The success of many dentist-patient relationships depends on our ability to communicate. The DDU outlines some practical tips to help you measure your own ability to listen, speak and relate to patients.

Rupert Hoppenbrouwers, head of the DDU
Publication date: 18 November 2004


Good communication is essential for maintaining a high standard of patient care. Failures in communication are a common theme in patient complaints and claims notified to the DDU. In the DDU's experience, complaints and claims seldom arise solely from problems with clinical management. They are generally caused or exacerbated by problems in administration systems, procedures and lines of communication.

It may not surprise you to learn that analysis of DDU data showed that, between 1996 and 1998, 34% of complaints resulted from failures in communication, including allegations of rudeness and administrative errors. Failure to communicate effectively can have an impact on the quality of care provided and the GDC expects dentists to provide a high standard of care.

Managing expectations
To improve patient care and reduce the risk of complaints, it is important for dentists to ensure good communication, part of which may be to manage patient expectations.

Patients need to understand why treatment is necessary, the risks involved in having or not having treatment, and any alternatives. They also need to appreciate whether the treatment will be provided privately or under NHS arrangements, and what it will cost.

Many misunderstandings can be avoided by simply talking to your patients. When meeting patients you may wish to consider the following points:

Who's the patient?
Get off to a good start. Before anything else, check it is your patient. Make sure your patient knows who you are. Stop. Watch and listen for some acknowledgement or confirmation that the patient has understood.

Listen
Ask open questions (ones that require more than "yes" or "no" answers). Make eye contact. Watch for non-verbal signals. Try not to interrupt but acknowledge what they say regularly. Respond appropriately. To check that you understand what the patient has told you, repeat it back to them.

Does the patient understand?
While you talk, watch for appropriate acknowledgements and/or signs of confusion. Remember, you know masses of dental words that mean nothing to many patients. Be particularly careful when talking to the elderly, the confused or those in distress. From time to time, ask. Patients who normally speak another language may require an interpreter to ensure that any explanations are given in a language they understand. If you are not sure that the patient has understood you, invite them to repeat what you have said.

If you wish to examine the patient, you will need to explain in advance what you intend to do during the course of the examination so that your actions are not misunderstood. Towards the end of the consultation, give the patient a chance to ask further questions.

Be courteous
The dentist/patient relationship is primarily professional, not social. Maintain an appropriate tone and avoid over-familiarity. The use of first names may be resented. Even if you are extremely busy, under pressure or tired, don't let your politeness suffer. At all times, treat patients as social equals, not inferiors.

Manage your response
If patients are unreasonable or display discourtesy, point this out but stay calm and in control of your emotions. Allow them time to put their point or explain their problem. If time is short, find a diplomatic way to move the conversation on.

Apologise if warranted
If patients have a genuine cause for complaint (for instance, an especially long wait for the consultation) explain promptly and apologise. If the patient is expressing anger, control your own temper.

Dental treatment can go wrong. Usually, an immediate apology is appropriate. Saying sorry is not an admission of liability. If, for instance, you suspect the patient has suffered harm as a result of treatment, pass on your suspicions to your senior, who will find out all the facts and will probably be the person who explains the situation to the patient (or to relatives).

Your school, hospital or dental practice will have a complaints procedure and you should familiarise yourself with it. Whenever a complaint is made, listen carefully. Before responding, make sure you know exactly what the patient's concerns are. Remember, anxiety plus uncertainty equals anger. You can halt this process by offering reassurance and explanation.

Write it down
It is important that you record what has been said to the patient and what you found on examination. Good notes that are legible, accurate and written while the facts are still clear in your mind, protect the patient and you. Sign and date your notes clearly.

For most of us, good communication skills take time to develop and refine. Keeping these seven points in mind when you speak to patients will make you a more effective dentist and reduce the risk of a complaint arising from a simple misunderstanding that could have been easily avoided.

الله يعطيك العافية يا زوربا على الموضوع الحلو.
ولسع ما قرأته كله، بس اطلعت عليه بشكل عام، وحفظته عالجهاز مشان أقرأه كله.
وشكراً على تعبك معنا.