There is hearing, and then there is hearing

Apr 4, 2010

Editor's note: The Coaches Corner column appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

A true story:

A few days ago I started to gingerly excavate around an old and very broken-down restoration on an upper molar. My patient, whom I'll call Pat, has been in my regular care for 26 years and had always accepted my treatment recommendations. Consequently, he was in excellent oral health and had a full complement of his natural teeth.

After carefully removing Pat's recurrent decay and ascertaining that there was no pulpal exposure, I sat him up, showed him the digital x-ray image, and explained why I was recommending a crown for the tooth.

When we were at the same eye level, I quickly reviewed his chart and noted that six months ago we had discussed the same tooth I'd just worked on. I had remarked that it, and the one next to it, would soon need extensive work, crowns at a minimum. As I reminded Pat of the conversation, he nodded. Naturally I took this to mean that he heard, understood, and agreed with my findings and recommendations.

You know what's coming next. (If I could include a sound file here, it would be the Jaws theme.) A few minutes later, at the front desk, Pat expressed dismay at the sight of the bill, even though he knew our fees beforehand. The next morning he called me and said he felt blindsided. I stayed on the phone for almost 30 minutes, just listening.

"Thank god he felt close enough to me to complain," I thought. His appointment would give me a better sense of his state of mind moving forward. I sensed that this would be but a blip in our relationship.

OK, what is the coaching lesson, the takeaway, in this story?

Never, ever assume that because you said something (and even wrote it down), that it was heard and understood. This not only pertains to your patients, business associates, and staff members, but even family members. There is hearing, and then there is hearing. One involves the auditory nerve and its ability to receive signals. The other is a far more complex and sophisticated apparatus that includes taking in and internalizing information. To truly lead -- and yes, doctor, that is what we are required to do -- we have to confirm that what we said (and what we heard) is the same thing that was received.

The takeaways:

When you are talking to your patient, especially about money, make direct eye contact. Do not be distracted.
Neither scream nor whisper. When we talk about money our voices tend to get softer, perhaps indicating our own uneasiness. Your language should be clear, direct, and audible.
Assume nothing. If you are at all in doubt that what you said was heard, ask the patient, "Was I clear?" or "Do you have any questions?"
Judge the answer. Was the patient engaged? Now you should either move on or repeat what you said in another way. Do not rush!
Understanding is not guaranteed. Efforts to improve should be endless.

Our screensaver should boldly state: End miscommunication forever!

Alan Goldstein, D.M.D., F A.C.D., is a member of the Dental Coaches Association, an organization of dentists and professional coaches who are committed to bringing professional coaching to the dental profession. Learn more by visiting www.dentalcoachesassociation.org.

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