By Mary Osborne, RDH 

How can we make recommendations for care without fully understanding what the patient aspires to? The patient’s goals are the context or should be the context for recommendations that we are going to make as their partner in health. Too often, context is the missing piece in our conversations with patients.  

I’ve heard that Dr. Bob Barkley would say to his patients, “You know, Mrs. Jones, if I had taken X-rays of you every six months since you were born, we would have 80 sets of x-rays. And if I stacked them one on top of another and then thumbed through them, I would have a movie of the health of your mouth for the last 40 years. We would see how your teeth changed from health to the degree of breakdown we see today. We can’t do anything now to change that movie. That movie has already been made. But, if you like, you and I can work together to create the movie for the next 40 years. Is that something you’d like to do?” 

If we get agreement from the patient, “Yes, I’d like to work together with you to plan for the next 40 years,” that’s not a specific goal, but it begins to create a context for our recommendations. Instead of the provider setting the expectations of the patient, it becomes more of a mutual agreement to long-term planning, so that there’s a buy-in by both parties in the relationship. That’s moving toward a partnership.  

When we set a general mutual goal during the preclinical consults, it fits in well with our not knowing what we will uncover during the clinical piece of the appointment. Dentists and hygienists can be direct about it, and I think there is value in saying, “I’d like to come to a mutual agreement that we work together to understand what is going on in your mouth, and based on the circumstances we find, come up with the best solutions for you. Is that something you would like to do?” 

We can set expectations by saying, “As we go through this process, I will be asking for your input. We’ll take it slow and be thorough. We’ll discuss what you and I discover, and together we can think through the next steps you may want to take. How does that sound to you?” 

I think it is essential to this process to invite the patient to be in shared control by asking, “Would you like to proceed with the clinical examination? Do you have any questions for me before we begin?” 

When we come to the conversation as fellow travelers with the attitude that “the two of us can work together,” we open ourselves to working toward mutual agreement about what it’s going to take for this particular person to achieve the level of health to which they aspire. Starting as partners with the goal of improved health is a low-stress way of being in a relationship that is comfortable for both parties. 

By Edwin “Mac” McDonald DDS  

Change isn’t just about external circumstances; it’s also an inner evolution. We go on a transformative journey, and our reflections as we go touch upon our intention and legacy, our personal identity amidst the change, and decisions we make as the change unfolds.  

Challenge 1: Intention and Legacy 

When facing change, having a clear intention is like setting the compass for your journey. What legacy do you aspire to leave behind? Aligning your actions with your deeply held beliefs ensures congruence between your intentions and outcomes. But stress may cause you to move away from your most deeply held beliefs. I’ve witnessed this happen, just as I’ve witnessed deeply held beliefs guide what happens. 

Challenge 2: Personal Identity Amidst Change 

The question “Who do I want to be during this transition?” is profound. It invites introspection. Consider how you want to show up for yourself and those around you, especially those who are most important to you. Authenticity matters. 

Challenge 3: Listening and Accountability 

Change often involves decisions. Whose voices matter? Listening deeply to trusted individuals—those who respect and understand you—can provide valuable perspectives. Forming a leadership team of diverse viewpoints helps guide you toward success. 

The Importance of Values During Dental Practice Mergers and Acquisitions 

Many private dental practices are being acquired by large partnerships in 2024. These transitions have tons of potential and profit associated with them. Associated with these transitions are complex changes for the practice owner and team members…expanded ownership, more complex organizational structure, new operational systems, and a distancing of some decision making. They also come with the unknown of who will be your future partners after the next sale of the organization. Are you prepared for all of that?  

Preparing yourself and your team is essential. On the front end, asking every possible question including questions about the partnership’s core values, how they are integrated into the day-to-day operations, and communicating the importance of that to you and your team is essential to long term success. These questions and expressions are an attempt to examine the congruence and compatibility between you, your team, and your new partners. 

I am witnessing several friends transition successfully to one of these new partnerships. The common factor I observe is that each dentist has great self-awareness and received very strong assurance that they would retain autonomy to continue to practice according to the most deeply rooted values. I also observed that the large partnership was very stable with excellent systems and had high quality leadership.  

My father often told me: “The person that you have an agreement with is more important than the agreement itself.” In other words, a person of strong character will find a way to honor the intent of the agreement regardless of the specific circumstances of the moment. Values have longevity. Circumstances come and go. 

I have also witnessed an abandonment of strongly held values as an organization was going through the painful changes of decline. In abandoning their values, stakeholders were hurt and distanced themselves. It intensified and accelerated the decline. Values matter. Character counts. Clinging to our core values in times of change or decline will increase and accelerate recovery. There are countless Fortune 500 case studies to support this idea. 

Another Example of Values in Transition from My Life 

Finally, I want to leave you with a case study from my church, The Village Church. We had become a multi-site church in response to the demand of many people attending our main campus. As it grew, our leadership became painfully aware that it was not fulfilling our mission and it was not consistent with our closely held values of community and individual relationships. Over a period of several years, each church was given the opportunity to vote on becoming independent. They all voted around 95% in favor of the change. We gave away around 40 million dollars of real estate, equipment, furniture, and other assets to all of the churches.  

Today, the new independent churches are thriving as is our main campus where we attend. The decision was in conflict with everything that is happening in our business and church worlds where there is constant consolidation and scaling. However, the decision was consistent with the values that drive the purpose of the church. The change created multiple thriving churches that are serving their specific communities and growing people and their impact on our world. 

By Mary Osborne, RDH  

The questions we ask on a health history form have more to do with disease history than health history, right? The focus is on disease right away. I like to shift that focus to health by saying, “I see that you’ve filled out this history and I’d like to talk to you about specifics, but I wonder if we can begin by you telling me a bit about your health in general? How healthy do you think you are?”  

I have found that if I start with health, I’m more likely to have a patient talk about health. If a patient says, “I think I’m pretty healthy,” I can ask, “What do you do to take care of yourself?” I can relate by acknowledging that I am trying to take better care of myself and how it isn’t always easy. Or I can pick up on something that is important to the patient, such as a concerted effort to get enough sleep or stick to healthier foods or to bicycle many miles a week. I can say, “Tell me more about that. It sounds like you feel better when you do that.”   

The questions you ask shape the conversation. And by the way, that does not just apply to reviewing a health history with new patients. It applies to every single interaction, with every single patient, with everyone on the team.   

When someone comes for their routine hygiene check, I might ask about their recent vacation or how their kids are doing, but I also always ask questions that open a conversation about health. Instead of starting with, “Have there been any changes in your health history since I last saw you?” I like to ask, “How has your health been since I last saw you?” Instead of asking, “Have there been any dental problems that you want us to pay attention to,” I ask, “What have you been noticing about your teeth recently? What are you noticing when you brush or when you floss?”  

We have to deal with disease. That’s a part of our job but moving toward health is more enriching. It’s positive.   

If you want to be seen as a partner in health, then moving the conversation in the direction of health is much more powerful than focusing on disease. The truth is everyone has a personal health story. There are things they are happy about and things they are sad about. When we take a little time to explore that story with questions, we and our patient gain insight into their experiences, attitudes, and feelings about their health. We and our patient get a better understanding of their motivations and the strategies they employ to become healthier. If we invite them to share their perspective with us, they will be more willing to hear our perspective, and we can extend an invitation: “Would you like to hear my perspective about that?”  

I recognize that inviting and engaging the patient in expanded conversations about their health may take a little more time, but it is effective time. Over the years, I noticed that when I thought I was being most efficient, I was generally being less effective. And in the long run, I ended up spending more time understanding what the problem was and trying to give more information without getting enough feedback to know if I was being heard or influencing the patient.   

One of my favorite things to hear from a patient is “You know, I never thought about that before.” I remember a woman who told me that she had been a smoker, but she had quit smoking. And I asked her how she did that. What prompted her? She said it was when her daughter was born that she realized that she didn’t want the smoke around her daughter. In her health review and preclinical conversation, she mentioned one of the things she did for exercise was tap dancing lessons, so I asked her how she got into that, and she said, “I figured I could spend time with my daughter, get exercise myself, and set a good example for my daughter. Wow, I guess my daughter is really a good influence on my health, isn’t she?” 

Those are the light bulb moments that light up my day.  

By Clayton Davis, DDS 

About 15 years ago, my wife and I were on a trip to New York City. My laboratory had told me about two dentists there who practiced together and did an amazing amount of cosmetic and restorative dentistry. Their best month was about six or seven times more than my best month, so I was curious. I knew they had studied with some of the same mentors I had. They had gone to Pankey and Dawson. They have a a comprehensive approach. While I was in New York, one morning I told my wife I was going to visit their Manhattan office and see what I could learn. 

Their office had reasonable furnishings (nothing fancy) and a reasonable level of equipment. It was tidy with nice staff. It seemed similar to what I have in my office. I sat down with the dentist who was there that day, and he shared with me what they do in their practice. They do a fair amount of marketing in health and beauty magazines that are circulated in the New York City area but otherwise it all sounded very familiar to my practice.  

A few moments later, there was a knock at the door. It was the hygienist, and she said, “Doctor, ready when you get a chance for your examination. Mr. Anderson is in today, you may not recall, but he had said that he wanted to get his veneers done after his daughter graduated from college. That was a couple years ago when he said that, and his daughter is graduating in June, so it’s time to bring that up again. I mentioned it to him today, and he’s scheduled to start that in July. So, when you want to come on in and talk to him about it, that would be great.” 

She walked away, and I looked at the dentist. I said, “What just happened? The hygienist handled everything about moving that patient forward for treatment. I can’t get mine to do that. As a matter of fact, we’ve had conversations, and they don’t seem to feel comfortable doing that.” 

He said, “I don’t know. We talked to them about it, and they’re tremendous about it. They really help our practice move patients into treatment.” 

I went home wondering how I could move my hygienists in the same direction, and an old business concept came back to me. If you want to improve something, you need to come up with a way to measure it. So, I came up with a form for logging what I call “Hygiene Points” and presented it to my hygienists. We talked about how we want to improve our ability to move patients forward with their treatment through the hygiene department. I simply asked them to score themselves on how it went at each appointment in talking to patients about any kind of treatment that came up. 

As each patient passes through hygiene, they receive a score. The lowest score, a score of 1, is for when I come into the operatory, talk to the hygiene patient, bring up some previously recommended treatment, and they go ahead and schedule it. A score of 2 is for when the hygienist finds a problem like a cracked tooth and says that it needs to be monitored. A score of 3 is for when I’m in hygiene and diagnose something new and get the patient to commit to schedule treatment. A score of 4 is for when the hygienist gets previously recommended treatment scheduled at the front desk without my involvement. A score of 5 is for when the hygienist takes an intraoral picture and points out a problem to me and I get a commitment to schedule. In other words, they say, “Let’s take a picture of this. I want Dr. Davis’s opinion on it when he comes in the room.” And then because the hygienist was concerned and I confirm in front of the patient that this is an issue that needs to be addressed, the patient schedules treatment. The collaboration and communication go so well, this is worth 5 points. And then the ultimate score is 6 for when the hygienist gets a commitment to schedule treatment for an obvious problem before I come in to confirm the diagnosis.  

The first couple of months that we used this scoring, we recorded a baseline monthly total.  After that, the competitive instincts of the hygienists kicked in and they wanted to improve their total score each month. I did not give them a reward incentive, and over two years, more production was coming out of hygiene. The old saw “You can improve what you measure” has certainly increased restorative collaboration and revenue in our practice, and the pursuit of higher Hygiene Points has been fun. 

Laura S. Harkin, DMD 

I’m the owner of a third-generation dental practice. My father was a special person who cared for his patients as much as he did his dentistry. One important piece of advice that he gave was to make sure that my patient records were always complete and pristine. He said, “Anything that you are sending to the laboratory or to a specialist, even down to how you write your lab script or note, must be precise. And the reason is not only to minimize adjustment at the end but to also set an expectation for the same level of care returned by the lab or specialist.” 

As a team, we have spent time evaluating our models and photos to discuss how they can be improved and to recognize our highest standard. Recently, I became a little concerned about some of the radiographs we’d taken in the office. I encountered a few bitewings in which I was able to see the bone levels or the image wasn’t anterior enough to check the distal of the canine. So, as a team, we set aside time to review current x-rays and discuss the diagnostic qualities that we seek to achieve in each type.  

A team huddle provides built-in time and a safe place to do something like this. While reviewing the images, it became very clear that the team knew how to take vertical and horizontal bitewings. They also had a clear visual for how the images should look. Sometimes, however, a team member was shy about retaking an x-ray for they worried that a patient would be uncomfortable with the process. Other times, I imagine, they felt pressed for time and hurried to move down their checklist. 

Our review of images reinforced the level of care we collectively aim to achieve in all facets of our clinical day. Just as we strive for beautiful, mounted study casts, we take our x-rays with intention for our ourselves, our referral sources, and, above all, our patients. Consider taking a team meeting to share each other’s tips and tricks for taking x-rays in patients with difficult anatomy, a gag reflex, or missing teeth. Our own team members have a wealth of knowledge that sometimes doesn’t move from one treatment room to the next! 

By Pina Johnson, Professional Certified Coach, and Edwin (Mac) McDonald, DDS 

B.F. Skinner, a noted 20th century behavioral psychologist, conducted an intriguing and provocative experiment using laboratory mice. Using behavioral conditioning he was able to condition one group of mice to believe that through their actions they were able to determine their fate. Using the same methodology, he also succeeded in conditioning another group of mice to believe that there was nothing they could do to alter their fate. 

He then placed the first group of mice, the ones that believed their actions mattered, into a large tub filled with water. As anticipated, this group of mice, when placed in a life-threatening situation, acted instinctively and began to swim to the side of the large water-filled tub. Upon reaching the edge of the tub the mice were able to crawl out to safety. 

The second group of mice, the ones that believed that their actions were meaningless, when placed in the tub of water, simply sank to the bottom and drowned. Appropriately, the lack of responsiveness displayed by the second group of mice was termed “learned helplessness.” 

Culture Lifts or Sinks Ambition 

Belief that our actions and choices matter is essential to “making things happen.” 

According to Edgar Schein, an icon of modern leadership thought, the primary function of leadership is to create an organizational culture. The culture that we choose to create will influence every aspect of our organization and ultimately determine our dental practice’s success or failure. 

Value-based leaders understand the power to alter the course of the organization does not reside with a few; it is shared by many. Organizations with cultures based on shared beliefs and purpose are higher performing. Leaders of the highest performing organizations foster cultures rich in collaborative decision making and a profound belief that everyone has influence. 

Counter Learned Helplessness by Empowering Self-Confidence 

We have come to recognize that good-old “self-confidence” is a learned competency, and effective leaders create organizational cultures that promote and teach self-confidence to each individual team member. This is accomplished by empowering teams through collaborative decision making and ensuring each team member has been given the knowledge, skill, support, resources, and appropriate authority to accomplish each task required to meet the shared goal. 

Unleash Teamwork and Creativity 

In organizations with shared leadership cultures, human self-confidence is unleashed beyond saving oneself to act in the best interest of the organization. Knowing that our individual actions will have some effect on our organization’s future (and thus on our own future and the future of others we value) compels us to want to take actions that have positive benefit for everyone. This is “meaningful” for the individuals within the organization. This raises their engagement in the work and simultaneously generates a sense of wellbeing.  

In our dental practices, “We are serving others with empathy and care to ultimately improve their wellbeing.” This is a form of love. It begets appreciation and reciprocity. When the slings and arrows of daily life initiate negative thoughts of being out of control of a situation, remembering our purpose and prior successes enables us to see disappointments and frustrations as opportunities to create a new type of approach and carry on. 

The goal for effective leaders is to allow all of this to happen in a psychologically safe environment in which our staff need not fear repercussions for their well-intended actions even if the outcome of these actions is less than ideal. By creating organizational cultures that are psychologically safe, we draw out our organizational creativity which is often stifled by the psychological repression found in command-and-control cultures. 

Creative thinking is considered to be one our highest-level cognitive functions and has been found to be a distinguishing characteristic of exceptional organizations. The wise leader understands that their organization is best served through shared power, collaboration, and utilization of their organization’s collective creativity. 

By Pina Johnson Professional Certified Coach 

 What motivates teams is a question that has been asked for as long as someone has been seeking solutions for organizational performance. The day of top-down (or command-and-control) leadership is gone.  

Daniel Pink, in his 2009 book Drive: The Surprising Truth About What Motivates Us, takes a deep dive into the decades long effort to understand the research around human motivation in the modern workplace. Consistently, employers believe they are doing a great job of recognizing, rewarding, and motivating their employees. The people that work for them report the opposite. The tension between the two groups is observable and measurable. In this book, Pink discusses the key patterns that are consistent in what motivates people., takes a deep dive into the decades long effort to understand the research around human motivation in the modern workplace. To his credit, he uncovers the key patterns that are consistent in what motivates people. 

What doesn’t work—external rewards and punishments 

Although there are times and places to administer rewards (carrots) and consequences for behaviors that violate the organization’s values (sticks), “carrot and stick” strategies do not work and have not been working for quite some time. In fact, according to a great deal of research, these strategies reduce performance over time after a brief initial improvement when they are introduced.  

What does work—internal motivations 

Research has clearly demonstrated that there are three primary internal motivations that drive team member engagement: 

1. Autonomy 

1. Mastery 

1. Purpose 

Autonomy over your work appears to be the strongest driving force among those three. There are many aspects to autonomy that you can explore in Daniel Pink’s book. My takeaways are that people want: 

• Control over how they do their work 
• Ability to creatively enhance the methodology of their work 
• A strong voice in the direction and future of their work 

This begs the questions:  

• Have you met individually with each team member and talked about this?  
• Are you giving them the freedom to do their jobs well?  
• Are you developing them with training opportunities and direct challenges?  

Responsibility without authority creates frustration. Responsibility demands autonomy. 

Mastery is defined as the desire to get better and better at something that matters. You can feel the natural connection to Autonomy as the desire to improve is based in each person’s unique gifts, talents, skills, and desire to use these for something important.  

Control seeks compliance. Autonomy seeks engagement. When a person becomes fully engaged in an activity, and is challenged enough to be stimulated, they can lose themself in that activity be it work or play. That optimal state of peak performance is described as flow. Mastery happens in and through those experiences of flow. Mastery is a mindset that requires a great deal of grit and becomes the infinite game that we never complete. 

Purpose answers the question for each person: “What are you supposed to do with your one short life?” When the organization has a clear purpose, the individual understands their role in that purpose. When they connect the organization’s purpose to their own life’s purpose, then you have a powerful force at work. Is the purpose of your organization clear? Have you asked the key people in your organization what their purpose is? Have you helped them to connect those two purposes?  

Our responsibility 

As practice owners and leaders, we are people developers. Everyone possesses a unique set of gifts, talents, hopes, dreams, and ultimately a life purpose. Unlocking that unique set of internal motivators for everyone on your team is the key to building an abundant future. That future is defined by a transformational mindset rather than a transactional mindset in which power is limited by time, redundancy, compliance, and efficiency.  

Each person motivates themself. Our role as a leader is to help our team members, one at a time, to discover, connect with, and unleash their powerful internal motivators. Then together, as a team, we can channel all of that discretionary energy into a shared mental model with a laser-like focus on the organization’s clearly defined and stated purpose.  

Pina Johnson PCC is a Certified Professional Coach with the International Coach Federation, and as a former practice administrator, she has over 20 years of experience in the dental field. Her coaching strategy and emphasis lie in developing leadership skills and practice cultures that produce peak-performing teams along with increased productivity and profitability. In her private practice, Pina specializes in group coaching. Partnering with Drs. Joel Small and Edwin (Mac) McDonald at Line of Sight Coaching, she coaches many dental teams with great success, resulting in increased employee engagement, reduced stress, improved performance, and enhanced communication. Pina received her professional coaching certification from the University of California, Davis. Upon completing her training, she was invited back to serve in multiple capacities as a UC Davis coaching program faculty member. Pina has been a featured speaker covering topics including, The Neuroscience of Trust, Management Behaviors that Foster Employee Engagement, and How to Talk So Your Staff Will Listen, and Listen So Your Staff Will Talk. 

Pina is a Member of the American Association of Dental Office Managers, Dental Speaking Consulting Network, Dental Entrepreneur Women, International Coach Federation, and the ICF Sacramento Chapter. 

Paul Henny DDS

I wrote about this topic last October in The Never-Ending Interview and wanted to revisit it to connect the timeless teachings with my most recent thoughts. Bear with me as I recount some of the history from that previous article. 

Dr. F. Harold Wirth had a very successful restorative practice in downtown New Orleans but he always felt that something was missing until he met Dr. L.D. Pankey and was influenced by his teachings. Dr. Wirth became a missionary for Dr. Pankey’s philosophy of dentistry and life, and he gave Dr. Pankey most of the credit for developing a deeper understanding of people, both physically and emotionally.  

One of Dr. Wirth’s key messages from the podium was that dentists are always presenting the case, even from the beginning of their first encounter with the patient. Another key message was that the patient’s feelings matter in accepting care and the patient interview should be forever ongoing. 

He said, “Every time the patient comes in, you’re doing a presentation. As a matter of fact, I think the interview is forever ongoing. It might only be one word, but every time the patient comes into your office, you should be interviewing them.” 

He said, “Ask questions that have to do with how the person feels. A case history is exploring what happened. An interview is about how they feel! You need to understand the difference!” 

We might ask, “Since I last saw you, have you noticed any changes in your oral health? How do you feel about these changes?” We might ask, “How do you feel about the appearance of your teeth?” or “How do you feel about the restorations we did?” We might ask, “At your last visit, you talked about the possibility of doing ortho; how do you feel about that now?” We might ask, “You mentioned last visit that you weren’t looking forward to Thanksgiving because it was difficult to eat all your favorite foods. Would you feel good about revisiting the possibility of replacing your denture with something more stable?”  

Do you feel better after a long conversation with someone who knows you well on the emotional level? I know I do. Over time, those kinds of conversations cause us to feel more positive and hopeful. They occur when a person gifts us their full attention while making no attempt to judge. And because we experience no judgment, we share more feelings, which leads us into an even deeper level of self-understanding. 

Doctor-patient conversations that tap into how a patient is feeling on an emotional level enable patients to grow in trust and to become more open to the possibilities we offer.  

In her recent blog series, Mary Osborne has encouraged us to journey toward health with our patients as fellow travelers because we all have health issues we hope to resolve. We can make connections over shared feelings and hopes. These connections bond us so we can pursue a mutual, positive goal with our patient.  

What I love and sticks with me from Mary’s blog is that the medical health review during each preclinical interview is an ideal time to check-in about feelings regarding health in general. So, if you and your team are not doing that now, you might want to add a question about the patient’s feelings about their current health. It’s ideal if the doctor or hygienist  asks the question. It may be as simple as “How do you feel about your overall health?” Wait for the patient to think and speak.  

One of my favorite quotes is this: 

Any kind of gesture that pulls another living soul out of despair is indistinguishable from magic. – Michael Xavier, Author 

The medical history review is a prime opportunity to demonstrate we care. Expanding our preclinical interview to routinely ask one or more questions that surface feelings related to health will give us opportunities to touch hearts on a deeper level. This will engender greater trust so patients more readily accept us as partners in their health.  

By Mary Osborne, RDH  

The late Dr. Bob Barkley said your dental degree gives you the right to practice dentistry, but you have to earn the right to influence your patients. How do we earn the right to influence? How do we get that invitation we need to be invited into influence? 

There is a powerful tool you already have in your practice that can enhance your relationships from the initial visit through continuing care: a Health History. The Medical History forms most offices use are designed to efficiently gather information from patients about existing and previous conditions and diseases. Patients quickly check boxes. But it can do so much more. If you use health histories as opportunities to begin a dialogue with your patients you can also connect with them in the context of a mutually interesting topic — their health! 

I might begin a conversation with a new patient by saying “In this practice we believe that the health of your teeth is related to your overall health. I know you filled out this health history form and we can talk about the specifics of that, but I wonder if we could begin by taking a few minutes for you to tell me a little bit about your health in general.” Beginning with a conversation in that way it takes us out of focus on disease and opens the door to talking about health; what they know about their health, how they feel about it, and what they do to maintain health. Similarly, when a patient comes in for a hygiene visit instead of asking if there are any changes in their medical history, I might ask, “How has your health been since I saw you last?”  If we listen carefully to their stories about health, we will gather important clinical data, and we will also begin to understand their values. We will begin to co-discover what is important to them. 

The concept of co-discovery is frequently seen as having to do with helping the patient see current clinical conditions that we see. In that way, it’s a very useful tool. But I’d like you to begin to also think about co-discovery as a way of being in relationship with your patients. When you take a few minutes to have a dialogue about health you learn about your patients, as they learn about themselves. It is an opportunity for you to learn about their experiences, concerns, and perceived barriers to health—and it’s also an opportunity for patients to learn about themselves. 

In her book, “Kitchen Table Wisdom,” Dr. Rachel Naomi Remen says, “When you listen generously to people they can hear truth in themselves, often for the first time.” If you’ve had a conversation like this you know the magic that occurs as a patient realizes things about themselves they’ve never thought of before. As they speak out loud they hear themselves for the first time. I have found that if I show up as an understanding fellow traveler with a desire to learn, it opens the door for them to begin to see me as a trusted advisor. 

By Mary Osborne, RDH 

There was a time when I thought “partnering in health” was just about getting people to take better care of their teeth. 

Many years ago, I had a patient who was excellent with her home care, but she showed up periodically with an acute periodontal infection. We asked about stress and her overall health, but she was not aware of any issues. We would treat the infection and she would be fine for a sometime. We knew she worked for National Public Radio, and one day we made the connection that her infections showed up concurrent with NPR’s fund-raising drives. That shared realization allowed us to help her see that her stress was affecting her dental health and her overall health. She was open to conversations about lifestyle changes that would help her be healthier. My relationship with her influenced my thinking and my ability to connect with my patients from a perspective of Whole-health Dentistry. I came to understand that I had been missing opportunities to influence the way people think and feel about health. I knew that I wanted my patients to see me as “a partner in health.” 

Unfortunately, most of our patients come to us with the perspective that we are fixers of teeth, not partners in health. 

In the culture today people are bombarded with information about what is healthy. From friends and families, social and news media, and a wide variety of health care practitioners, everybody expresses opinions on how they are supposed to take care of themselves. Why, then, are we surprised when our patients don’t know whom to trust? Why are we surprised when they shrug their shoulders or appear confused? It’s not always a case of conflicting facts but a case of various perspectives that people don’t know how to navigate. 

Think about where you place your trust. How do you decide whom to trust about decisions—whether it’s about your health, or about your finances, or about how you raise your children? When I ask myself that question, two criteria surface. They need to know their subject and to know me. I want that person to know what it is they’re talking about. I want them to be well informed. I also want someone who knows me, who understands my values. I want that person to have a sense of who I am and what is important to me. 

As we get to know our patients over the years, most of them come to see us as trusted advisors when it comes to their dental health—but fewer see us as trusted advisors when it comes to their general health. If we jump too quickly to making recommendations about their overall health, we are more likely to meet resistance. If we want to cross the bridge into influencing our patients’ overall health and wellbeing, I believe we need an invitation to cross that bridge.   

The Missing Piece in our quest to influence the overall health of our patients is the failure to invite patients to share their perspectives on health. Beginning a conversation with a new patient with the question, “What can you tell me about your health in general?” is an invitation for them to talk about their experience of their health, not just details. Instead of “reviewing” health histories, what if we “explore” health histories? As we connect and get to know each other we can learn to listen beyond information to hear attitudes, beliefs, fears, biases, concerns, barriers, etc. As you understand their perspectives on health issues that come up in conversation, it’s easy to ask if they would like your perspective on that issue. These conversations often lead to more questions and answers that invite more and more invitations from our patients to be their partner in health.