In dealing with doctors and staff I often find that they have the premise of who is in control with clients backwards. Doctors and staff may have education, intellect and personality on their side but if they do not understand that the client is the final determining factor regarding treatment they are missing a key factor in practice success. Everything we do with our client should be focused on helping them identify the appropriate choices that they have available to achieve maximum comfort, function, health and aesthetics. Clients know best what is right for them. We are there to help good things happen.
All of us have suffered through multitudes of slides from folks on the lecture circuit showing great clinical skills and improved appearance. Few lecturers stop and discuss what it was that made the client choose them and why the client agreed to pay for their care with gratitude. There are many skilled doctors who could be performing significant amounts of excellent service, but they are not doing so because they have not learned the essential personal skills to allow people to find value in their office. They get along telling people what to do and fixing one tooth at a time. They wonder why they don’t get more referrals.
There is an old saying: “Show me where you spend your money and I will know your value systems.” If we do not learn enough about our client to know their value systems we can never expect them to spend their money with us on excellent dental care. We begin the process of understanding value with our clients from their first contact with us. That may be a phone call or a visit to our web page. We emphasize that our most important mission is to understand what outcome they are looking for from their interaction with us. We want a relationship based on honesty, mutual respect and trust. Sometimes this happens quickly and sometimes this takes years.
We may know from a clinical perspective what is ideal for a client but they may not be able to take ownership of their specific problems. If we try to “fix” the problems but they do not “own” the problems we have a disaster in the making. Without ownership the client does not value the care skill and judgement you have rendered. When things go wrong, and they will, it will always be “your crown came off doc” rather than “my crown came off eating a caramel”. Without ownership the fees will always be too high no matter what it is.
L. D. Pankey used to relate this issue to what he called “dental I Q” or being above or below “the line”. Many who heard him speak on his philosophy of dentistry thought he was talking about money. He was really talking about whether the client owned their dental problems, had the intellect to understand them and the willingness to pay for and maintain the dentistry needed to help them regain their dental health. We can help people improve their dental I Q but only with significant time and effort at building relationships and trust.
Our role, doctors and staff, is to listen with the intent of understanding, not with the intent to reply. When we truly understand the outcomes our client is expressing we can begin the process of education necessary to provide them with alternatives open to them. We cannot do this without a through diagnosis, a comprehensive and thoughtful treatment plan and a consultation with all appropriate parties present. Each of these steps allows all parties to develop a deeper understanding of one another and refine treatment options that have the potential for long-term success. The consultation is not a “selling” visit, it is a time to re-clarify our understanding of our client’s goals and provide possible outcomes that they may choose. As long as our client knows the risks and rewards of the option they are considering we are fulfilling our role as educator/professional. They may make choices that we are unwilling or unable to provide, but the choice is theirs not ours. We are able to provide care, skill and judgement based on the outcomes defined with the client, the means all parties agree are necessary to reach those outcomes and fees that all parties agree are justified. Our control is whether we are comfortable providing these elements in this case as we have the privilege of saying no. Beyond that the client is in control.
 Stephen Covey, Stephencovey.com