Dental analogies đối thoại nha khoa

Giao tiếp nha khoa Các trường hợp giao tiếp thông dụng trong nha khoa bằng bằng tiếng anh giữa bác sĩ điều trị và bệnh nhân. Tiếp anh giao tiếp trong nha khoa giữa bác sĩ điều trị và bệnh nhân trong nhiều trường hợp khác nhau, thích hợp cho sinh viên răng hàm mặt muốn học thêm tiếng anh và học cách tư vấn điều trị cho từng bệnh nhân.

Copyright © 2013 Dr Rick Waters

This material is protected under thecopyright laws of the United States ofAmerica All rights are reserved Nopart of this book may be reproduced,stored in mechanical or electronicretrieval systems, or transcribed inany way by any means without theprior, written consent of the authors,except where allowed by law or forthe creation of any recordings or

other material intended for use by theblind

International Standard Book Number

Clinical mastery comes as the result of

an adequate professional education,both through dental schooling and

post-graduate continuing education.Business and organizational skills,following a rather shallow

introduction in dental school, aredeveloped experientially and throughcontinuing education The

communication skills, cited as amongthe most important, have traditionallybeen slighted As such, the palette ofresources from which to choose tobetter one's communication abilities

is small This book was written toaffect, profoundly and favorably, thecommunication skills of the dentistand dental team members

Few would argue the premise thatdental treatment should never be

delivered to a patient without thatpatient's willful consent In properlegal, ethical, and moral

considerations, that patient's

informed consent must be based on athorough knowledge of the facts — ofthe pluses and minuses of both

treatment and non-treatment

Autonomy in dental care helps thepatient realize dental self-

actualization according to particularneeds and desires Unfortunately,some presenters are unable to

adequately introduce the necessarytreatment plan in a way that createstrue desire by the patient With oftenonly a single chance to make this

presentation to a patient, this

miscommunication may cause thedentist to miss out completely on theopportunity to provide the

appropriate care for that particularpatient Thus, the importance of thetreatment plan presentation cannot

be overemphasized

The treatment plan presentation issimply an organized presentation ofdental needs and a plan or plans forsolutions to answer those needs It isakin to a sales presentation which, onits highest level, concentrates in

finding a particular need and fillingthat need Sales presentations can beabout intangibles, like insurance, or

something more substantive, like thedelivery of dentistry The selling of theitem is simply the formal process bywhich needs are determined,

communicated to the client or

patient, and filled

Unfortunately, many dentists find theidea of selling "raw," to a degree.Nonetheless, the fact remains:

practically every successful person inhis or her chosen profession proposes

a service, idea, or product believing itwill make the client’s life better Forexample, the primary goals in

healthcare are to properly provide forpatient needs and to promote healthand well-being

To meet those ends, adequate patienteducation is mandatory Deviationfrom properly presenting alternatives

is especially disserving in healthcaresituations Certainly, failure in theultimate goal of helping the patientachieve dental self-actualization

through autonomy is a worse ill thanany act of selling

Dentistry well-deserves the accoladesbestowed upon it for its successes inpreventive care and attending to

patient needs in a timely,

cost-effective, and honorable manner.Now, more is being demanded of thedentist, both from within the medico-legal arena and from patients

themselves Most patients want to beinvolved in treatment planning and it

is the dentist's responsibility to becertain that each patient understandsthe thinking behind the doctor's

proposed treatments

In order for informed consent to work,the patient must have a crystallizedmental image about his or her

problem(s) and the proposed

solution(s) To do this, dentists

traditionally use brochures, diagrams,and models to educate patients

Unless these teaching tools can besent home with the patient, residualeffects are short-lived Even whenthey ARE provided to the patient,

they can get lost and even destroyed.

More modern educational means,including multimedia and the use ofthe intraoral camera, can bring thepatient to an even higher level ofunderstanding However, it still maynot be any longer lasting than thatachieved by using the aforementionedtangible means In addition, calling toattention one's own periodontal

disease or broken tooth via an

intraoral camera and 42-inch LCDmonitor does not automatically create

a want for treatment within that

patient; rather, if not properly

managed it may embarrass or, evenworse, sell the patient on the service

without emphasizing its implicit value.Such a "sale" does little to serve thepatient properly and may even

condemn the "service" to imminentfailure

What is a better way?

Every day, throughout the world,there are many sales presentationsthat result in the acceptance of thingsvalued at hundreds of thousands ofdollars and more Of course, thesepresentations occur outside dentistry.Still, they do happen and the

purchase of the service or productbeing presented is often predicated

on the acceptance of an idea alone In

the business world, it is called "sellingthe sizzle, not the steak." It is whatmany dentists hope to do at everytreatment plan presentation Sadly, itoften meets with failure The moreclearly the patient understands theneed and the prescribed solution(s),the better the chance of case

acceptance and post-treatment

satisfaction for both the patient andthe dentist

The direct, one-to-one informationtransfer between the minds of thedentist and the patient is the

preferred communication method indentistry, operating on an almostethereal plane "Modern" time

constraints, attributed to increasedpaperwork and the like, make everypatient’s visit and what is said at thatvisit even more valuable.

In order to "sell the sizzle, not thesteak," exact information must beshared When done properly, thepatient leaves with an indelible, yetsatisfying, mental image that may beall it takes, either now or later, toresell the patient on the need for theprescribed care

A strong means of information

transfer involves the use of

metaphors or analogies to help thepatient arrange his or her own

thoughts for maximum result Notethis example about the power of thehuman mind:

A wanderer in the old days of Egyptcame upon a young man who wasforever looking for a fast and easy way

to make more money This young manhad done well for himself and wasnow looking with even more fervorand greed The wanderer made anoffer to the lad "I can sell this magiclamp and secret formula, only once,for 1000 gold coins and I guaranteethat, together, they can turn sand intogold." Naturally, the young man wasinterested "You guarantee the

formula?" "Or your money is

returned." the wanderer countered.The lad succumbed to the offer andthe deal was struck "The only

condition that will make the formulanot work." added the wanderer as hehanded over the lamp and

incantation, "is if, while rubbing thelamp, you happen to think of a

monkey with a red tail Then, theformula will not work."

Woe is this young man who will nowfind it nearly impossible to not think

of a red-tailed monkey

So strong is the human

communicative experience

Most people cannot create and

deliver such clever narratives as thatscripted above For them, a source ofdescriptive stories to help makepoints is needed “Dental Analogies”

is the first book of that kind It is acollection of ingenious analogiescreated from hundreds of ideas frompracticing dentists from across

America and presented in a veryuseable format – including an

expansive index These dentists areusing these analogies every day andreport that they do, indeed, work –and work well

As a reference, this book's analogiesprovide the dentist and team

members many stories to share withpatients that successfully comparevarious dental modalities to morefamiliar laymen's situations.

Afterwards, the patient has a greaterunderstanding of the dental

condition

Consider this example: A long-lostdental patient may question the needfor comprehensive periodontal

therapies like root planing and

curettage, subgingival irrigation, andeven surgery, citing the absence ofsignificant symptoms An analogy such

as that found on pages 80-81 can beused It compares the problem and itssolutions to a failure to provide

regular oil and filter changes for anautomobile (with the concomitantexpense and inconvenience of a majorengine overhaul, et cetera.) Thus, thepatient better understands why onebrief dental "cleaning" cannot undowhat years of neglect have caused.Additionally, it does not point a fingernor does it belittle the patient It

simply redirects the patient's mind to

a more familiar problem that is betterunderstood and accepted

Julian Jaynes, in The Origin of

Consciousness in the Breakdown ofthe Bicameral Mind (Houghton Mifflin,Co., Boston, 1976) wrote:

"Understanding a thing is to arrive at

a metaphor for that thing by

substituting something more familiar

to us And the feeling of familiarity isthe feeling of understanding (authors'emphasis)." A metaphor is a figure ofspeech in which a word or phraseliterally denoting one kind of object oridea is used in place of another,

suggesting a likeness or analogy

between them

This book of analogies is helpful notjust for answering questions and

objections, but for anticipating them

as well For example, before

presenting a case to a patient thatinvolves implants or several units ofcrown and bridge, pages 92 through

114 could be referenced From thesethe financial coordinator or the

doctor could select analogies suited to the particulars of that

best-patient's hobbies, occupation, andother interests Maximum

effectiveness is realized if the financialcoordinator or doctor has really

gotten to know the patient

personally

One of dentistry's most respectedfigures, Dr Lindsey Pankey, once said,

"Never treat a stranger." He proposed

up to 22 separate questions that can

be used to get to know a patient

before initiating treatment (A

Philosophy of the Practice of

Dentistry, by Lindsey D Pankey andWilliam J Davis, Medical College

Press, Toledo, OH, 1987) Informationlike this can be used to help select themost appropriate analogies for a

treatment plan presentation

Some dentists have integrated a study

of these analogies in their team

meetings and "huddles" – like an

Analogy of the Day One doctor

reports excellent results educating hisstaff this way

Readers may find it helpful to firstreview all of the analogies, noting thetopics, keywords, and the layout Theextensive index in the back makes

retrieval of an appropriate analogyquick and easy The analogies should

be modified and adapted to particularstyles of practice and speech

As new analogies are created, bornfrom the many ideas that these will

no doubt trigger, they can be writtenout on the available blank areas

found throughout on the book’s

pages In addition, we appreciatethem being shared with us for futureeditions of Dental Analogies

Please list The Topic, The Situation,The Patient's Question, The ResponseUsing an Analogy, and Some

Keywords Email it all to

drh20s@gmail.com or mail it to Dr.Rick Waters, 385 Pinewood Circle,Athens, GA 30606

We especially appreciate analogiesthat address the use of the LASER,implants, 3D x-ray, and other

emerging dental technologies Sharingyour ideas with us eventually helpsthe entire dental profession, which is

an implicit part of being in any

profession Most Dental Codes ofEthics state something to the effectthat, "The dentist has the obligation

of making the fruits of his discoveriesavailable to all when they are useful

in safeguarding or promoting thehealth of the public." Such is how it

should be Thankfully, we have foundthat this is how it is.

We want to thank everyone who

contributed ideas toward this book,especially Doctors: W Adams, G Alex,

D Alleman, W Allen, A Allgood, T.Aspes, M Babcock, R Berlin, M Binns,

P Bracken, S Brewer, L Broadrick, D.Brockington, B Brooks, T Brooks, C.Burch, W Callahan, D Cassidy, S.Cohen, A Collins T Conner, C

Creager, L Darby III, E Douglas, R.Dyer, J Elliott, S Erwin, D Felker, M.Gobbel, G Goldstein, J Harden, P.Hauser, M Healey, K Henry, K

Houston, R Johnson K Kay V

Koehler, L Landers, H Lanier Jr., J

Linatoc, J Linuter, C Little, G Madray,

R Manus, C Martin, F Matthews, K.Mattison, T McDougal, H McLaughlinJr., D Mentz, B Patrick, R Piede, T.Pierce, B Powell, S Powell, S Prince,

N Pylant, H Rackley, J Ralston, V.Riccardi, E Salley, P Salter, A

Sanchez, P Shaw, S Smith, S Stein, S.Taylor R Wand, R Waters R WaughJr., M Webster, R Weinman K

White, E Willis Jr., and M Winter. 

THE ANALOGIES

“COMPREHENSIVE EXAMINATION"

Situation: This young patient wants tohave her teeth cosmetically lightened,but is not now interested in her

overall dental health and needs,

otherwise

Patient: "I just want my teeth to bewhiter Let's do that first and, if itturns out well, I'll go ahead and havethe rest of my needs seen about."

Response: "Kelly, we need to look atyour restorative needs before thecosmetic care is delivered to preventfuture problems It is like making acake All of the ingredients are

necessary in the proper sequence andamounts for it to cook properly Andthen, we have to wait to place theicing after the cake has baked andcooled Dentistry is like that Propersequences make for proper dentistry."

Keywords: cosmetic dentistry, cake,ingredients, icing, sequence

"COMPREHENSIVE EXAMINATION"

Situation: This patient wants his workphased or staggered, and doesn'twant a complete examination, with x-rays, models, etc He prefers his

money be spent actually repairing histeeth, rather than for "extravagantitems," as he views them.

Patient: "Doctor, I want to spend mymoney fixing my teeth, not for modelsand such Just start fixing what needsfixing and after a while we'll havethem all caught up, won't we?"

Response: "Well, Tony, we could dothat But I would like for us to still befriends outside the office! Let mecompare it to automobile repairs If abody shop repaired the outside of anaccident-damaged car, neglecting tocheck internal parts like the radiator,there's a chance of later failure,

causing the driver to maybe becomestranded The x-rays and models give

us everything we need to make sureyou are attended to properly Thelittle extra expense up front can

actually save you a lot of money later

in unplanned extra dental needs.With your permission, I’d like to beginthe comprehensive exam today."

Situation: This patient is in a hurryand wants only the problematic toothrestored She has no interest in

comprehensive dental diagnosis andcare at this time

Patient: "Doctor, I really don't want

to spend time and money on all ofthose x- rays now I just want thisbroken tooth fixed."

Response: "I understand your

concerns, Sallie, and I assure you wewill take care of you But, we need acomplete exam and x-rays to makeabsolutely certain that it is, indeed,the broken tooth causing your pain.The examination process helps me

treat you properly It's like sewing.When you make a dress, you cut andfit the pattern before committingyourself to the stitching Since wehave time and you are here, whydon't we go ahead and determine allyour needs?"

Keywords: sewing, time, expense

"COMPREHENSIVE EXAMINATION”

Situation: This patient questions theneed for a comprehensive

examination

Patient: "Doctor, I really don’t care tohave all that examining done Just fixthis tooth that is bothering me."

Response: "Mr Rogers, I understandyour concern for that tooth and I canassure you we will take care of it But,

in order for me to restore it properly, Ineed to detect exactly what needs to

be done It is like a carpenter told meonce: you should measure twice andcut once An examination is the

'measure' that I need to do beforetreating you."

Keywords: examination, carpenter,measure, comprehensive examination

"COMPREHENSIVE EXAMINATION"

Situation: This patient wants his

treatment to be phased or staggered,and is not, at this point, interested in

a comprehensive examination with rays, study models, etc He prefersthat his money be spent "fixing them,not for just looking at them," as heputs it

x-Patient: "Doctor, I'd rather spend mymoney fixing these teeth than makingmolds and x-rays and such Just startfixing them and after a few visits,they'll be caught up, won't they?"

Response: "Mr Kennedy, we could dothat But then, I want you to still like

me when we meet outside the office

If I were a contractor, building you ahouse, you and I would both insist onplans for the floor layout, the siteelevations, the wiring plan, the

heating and air plans, the cabinetryplans, etc Can you imagine the

differences in the house you wouldimagine and mentally plan and theone I would build without any plans?

We would be redoing a lot of work.The only way I can properly begin totreat your dental condition is withplans, so we both know where we areheading That actually saves you

money, since it eliminates redoingthings at your expense Plus, it

minimizes surprises and the potentialfor extra expenses that we didn'tcount on."

Keywords: contractor, plans,

comprehensive care, work-up, savesmoney, re-treating, treatment plans

"COMPREHENSIVE EXAMINATION"

Situation: This patient has come tothe office needing teeth restored andfigures to make the most of this visit.Gross calculus is evident and he is

resistant to its removal,

pre-restorative

Patient: "Doctor, I don’t want my

teeth cleaned right now Just fix theone that's broken And, while you’re

in there, if you see any others thatneed fillings, go ahead and take care

of them too."

Response: "Mr Davison, you havecalculus all over your teeth And,

there are others that need repair But,

it will take more time than this onevisit allows If I were an auto mechanicwho allocated only enough time torebuild a four-cylinder motor and inrolled a V-8, you know I’d be thrown

off The lack of parts and adequatetime would pose serious problems I

am prepared to take care of yourimmediate problem today — the

broken tooth that is sensitive Before

we do any more treatments, however,

we must get your teeth and gumscaught back up to health As an

example, if you wanted me to paintyour rusty car, you'd want the ruststopped first, wouldn't you?"

Keywords: restorative, cleaning,

painting, rust, limited treatment,engine overhaul, mechanic

"COMPREHENSIVE CARE'

Situation: This lady only wants herteeth "cleaned" and is not currentlyinterested in comprehensive dentalcare

Patient: "I don't want a completeexamination I just want my teethcleaned, that's all I don't think

anything's wrong since they don'thurt."

Response: "Ellen, if you became

pregnant, you wouldn't just wait untildelivery day to see the doctor, wouldyou? You would become involved inproper prenatal care and then in

follow-up care for the baby That'sknown as comprehensive care Indentistry, proper treatment involvesthe same thing, comprehensive care.Without that, your visit with thedental hygienist for a cleaning ispartially wasted."

Keywords: pregnancy, comprehensivecare

"COMPREHENSIVE CARE"

Situation: This gentleman acts

disinterested in oral rehabilitation

Patient: "I'd just as soon have youtake the ones out that will cost a lot

to fix and fill the ones that can besaved."

Response: "Mr Williams, if I sent you

on a late-in-the-day errand into a badarea of the city in a car with majorengine trouble, you would be hesitant

at best; and, when beginning a

vacation, if your airline pilot told youthat only two of the four engineswork, but it will just make the triptake longer, you probably would

worry a little Trying to function withtoo-few teeth is just as risky The jawjoints, muscles, and teeth's roots, areall susceptible to major trauma by

carrying too heavy of a load Then,when they fail, it is usually

irreparable."

Keywords: fees, comprehensive care,airliner, engine failure, inner-city 

"COMPREHENSIVE CARE”

Situation: The patient is receptive tomajor rehabilitative care, but wouldlike to stagger the treatment over alonger time frame and wants tomanipulate insurance benefits tomaximize usage