I have been thinking a lot lately about standardised responses to questions or situations. I don’t just mean using things like OHI postcards even though I think they are invaluable (here if you haven’t seen them: http://www.drchrisharper.co.uk/blog/ohi-postcards). But rather standardised responses to the awkward situations such as a patient questioning why dentistry is “so expensive!”. Today I will be considering how to respond to patients who can’t make up their mind about what they want to do. The words in the quote attached (or words very much like these) are ones that I seem to say a lot more now than I used to. I am very happy to guide a patient through any decision relating to their teeth and sometimes the choice is simple. For example if a patient says "I just want the longest lasting solution" I can say "Well in that case you should have X."
However it seems increasingly common to encounter patients who initially don't seem to have a clear idea about what they want from their teeth and wish to put ownership of all decisions onto the shoulders of the treating clinician. In times gone by this may have been normal, but in the modern environment of informed consent (or as close as you can feasibly get to it), it would be inappropriate for us to see a problem with numerous justifiable treatment choices and not present those options for the patient to consider. If a patient says "I just don't know what I want. What would you do?", how do you respond? Is it with a specific treatment recommendation? Or do you respond by delving deeper with further questions to try to get a better understanding of what treatment outcomes the patient actually desires? Because for me that is what normally follows my stock statement above and I personally believe that has to be the key to providing treatment that has a better chance of meeting the patients expectations. How do you respond when a pt says “What would you do?”
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August 2020
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