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How to Deliver Bad News

October 19, 2015

Filed under: Case Presentation,Communication — Tags: , , — Barry @ 2:34 PM

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As a practicing dentist for over forty years, if there is something I do regularly it’s deliver bad news.  As the GEICO ad tells us…“if you’re a doctor you deliver bad news…it’s what you do.”

Not a day goes by when I don’t have to tell someone that they have a cavity, periodontal disease or worse yet, how much it will cost them.  And it’s not just the dentistry: how about when a case comes back from the lab and the shade is off or worse, we need to take another impression.  In a dental practice the situations are endless.

It’s a rare moment when we get to say “Mrs. Jones…it’s a boy.”

This is not the fun part of a dentist’s job…and many dentists paradoxically try to avoid it.

Think about that for a second.

A longtime patient comes in for a routine cleaning and you discover early decay under a old long-span bridge.  It’s a bridge you made for her fifteen years ago.  She comes in regularly and she has not needed work in years.  You know she’s under the impression that as long as she flosses daily and comes in on a regular basis that she is immune to major problems.  Worse yet, she is recently divorced and approaching retirement.

Tense times…for everyone, unless of course you lack empathy.  That’s another problem, but if you truly want to master the art of delivering bad news better – then this may interest you.

Leadership and communication lie at the center of your success in dentistry.  Present your case in a positive manner and you will get more acceptance, less complaints and most importantly better health for everyone.  In the past I have written blog posts about the charismatic dentist and empathy…delivering bad news better can go a long way to improving your charisma scores.

In a new book, Broadcasting Happiness, The Science of Igniting and Sustaining Positive Change, author Michelle Gielan offers her Four Cs on how to deliver bad news.

If you practice the Four Cs I am sure your dental practice will become more positive in every way and you will never complain about “people” again.

Let’s take a look at the Four Cs in dental practice:

  1. Create Social Capital.  A buzzword being used these days in business and sports, is culture.  But what exactly does that mean?  Dental practices need to build cultures of trust.  Covey, years ago referred to an emotional bank account.  Social capital refers to the resources that we have available to us based on trust and the willingness of practice to support our actions.  For patients of record this trust is built up over the years.  For new patients it is built through the examination process, and how the practice welcomes patients in.  Other resources include our ability to communicate, educate and motivate through listening and clear expression of thoughts and ideas.
  2. Give Context.  How you frame your conversation means everything.  If we frame our treatment in negativity…pain, cost and inconvenience, our acceptance will go down.  Just this morning I entered my hygiene room and my patient sensed my presence and said, “Uh Oh!”  She was joking, but let’s be honest most patients frame their dental visits negatively.  One way to provide context is to use what I call a “reason why philosophy.”  It takes a bit longer but I usually give a thorough explanation about why I need to do dentistry.  Not only what needs to be done but why it needs to be done.  This takes a bit of skill. but it can be learned.  Many dental practices use what author Gielan calls a Band-Aid mentality in delivering bad news- they just rip it off fast so it won’t hurt as much.  I hate when that happens to me…the reason why philosophy builds trust.  This comes up more often than we might think.  Even in the case of a patient who repeatedly refuses x-rays…just saying “because I said so,”  doesn’t inspire trust.  Taking the time to give a well thought explanation goes a long way.
  3. Express Compassion.  One of the strangest things for me to understand is noticing how so many of my dentist friends feel when they are on the receiving side of bad news.  And I mean any bad news.  They especially love to complain about the cost of things these days, yet they have no problem dispensing the bad news.  It’s human nature to not take bad news well.  Just knowing that means we have to step back and show empathy…it’s appreciated.  Dentistry is expensive these days.  If you’re reading this and getting angry because your fees are justified, I get it.  You know who doesn’t get it?  Most patients, so show compassion.  Talk about it.  And it gets worse when it’s your work that fails.  According to Michelle Gielan, compassion not only makes moral sense, it makes business sense. 
  4. Stay Committed.  Earlier I said that delivering bad news was an aspect of leadership and communication.  The leader’s commitment is to the patient and their well being.  Leaders deliver long term value and in order to do that we must remain committed.  In the end delivering bad news starts with being human.  If we remind our patients of what John Lennon once said, “Everything will be okay in the end.  If it’s not okay, it’s not the end.”

So take heart, if delivering bad news gets you down, use these 4 Cs to change the way you look at things—because “if you change the way you look at things the things you look at change.”

 

 

 

 

 

 

 

 

One Habit That Will Make You Unique

March 30, 2015

Filed under: Ethics,Happiness,Leadership — Tags: , , — Barry @ 11:08 AM

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And the Academy Award for Best Actor in a motion picture goes to…Eddie Redmayne…for his role of Stephen Hawking in The Theory of Everything.   What a moment.  The cameras switched over to a very disappointed Michael Keaton who was really counting on giving his acceptance speech.  That didn’t happen.  The Academy gave it to the relative novice because of the masterful job he did in portraying Stephen Hawking the Nobel Prize winning physicist and a victim of ALS.

Redmayne, in the tradition of many other great actors like Daniel Day-Lewis in My Left Foot, and Dustin Hoffman in Tootsie, won the award because of the difficulty of the role.  It required putting himself in the place of an another and actually becoming that person.  For Lewis it was the palsied Christy Brown, for Hoffman it was the role of a woman, and for Redmayne it was Hawking, who has been confined to a wheelchair and cannot speak since 1985.

Amazing performances all.  The one quality that makes those roles possible: empathy.

The dictionary defines empathy as:

The art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions.

As dentists we must master the “art” of empathy in order to be truly successful.  Empathy and the habits that are necessary to develop, will be the trait that will separate dentists in the future. 

We live in a time where there is a deficit of empathy.  Most of us are overly concerned with ourselves rather than “the other.”  It’s a paradox, but none other than the famous motivational speaker, Zig Ziglar used to say, “You will get all you want in life, if you help enough other people get what they want.”

I take nothing away from Michael Keaton and as I will explain I really liked his movie Birdman better, but as far as acting performances go Redmayne became Stephen Hawking.

You see, Birdman, Keaton’s award winning movie discussed just that sentiment.  It was subtitled, The Unexpected Virtue of Ignorance.  What does that mean?

It can be summed up in a scene where Keaton is arguing with a reviewer about how good an actor he is (in the movie…not in real life…seems to be his haunting theme).  She tells him he’s a celebrity, not an actor.

WATCH THE CLIP:<iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/4d5KovCbU8w” frameborder=”0″ allowfullscreen></iframe>

So what is the difference?  Today it’s easy to become a celebrity…yes, even in a field like dentistry.  I see so many dentists who are more interested in Facebook and Twitter (a theme also revealed in Birdman—when he walked down Broadway in his whitey tighties, I guess that was the unexpected virtue of ignorance.), than in truly treating each and every patient with empathy.  They want to become celebrities—smile artists.

Empathy is what makes us human.  It keeps everything real.  The question is, can it be developed or is it just something we have or not. 

I guess, if actors can develop it, we can create the habit of empathy.

When I studied the Pankey philosophy, I noted that L.D. Pankey used the word virtue a lot.  Aristotle used that word.  I never quite grasped what it meant to the Greeks, but the writers of Birdman also used it in their subtitle.

A virtue refers to actions taken to create a level of excellence.  It takes practice to develop excellence, and enough good habits lead to what Aristotle called the “good life.”

Dentists understand this when it comes to technical practice…but what about the habit of empathy, or as Stephen Covey said, “Seek first to understand, before trying to be understood.”

What are some things we can do to develop empathy:

  • Become Spock-like.  Get into a mind-meld mindset.  Imagine yourself knowing what the other is thinking.

  • Follow the Platinum Rule—I used to think the Golden Rule was the right thing but the Platinum Rule states that you should treat people not as you would want to be treated but as they want to be treated.  As if you were the other.

  • Use creative storytelling to imagine yourself in the life of the other.  Great empathists like Gandhi, and Nelson Mandela were masters of this.

  • Immerse yourself in the actual dental experience,  Feel that fear, feel the financial pressure.  Many dentists are masters of the “should,” without ever having experienced what it is to have extensive dentistry.

  • Practice the art of conversation.  Learn the language of empathy and take the time to understand patients.

  • Be curious about the lives of patients…as Pankey used to say, their circumstances, objectives and temperament.

  • Share your story with people…get deep.  Go further than small talk about the weather and sports.  As author Bren’e Brown advises, become vulnerable.

These are just a few of the things that we can do to practice empathy.  Readers of my book, Art of Examination, know that the dentists can build these into their daily practice…so in the end they will not only play the role of a real human dentist but they can actually become one.

 

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