Patients gravitate toward and stay loyal to dental practices in which the dentist and care team love what they do.  

When you are enthusiastic about your work and how you do it, you can’t help but talk about it, can you? You can’t help but show it.

This enthusiasm affects patients in multiple ways. 

• Your happy office is a delight to visit under most circumstances. 
• The confidence you exude makes potentially stressful visits more comfortable and allows patients to trust in your care.  
• Their curiosity in dentistry and what you can achieve together is peaked. They ask more questions. This, in turn, sparks the patient’s desire to make changes in their health and smile. 
• Because your happiness has spread throughout your care team, the support patients receive throughout their experience is exceptional. 
• You surround them with so much positive energy they feel free to get to know you too. 
• Consistent happy experiences lead to patients feeling like they are among family and friends. 
• And, you’ve all seen this. Patients want to emulate your happiness in their own lives. They want to be like you. 

What is happiness anyway? The definition that I like is “the ability to feel satisfied with your life, to enjoy yourself and others, and to have fun in the present.” This certainly is what your patients enjoy when they visit. 

So, what brings about happiness in dental practice? Perhaps, you’ll agree: 

• Doing what you love to do most of the time, applying your talents and strengths 
• Being outwardly focused on the well-being of others 
• Effectively motivating and leading others to optimal health 
• Being true to your own personal values 
• Ever be it dynamic–Pursuing your own vision of practice (in the case of the dentist) and a coherent practice vision to which you contribute (in the case of team members) 
• Working in a care team that is high functioning with high EQ 
• Effective systems that facilitate doing what you love most 
• Ability to successfully problem solve and adapt with confidence 
• Patients who appreciate what you do together  
• Continuously mastering higher standards of care 
• Multiple moments of true connection with others every day 
• Understanding of yourself and others 
• Satisfaction with your life outside the office 
• Optimism and gratitude 

A patient’s feeling of comfort and trust is increased when you demonstrate you appreciate your team.

Showing appreciation to your team in front of patients demonstrates you respect the people who support you in serving patients. This only raises their opinion of your quality of care.

• When patients witness you calmly moving through moments of stress with instructions to your team delivered in a calm tone, a smile, and thanks, it speaks volumes to patients who are eager to have confidence in their care.
• When you spend time informing team members well and empowering them with knowledge of “the why” of your diagnoses and treatment plans, they naturally and appropriately prepare patients for your case presentation, answer questions, and encourage patients to move forward. Expressed gratitude for this support is a positive affirmation that creates growing team confidence, competence and job satisfaction. And this fosters a happy work environment and employee retention. Patients are highly attuned to team happiness and are relaxed among your loyal team members they have come to know. Again, this increases trust.
• A team’s feeling of appreciation will be undermined, and individuals easily become stressed when they are chronically overworked or asked to perform tasks they are not well prepared to do. Be alert to lead them through stress with assurances and demonstration that you care enough to take measures that will restore work balance and comfort.

There are multiple situational stresses that occur every day in your practice that produce the flow of stress hormones, 112 of them to be exact. And when there are stress hormones building up in the bloodstream, the physiological and psychological consequences are noticeable to patients. Fortunately, PankeyGram readers and participants in Pankey Institute courses and study clubs receive a constant flow of fine examples of colleagues showing appreciation for their teams. Showing gratitude doesn’t always have to be done in a big way or at great expense. A positive spoken affirmation in any given moment is going to release some oxytocin. And that’s what we want!

It’s early in the morning and the first sip of coffee full of that fresh aroma just went down with a sigh, a sagging of the shoulders and a feeling of here we go for another day. My mind is starting to run the list of what is on the day’s agenda…work deadlines and meetings…the kids’ schedules…what is my spouse doing today? Did I pay that electric bill or not? Then it hits. Oh, that’s right! I have a dental appointment today!

The morning life puzzle pieces all start to come together as they always do.

Everyone and everything are in their place. And off I go to the dentist with that fearful thought, “I hope they don’t hurt me today.” Parking in a rush and taking a breath before entering the dental office door, I worry, “Am I just in time?” A gentle face looks up, smiles and greets me by name. With that kind hello, I begin to relax and mentally whisper to myself, “I’m safe here. They know me. They want to take care of me. They’re happy to see me. I’ll be okay.”

The reality is this kind of personalized attention and care is slowly going away.

In medicine and dentistry, consolidation of practices into corporate entities has forced doctors to “run” on a patient-number schedule and production list. Statistics and numbers are slowly pulling their want and desire to give personalized care away from them. And I, the Patient, don’t want to be treated this way.

I’m glad my dentist takes time to know me and my concerns, spends time diagnosing and planning treatment that is individualized and best for me, and doesn’t let insurance companies limit my choices and the quality and quantity of care I receive. What’s important to me is I trust this type of dental care, I think I deserve this type of care—and the comfort I feel during my dental visits is priceless.

The Ancient Greek aphorism “Know Thyself” is one of the Delphic Maxims inscribed on the ancient Temple of Apollo. Dr. Pankey referenced this aphorism because self-awareness is key to our ability to stand apart from our patients and form healthy and effective interpersonal boundaries. This ability to “stand apart” greatly influences how we see our patients and the world that surrounds THEM. It not only affects our attitudes. It also affects our behaviors.

Lack of Self-Awareness Leads to Misinterpretation of Patient Behavior

Until we take into account how we see ourselves, we will be unable to understand how our patients see and feel about themselves and what the dental issues they are experiencing mean to them. This is because a lack of self-awareness causes us to function more on assumption than reality, and this in turn causes us to project our prospective onto our patient’s behavior and then fool ourselves into thinking that we are being objective. These assumption-laden relationships significantly limit our potential to positively influence and relate effectively with our patients. And this limited ability to relate to our patients on a deeper level easily leads to misunderstandings, the devaluing of recommendations, deferral to insurance companies, and even to open conflict.

Knowing Yourself Leads to Knowing Your Patient

Bob Barkley’s co-discovery method is the pathway to “knowing our patients” as well as allowing our patients, over time, to know us on a philosophical level. And it is the practice philosophy which moves people toward health or keeps them stalemated in dependency. Knowing yourself leads to knowing your patient which allows you to optimally apply your knowledge. And isn’t that your mission?

Three-quarters of human brain growth takes place in the first three years of life.

And that represents almost everything except the prefrontal cortex, which does not fully mature until around the age of twenty-five. This means that our ability to cognitively process…our ability to understand and respond appropriately to lower brain functioning, and particularly our emotional system, is quite limited early-on. Yet that is exactly when most of our beliefs about the world and how it works are formed and rarely challenged. So, when a person comes into the office claiming that “When I was a kid, the dentist put both feet on my chest to extract the tooth. It was horrible. I hate going to the dentist,” we are actually dealing with a belief and not a fact.

Responding to “When I was a kid…”

It is counterproductive to begin a new relationship with a person by telling them that they are wrong and don’t know what they are talking about. So, we have to begin someplace else, with the goal of facilitating a change in belief over time, and not with a goal of convincing others how much we know and that they should surrender to our intellectual prowess. Start with the understanding that we humans don’t like to be challenged as wrong. Also understand that we’d often rather be wrong than right, simply because it feels better to our ego.

It turns out that the only way beliefs change is through an inside-out process of self-reflection, re-assessment, new realizations, and new assumptions repeatedly confirmed by new experience. Before there is a commitment to action, your patient with negative beliefs about dentistry must go through this. And, I’ll bet you weren’t thinking all of that was going on in your patients’ brains, but it is…every single day. That is why relationship-based dentistry holds so much power and potential.

Truly helping relationships are the only vehicle through which significant personal change occurs in dentistry. L.D. Pankey said, “Know your patient,” not because you can use the knowledge strategically to defeat them on an intellectual level, but rather to help pave the way toward significant change and therefore better decision-making.

We can’t manipulate our patients toward becoming healthier.

In fact, the more we try to manipulate people, the more their lower brain recognizes something is wrong. It doesn’t know what, but at least it’s smart enough to stop listening, and focus on self-preservation—like staying away from people who will likely put “both feet on their chest.”

It seems that “empathy” has become one of the most popular buzzwords in dentistry, and in spite of the popularity of its use, few people understand what it is and why it is so important.
Confusion may be rooted in dictionary definitions such as “the ability to understand and share the feelings of another.”

Can we really understand and share the feelings of another?

Avrom King used to say, “There is no such thing as a second-hand feeling.” It’s impossible for us to fully understand the feelings of another person. In truth, the best we can do is contemplate intellectually what a person MIGHT be feeling and then project our feelings upon our thinking.

Our feelings, and our patients’ feelings are unique to us and them. They cannot be fully explained or understood by others. Yet, they are valid because what we feel is our reality.
Our brains function based on mental models or “thought constructions.” These thought constructions may be fairly accurate, total fabrication, or something in-between. But in all cases, they are still our reality. And the only way for us to square the inaccuracy of our thought constructions with reality is to test them against what we perceive to be reality.

Perceptions are open to review. They change.

And, there is another problem. Our perception of reality is a thought construction as well. In other words, our brains function by testing our thought constructions against our thought constructions, and then we call the most successful ones “beliefs.”

Because a belief is still a thought construction, it is always up for review with regard to accuracy, unless of course, we don’t want to do that. And in that case, we choose to become dogmatic instead of continuously being open to refining our version of reality.

So, why is understanding this important?  Because beliefs, dogma, and empathy all fully infuse the relationship we have with ourselves as well as our patients.

What we think they think influences how we think.

Let me say that again. What we think they think influences how we think. So, if we come into a new relationship with beliefs about ourselves and other people which are rigid and dogmatic, then it is very unlikely that we will find the whole truth, and most certainly, we will never even come close to understanding our patient’s perspective. Yet, our patient’s perspective is the complete source of their motivation to act or change their perspective.

Empathy is an attempt to understand another’s thoughts and feelings.

Giving others quality attention signals we are interested in understanding what they think and feel. It signals that their thoughts and feelings are important to us. Empathizing is an act of caring about another person. When we give others this kind and quality of attention, it allows them to feel safe and accepted. And in that space, they are more likely to re-assess their beliefs about dentistry, dentists, and what dentistry might be able to do for them. Consequently empathy, non-judgmental acceptance, and behaving in a transparent authentic fashion is the pathway towards facilitating change in others. This is what Carl Rogers called “congruence.”

When patients feel supported and risk committing to change, we call it trust.

Change in attitudes, beliefs, and perspectives is what causes patients to commit to significant change, which at the end of the day is a risk…a risk taken because they feel like the people around them will support and care for them along their journey toward new understandings, perspectives, and experiences. And when that happens, we call it “trust,” which is at the foundation of every enduring and meaningful relationship.