silent period is when they are understanding what they just said.

Silently offer your open heart with compassion, allowing them time to spill out everything they need to say. Silently count to 10 before speaking, then use simple encouragements: “Is there anything more,” “Yes, I understand,” “I’m glad to know that,”  “I’m sorry to hear that,” or “Tell me more.”

To be continued …

Do you want to develop an emotionally engaged, relationship-based practice where people choose you over the insurance-driven option? It is not going to be your technical knowledge that does this. It is in how you touch people’s hearts.

Trust or the lack of it can be built within seconds. How can we best emotionally engage people? Immediately as you greet a person, focus on them – each and every time. Give the S-O-F-T-E-N approach a try:

How to Develop Trust in Only 10 Seconds

Smile: A welcoming greeting in any language.

Open up: Open body language – relaxed, welcoming, arms open, palms up.

Forward body lean: Again, welcoming, not aggressive. A slight forward lean can demonstrate attention, interest, engagement.

Touch: Lightly when and where appropriate. Studies indicate people feel a warmth of endorphins with a light human touch. A gentle handshake with the left hand also touching lightly can work. A light touch on the shoulder or arm is effective too.

Eye contact: This is the most important thing you can do to gain immediate connection. Immediately look the person in their right eye. Not to stare. Especially while you are speaking to the person. Recent studies indicate eye contact has dropped to the 30-60% range in today’s digital smartphone era. That’s a huge drop into disengagement. It drops even more when one is speaking.

We are losing human connection to the soul, yet 60-70% eye contact is ideal. Practice glancing into their right eye consistently. Yes it feels awkward at first and yes it takes conscious intent. Why the right eye you ask? Mostly so you don’t stare at the bridge of the nose and look cross-eyed, but also the right eye engages a person’s creative, intuitive parts of the right brain more quickly.

Nod: A slight affirmative nod as the person is speaking is a strong indicator to continue. Studies indicate a person even accepts criticism and correction better if one nods slightly while presenting bad news. A nod tends to indicate support, not just agreement.  

Interestingly, the reverse is also true. A shake of the head while giving supportive news can create a sense of skepticism. Yes, I can look like a bobblehead at times. Emotionally engaged attention is becoming a lost art. But it is the greatest way to touch a person’s heart.

In dentistry we have a huge advantage. We have multiple interactions every day with good folks who trust us enough to do scary things in one of the most intimate parts of the body. We can grow that trust to emotional engagement one person at a time.

What is the result of an army of emotionally engaged dental missionaries? Lots of loving people who say: “You have to go see my dentist. They’re the best in the world!” Whose world? Theirs.

How can you achieve an emotionally engaged, relationship-based practice where people choose you over the insurance-driven route? Practice, practice, practice – on people, not just their teeth. Start with your family! And love the practice.

There are three words on my business card that may seem obscure to patients at first. These words, which come to have important meaning later on in their relationship with my dental practice, are: Comprehensive, Restorative, and Esthetic.

Promising and Delivering a Luxury Patient Experience

Comprehensive

We look at the patient as a whole. We observe and diagnose globally. We intend to partner with our patients in a thorough individualized manner. The best dentistry does not happen when we just look at a tooth with a problem. In fact, it isn’t much better when a dentist has a look at ‘teeth’ plural.

Comprehensive dentistry considers the whole system and the individual. How are the muscles and joints that affect and are affected by the teeth and their use considered? How are the structures that support the teeth?

What are the factors unique to a patient’s habits, routines, and systemic health that relate to ideal dental health? What are a patient’s individual goals, desires, and expectations? Will the dentist take everything they can gather about the causes of problems and consider them in the solutions?

The list goes on. This is a highly intentional paradigm of patient care.

Restorative

The focus on restorative dentistry is just as it sounds. In our practice, we want to restore patients to an ideal state of health and function. We put tremendous effort toward continuing education, technology, and our approach to care beyond the average dental setting to achieve this ability.

Esthetic

Esthetic dentistry speaks to taking great care in the art and science of making dentistry beautiful. Yes, it is a nose thumbing at the overused term “Cosmetic Dentistry.”

We believe all good dental restoration is more beautiful if provided in the context of health and function. At the end of the day, we want to create smiles our patients can be proud of because they are beautiful, healthy, and durable.

We all have things we value enough to invest in. We all make choices that take effort because we want the result, just like my car that I enjoy and is reliable. I invite patients to consider that experience with their teeth through the approach of ‘Comprehensive, Esthetic, Restorative’ dentistry.

What do you do in your dental practice to make dental care a valued experience for patients?

When a car breaks down, the way we choose to have it repaired says a lot about how much we value our vehicle. A similar phenomenon occurs with dental care. 

In part 2 of this series about how we see a fix versus a valued service-based relationship, Dr. Kelly dives back into an experience that made him reflect on the dental profession. Keep reading for the rest of his story:

A Car Service Analogy: Obligation, Expense, or Experience

Coincidently, many days I use the analogy of cars to taking care of teeth with my patients. We wear away the surfaces of our teeth similarly to how tires age. We pay for maintenance and parts with an equal financial obligation and expense.

When we have to start over and restore our vehicle (or get a new one), sometimes it costs the same as major treatment we could have done for our teeth. Sometimes the auto investment is inconvenient and urgent. Often, if we choose, it is predictable and pleases us. We find ways to pay for it.

Individuals always seem to find ways to pay for the things they value. We choose our own experiences whether we know it or not. I invite my patients to consider experiencing dental care in my practice similarly to the good experience I have had with reliable and well-maintained cars.

The business card for my practice has three tag words on it: Restorative, Comprehensive, and Esthetic. I’ve been told that the meaning of these descriptors is too obscure for new patients to understand. Why not be like the dentist down the street and just say “Cosmetic” or “Family Dentistry”?

I believe every opportunity I have to help patients experience each of these focused goals for our patient care enriches the dentistry I can provide them. So many in our patient family have learned through these experiences exactly what these words mean.

To be continued …