Trust

Years ago a friend of mine, who is not a dentist, was visiting his brother in another city over a weekend, so they had some free time to kill. His brother, also is not a dentist, is sort of nerdy and loves gadgets. His idea of a fun outing for the two of them was to go down to the nearby convention center and try and crash a large dental meeting. Specifically he wanted to get onto the trade floor because, as his brother explained it to me, “That’s where all the cool stuff is.” They would go and ride in the dental chairs and look at the latest tooth extraction devices. How fun!

Well they ended up getting into a practice management lecture by someone obviously very popular with dentists because the two of them ended up standing in the back of a very large and completely filled room.

The speaker was explaining current trends in dentistry. The take away message, as he told me was that the average dental patient moves to a new dentist every few years. No longer are there that many long-term relationships between patients and their dentists. The reason given was due to a combination of factors, of which I can only recall a couple this many years later.  First, society is more mobile and people are moving in and out of cities and states more often than in the past. Second, dental insurance is constantly changing as employers shop for the best deals. All of a sudden, the family dentist is no longer on the patient’s plan, so they decide to go elsewhere to save money.

For these and other reasons, the speaker told this audience the office strategy must change and dentists have to essentially strike while the iron is hot. Dentists should look to treat with more crowns than conservative fillings. “You should understand,” I am told the expert said, “that the window of opportunity is shorter than ever before to sell the crown.”

Then my friend said, “That’s when I lost respect for the dental profession.” He decided he would never go to the same dentist twice. He figured he could get his teeth professionally cleaned this way using discount coupons offering free or discounted cleanings to new patients. If the dentist recommended a crown on this first visit, my friend was convinced it meant he attended that very same lecture or one just like it. His conclusion was that dentists care most about business, not people.

Now we can debate whether or not my friend’s account is accurate to the actual event and remarks of this unknown famous dentist, but it doesn’t really matter anymore. Trust was damaged, and not just between two people but between two groups of people. Stories get repeated, don’t you know.

The stories we hear and the interactions we experience personally, both good and bad, color our moods. They are like an annoying background noise playing all the time, especially while we are trying to make decisions about what we ought to do. When we feel fear and can’t put our finger exactly on its source, or we like or don’t like something or someone we may only have just met, often the source for this inexplicable mood is coming from somewhere in our past. This thing I am experiencing right now is reminding me of something that happened sometime before. It’s sort of like memory cells in the immune system that react when they encounter an antigen the body was exposed to at an earlier time. Suddenly after eating a peanut or being touched by latex the body develops an itch or goes into full blown anaphylactic shock. You and I have no control on what feelings come up in us. We do have control on how we choose to behave, however. In some instances when our lives are being disrupted by inexplicable emotions it is important to get help to sort through and identify what’s going on.

But now let’s think about when we are working with patients. If we are not in tune that this emotional tinnitus is ringing in both our and everyone else’s heads as we are trying to carry on conversations with each other, we will miss a lot of important, sometimes even critical, clues.

Now I will be the first to admit I have no special empathetic gene in me. I am for the most part just trying to stay on schedule, do my job and go home at a reasonable hour. But experience has taught me that patients will trust me more, in spite of the noise in their heads when they feel I have heard them and I have told them the truth. Glibness reinforces stereotypes in people’s minds. “Oh he is a dentist and all dentists are…” (fill in the blank).

Trust is slowly established when we learn to listen. This goes counter to the pace of most doctor schedules. Good listening – that form of listening that communicates that we value the other person and are willing to stop everything else to pay attention – has to be purposeful or intentional. It is best accomplished by looking eyeball to eyeball while sitting up and facing each other, not while the patient is reclined and the dentist, in mask and funny glasses is hovering behind the high beam of an inquisitor’s light. And trust also grows when words have no agenda than to be kind and truthful. Now the fact of the matter is, most patients need our services. Telling the truth is not necessarily a vow of poverty. But it does mean that the dentist’s priority is to always do what is best for the patient, even if it is not the most expensive option. Not every tooth needs a crown, or every mouth, periodontal surgery (that last one is for me).

Finally, let me take all of this one step further. Many who read my words here will think that it sounds nice but that the real world is a much more complicated place. Most dentists graduate with enormous debts; patients are more insurance driven than ever before; Corporate America has discovered that dentistry is a cash-cow ready to be devoured; and solo practicing dentists are finding that new patient examinations are dwindling and treatment plan acceptance is settling too often for the bare minimums. In other words, it’s a tough world out there. Times are hard.

First, understand that slick sales techniques do work. Everything consultants recommend will have a result, often one that actually improves the financial bottom line. But what you decide to do has more riding on it than simply increasing production in the short term. First, consider what it does to you when you sell people things they don’t really need. How does this affect your relationships in the office and away from the office? What happens to your basic opinion of people? For the most part, we think others are like us and we are like everyone else. Dentists who cut corners begin to believe, as my friend at the dental convention did, that everyone is out for whatever they can get. On the other hand, begin to treat people as you would want to be treated and your heart grows. You become happier – not that life is easy and all your financial pain goes instantly away, but your relationships deepen. You can trust those closest to you and they can trust you. What is this worth? As the MasterCard ad says, “Priceless.”

But there is a second very strong business rationale for honest dealings and taking the long view of patient care while everyone is telling you to strike while the iron is hot. People will slowly find you, or return to you. Your star can slowly rise, because people of integrity are more valuable in the world of business than anything or anyone else. This is not overnight slick marketing. It is living with your principles long enough for them to be seen.

There is a word-picture I got out of the book, The Fifth Discipline, by Peter Senge that I have used many times in presentations. Imagine your two hands are in front of you. You are pointing with your first fingers with your left finger pointing right and your right finger pointing left. Your left finger is directly above your right finger and looped between them is a rubber band. As you lift your left finger and hold your right finger in place, the rubber band stretches.  Your left finger represents your ambitions, dreams, plans and desires in life. Your right finger represents where you are right now. The rubber band represents the tension of living between reality and desire. The higher your dreams, the greater your tension, the more you see the difference between where you are and what you want.

To many, the tension is so uncomfortable, to get immediate relief, they lower their dreams, bringing them more in line with where they are right now. Instead of dreaming, they adapt and justify. They try to convince themselves that where they are isn’t so bad and that they just have to be realistic and accept life as it is. And sure enough, the tension goes out of the rubber band.

On the other hand (no pun intended) those who fix their dreams and manage the tension will see that their reality begins to lift. They are being pulled upward, and again the tension lifts, but this time due to the fact that reality improves. They begin to live the life they were meant to live all along. It isn’t quick or easy. Also another interesting thing happens as they are lifted from present reality. Their perspective changes and they begin to have new dreams. They also begin to learn to live in tension and the tension becomes more a way of life. Life for this group is no longer about lowering stress, it is about fulfilling dreams. So if you are living under enormous tension because you are idealistic, welcome to the club. You’re not alone. Hang in there. Dentistry is a learned procedure.

2 Comments

  1. I agrree with you 200 quadrillion percent!!!!!!! Can I quote you????? I wish I could take this letter and use it as my own (with just a few tweaks—-don’t worry —–I would not—that would not inspire trust) But you put into words what I have been feeling passionately about dentistry for so long and how I practice. This is not a market like we are selling cars!!!! Build trust and the trust and love will be returned by grateful patients. No one wants to be treated like they are a fresh piece of meat that is there to be slaughtered to pay for someone’s agenda when you go into a dental office. And yet that is what corporate dentistry is doing to dentists and dentistry—-making our profession more of a business with a bottom line than a health and healing profession. I believe we have lost trust and it is a shame. You said it much better Dr. Young.

    Reply
    • Dr. Benjamin Young

      Thanks Judy, for your kind words. It sounds like your are living your dream.

      Reply

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