Communication in dental practice

1. Codified communication (jargon)
Do we understand the codified language that we use? Check out this youtube on writting because it is an excellent expression of issues that we can relate to talking.
We need our foreign dental speak to communicate with collegues e.g. jargon is good and essential. But not for normal people (doesnt matter how academic they are).
The important part of communication is not what we know, but have we made a value proposition for the person listening to us. When someone says they don't understand it is not an opportunity to explain more. It means that you have NOT delivered valuable information. You need to address your value proposition.
If someone says "but what would you do?" it means you have not explained well enough for them to make a decision.
If you can't explain it simply, you don't understand it well enough.– Albert Einstein
Doctor Speak up http://www.doctorsspeakup.com. Worth looking at especially if English is not your first language

Read about how websites should be written: User-centric vs. Maker-centric Language: 3 Essential Guidelines Summary:
Aim: To engage users, website copy must speak to readers and not at them. Include words people can relate to, and avoid jargon, business speak, and feature-driven language.

2. Co-discovery or Shared discovery
This is to be used when talking with patients about conditions/problem they have. The purpose is to ensure the patient feels they have a problem that requires the solution that you have for their problem. The solution you have needs to satisfy how the patient wants to be in the future. (their value proposition)
The patient needs to be able to feel and know the consequence of their problem - what they will avoid by fixing it; what they will gain by not having it.

Show the patient "normal" ; then relate that to the patients present condition; and lastly look at the "future". (where they could be and where it looks like they are going!)
You and the patient are discovering the problem they have. You are not telling them what is wrong.

The problem isn't that the patient doesn't know the knowledge that is in your head (not a dental education issue);
The problem isn't that the patient needs to understand how you are going to treat this problem.
The problem isn't that the patient needs to know why the problem occured. (until you get the problem as a serious issue that needs to be prevented next time...but for today you need the patient to want a solution).

The focus is on consequences (what it means to the patients) and not why it has happened.

If the patient came to you because of they knew they had a problem then you are well on the way of the journey. But if this is a problem that you have found then you have a great task of:

You need to show that the instablity/tension/challenge =problem =poses a cost on them; or if solved, it will benefit them. "But, although, inconsistent, however, anomaly" - tension or challenge words used in writing. The problem needs to be one of instablity/tension/challenge for it to be something the patients care about. Do not use language of continuity or you give the patient mixed messages. Is it important now or not! Is that why they came to you or is it something you have found. If the patients do not perceive the problem then they DO NOT care about the solution.
Note: The problem needs to be unstable- you are aiming for tension.

The benefit of this technique is that it transfers the "power" to the patient. It acknowledges the patient's ability to understand and it "anchors the future".
Anchoring the future
This is a term for making the future feel like now. This is important because we are all terrible at taking notice of future consequences but by helping patients visualise the future we bring it closer to the patients decision making center. (Behaviour economics factor)

3. Patient decision tools
Helpful learning resources on ACSQHC site https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making
Patient decision tools are applicable when:

  1. there is more than one reasonable option
  2. no option has a clear advantage in terms of health outcomes
  3. each option has benefits and harms that patients may value differently

International patient decision aid standards collaboration
Ottawa patient decision aids site

4. Shared decision making
This process isn't giving patients the options. It is exploring options and the patients values and attitudes. It is for when patients have a choice. It has to include informed consent. When there is only one choice then shared decision making is unnecessary but informed consent is necessary.
SDM =Patients preferences + Evidence -based info + practitioners experience
From tha ACSQHC course (Risk communication modules), which is excellent:

 

Stories / Narratives / Analogues
It is so much easier to relate learning with a good story.
1. Caries
Do you know anyone who has had termites in their house? They don't find the damage until it is fairly severe - unless they get in an expert. You can repair the damage that termites do but if you don't get rid of the termites they will just destroy another part of the house.
2. Story for parafunctional activity: e.g. grinding or clentching
Fence post - rocking at night - if the soil is hard then the tooth (fence picket) will start to collapse at the bone (soil) level and you will get abfraction lesions; if the soil is soft then it will come away from the picket - which will loosen - and you will get perio (bone loss).
https://www.stitcher.com/show/protrusive-dental-podcast/episode/communicating-with-a-bruxist-pdp011-63677287

Terms
Keep it short (1-2 sentences) Explain in terms that relate what it means to the patient; not in terms of how it is done. e.g. a crown is something that covers the tooth to minimise the risk of fracture - instead of that you are going to cut a layer all around the tooth and take an impression and send it to the lab. (this is just how we think of things procedurally and technically)

 

  1. Term Technical Non-technical
    Caries   is a hole in the tooth that, unless something is done to stop the hole getting bigger, will get so big that not enough tooth will be left to ever fix the tooth
    Periapical abscess   bag of pus in the bone at the end of your tooth.
    Cracked tooth sydrome   Hairline crack in the tooth, and when you bite the tooth flexes and opens the crack up and the tooth lets you know it isn't happy about this so it lets you know
    Crown   cover or cap that protects and overlays a tooth so it envelops a split in that tooth so that when you chomp down, you can chomp knowing that the tooth is unlikely to be split any further
    Asymptomatic pulpitis   I know you’re not feeling it, but that tooth is hurting you. The infection is eating away at the bone, and eventually the spreading infection will cause pain—usually at the most inconvenient time.
    Rubber dam  

    We’re going to put something around the tooth now so that you won’t have to swallow the disinfectants we’ll be using during treatment. Once this protective shield is in place, you’ll be very comfortable. You still will be able to breathe right through your mouth if you want to, and through your nose, too

    For your comfort and convenience, I’m going to place a protective shield over your tooth.

    Raincoat