As I get more and more involved in helping doctors to improve their consultation skills, I continue to see things that have the potential to derail the start of an otherwise good patient start. An example of this occurred this past week, when reviewing a videotaped exam from one of my doctor clients.
During the consultation, the doctor informed the visitor, a young adult patient, that to get the optimal result, extractions were warranted. It was obvious to me from the reaction of the visitor that this was unwelcome and surprising news, which is understandable – but the doctor never asked for feedback, and this resulted in the worst possible outcome – the visitor left the practice with the unvoiced concerns being unaddressed.
It is important to remember that you are in a business in which, to achieve the desired result, some unwelcomed steps are sometimes necessary, be they extractions, special appliances, or some other unexpected step. The important thing to remember here is that nobody likes unpleasant surprises, and if you don’t take a moment to get those concerns out on the table where they can be addressed, you are very likely to lose the case.
The most common example of this outcome that I see is having the doctor tell the patient that they recommend extractions, and then leaving the consultation without identifying and addressing the person’s concerns. The patient then goes looking for an orthodontist who will do the work without the extractions, quickly finds one, and the case is lost. That happens often, and it is an avoidable outcome in most cases.
What can you, the doctor, do to address this issue?
- Always defend your recommendations as if they were going to be challenged by a competitor. “Mrs. Jones, let me explain to you why I recommend extractions as opposed to leaving these teeth as part of treatment.” The WHY is always the key. Explain in detail the logic you are using to support your recommendation.
- Invite feedback. “How do you feel about having the extractions?” “What is your reaction to having to wear braces for a few months before switching to trays?”
- Assume that there is a problem. Don’t say “Do you have any concerns?” The easy answer is “no”. Instead, say “what concerns do you have regarding my recommendations?
- Finally, remember that, particularly with adults, an optimal result may not be the desired one, and the patient may be willing to trade a perfect outcome for a treatment plan that better satisfies their lifestyle and concerns. In another example that I reviewed this past week, the doctor learned, after presenting a treatment plan that would produce the best possible result, that the adult patient didn’t want it to begin with; they wanted a good improvement in their appearance with, first and foremost, an appliance that would be minimally noticeable. Don’t assume that you know what your patient wants; ask good questions first and then adapt your treatment plan to the needs of your patient.