They've been doing some construction around my house, blocking off the street for about two weeks. It's astounding the number of people who pass the "road closed" barrier, get out of their car, move two more barriers to proceed on their original course rather than go 30 seconds off their course; a block out of their way.
It's an interesting observation of people and change and makes me think about the barriers many dental practices unwittingly put up.
The biggest barrier to relationship based dentistry is providing reasons for change by teaching, and telling. Listening alone isn't enough. EQ alone isn't enough. To truly facilitate the clarification of values which drive all behaviors, a conversational framework is needed to replace questions, teaching and telling.
Water bottles, Ipods, coffee and syrupy customer service is like painting over rust if interactions lack the skills required so that people feel profoundly understood.
Learning and motivation is an inside job. Until the client can place meaning on the problem, there is no problem! Telling them what meaning they should place upon any condition risks creating defensive reactance which can strengthen their resolve for the status quo.
Every decision to change involves ambivalence. It's normal. Dental professionals need to understand how to use a matrix of listening, delivering accurate empathy, different types of reflections to move people to action in as clients are facilitated to think out loud; metabolizing thoughts and feelings; identifying the congruence or incongruence with their values.
Motivational Interviewing is a semi directive, non judgemental communication skill that removes all barriers and sets a person free to choose according to their own values structure. It's counterintuitive. Over 80 clinical trials now support the methods.
As Pascal stated in 1623, “People are more likely to be persuaded by the reasons they have themselves discovered than by those that come into the minds of others.” Apparently, while change seems continuous some human behaviors remain constant. Remove the barriers so that people don't go around them either with defensiveness, silence, or no action or worse, choose a completely different route...another practice.
Tuesday, July 20, 2010
Monday, July 19, 2010
Where have all the flowers gone?
We've had a ton of rain this month...the farmers struggling again with the elements; the things over which they have no control. Makes me think of the many parallels to dentists.
A hunter seeks out opportunity, secures it and hunts again. The farmer on the other hand, seeks out good soil, works to understand the envrionment, plants a variety of crops, nurtures them, culitvates, and fertilizes them. The hunt for new patients is not fun for many.
To the farmer dentist, the concept is to build relationships but at the execution level it's a different story. Some things they cannot control like the economy but others they can, like who they bring on board, how they nurture and cultivate them be it team or patients; choosing to stick with what they believe in their souls or buying in to what they're told and sometimes it's by their teams.
A recent client (a veteran) wrote recently about the absolute joy in connecting with a new client who shared his valuing. It wasn't that they chose the optimal treatment. It was simply that he felt he could speak openly ...be his authentic self and learned a lot about this person in less than an hour. He felt connected - juiced. " Where are the people who are more like that" he asked.
Same fellow described the ugly front tooth of many years he saw on his near perfectly qualified receptionist. So he fixed it, for nothing and hired her without inquiring as to why an attractive gal would let it be.
With a big heart, you can hear her become the patients insurance agent - happily navigating the system for every person and affirming dentistry is expensive...too expensive; believing managing insurance is customer service. What is she nurturing?
Looking back, Doctor believes he's had a number of sympathetic (not empathetic) people whose view of customer service had to to with managing insurance. Sounds OK until we look a little closer. Nothing of the values alignment between doctor to team has been explored; what they stand for (the soil), nothing of the alignment of values with patients (the environment) was being explored and so they planted seeds of the insurance dependent variety expecting it to produce. In the absence of discussions of what people hoped for their future..only the here and now mattered; hence following the insurance agenda and making a farmer at heart in to a hunter.
Doctor had it in mind to plant a certain crop (those seeking health and a partnership) and the team another thus attracting dependency relationships and external decisions via insurance...under the guise of customer service.
Weeds spread, can take up a lot of time and choke out the flowers. So busy they became with getting remedial care approved and paid for, they have no time to cultivate the flowers...don't realize they are even there. The farmer grows weary with poor harvests.
Where have all the flowers gone? Maybe they can't spring up for all the distractions of coping with the weeds. Or maybe, there are new cultivating methods to be explored.
A hunter seeks out opportunity, secures it and hunts again. The farmer on the other hand, seeks out good soil, works to understand the envrionment, plants a variety of crops, nurtures them, culitvates, and fertilizes them. The hunt for new patients is not fun for many.
To the farmer dentist, the concept is to build relationships but at the execution level it's a different story. Some things they cannot control like the economy but others they can, like who they bring on board, how they nurture and cultivate them be it team or patients; choosing to stick with what they believe in their souls or buying in to what they're told and sometimes it's by their teams.
A recent client (a veteran) wrote recently about the absolute joy in connecting with a new client who shared his valuing. It wasn't that they chose the optimal treatment. It was simply that he felt he could speak openly ...be his authentic self and learned a lot about this person in less than an hour. He felt connected - juiced. " Where are the people who are more like that" he asked.
Same fellow described the ugly front tooth of many years he saw on his near perfectly qualified receptionist. So he fixed it, for nothing and hired her without inquiring as to why an attractive gal would let it be.
With a big heart, you can hear her become the patients insurance agent - happily navigating the system for every person and affirming dentistry is expensive...too expensive; believing managing insurance is customer service. What is she nurturing?
Looking back, Doctor believes he's had a number of sympathetic (not empathetic) people whose view of customer service had to to with managing insurance. Sounds OK until we look a little closer. Nothing of the values alignment between doctor to team has been explored; what they stand for (the soil), nothing of the alignment of values with patients (the environment) was being explored and so they planted seeds of the insurance dependent variety expecting it to produce. In the absence of discussions of what people hoped for their future..only the here and now mattered; hence following the insurance agenda and making a farmer at heart in to a hunter.
Doctor had it in mind to plant a certain crop (those seeking health and a partnership) and the team another thus attracting dependency relationships and external decisions via insurance...under the guise of customer service.
Weeds spread, can take up a lot of time and choke out the flowers. So busy they became with getting remedial care approved and paid for, they have no time to cultivate the flowers...don't realize they are even there. The farmer grows weary with poor harvests.
Where have all the flowers gone? Maybe they can't spring up for all the distractions of coping with the weeds. Or maybe, there are new cultivating methods to be explored.
We need new patients...are you sure?
With what seems like a dentist on every corner, the competition for patients is high. Many spend untold dollars on getting more people to walk through the door rather than considering their effectiveness with the people they currently have.
They feel like they've "informed" their patients well ...done all they can do...taught...cajoled...and end up waiting for a problem to present so they can fix it. So much for prevention.
Frequently when treatment is recommended, the response is "will my insurance cover it" leading many to believe their careers are inextricably tied to insurance benefits.
We are taught to teach. It come's naturally. However, that which is more effective is highly counterintuitive. There are skills needed to help people through change. It's not just a matter of listening, asking questions and EQ. There is a much more effective skill set available. Check out Motivational Interviewing. Motivational Interviewing in Health Care by Stephen Rollnick. A great book to serve as an introduction.
They feel like they've "informed" their patients well ...done all they can do...taught...cajoled...and end up waiting for a problem to present so they can fix it. So much for prevention.
Frequently when treatment is recommended, the response is "will my insurance cover it" leading many to believe their careers are inextricably tied to insurance benefits.
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