Relationship Selling in Dentistry

I recently flew home for the holidays to visit family in Canada. In an attempt to distract myself from the stress of the trip, I paid attention to the routine safety announcements. “Please put your oxygen mask on yourself first before you help others.” This familiar admonition is repeated every time you are about to take off. The idea behind the request is that “in the unlikely event of a loss in cabin pressure,” you have to be able-bodied before you assist others.

As I gripped the armrests and glanced at my neighbors, this concept took on new meaning, and I realized this is not only true physically but emotionally. In our daily interactions with patients we are confronted with an assortment of human behavior, which can be further amplified by the stress of visiting the dentist. Dentists must develop two skills that I believe are critical to interact with patients and develop lasting relationships—emotional intelligence and empathy.

Emotional intelligence (EQ) refers to the awareness, control, and management of our emotions. Armed with this self-awareness, we are better equipped to understand our patients. Often we are the brunt of our patients’ worst behavior. Imagine not understanding when your patient is angry, clueless, fearful, or apathetic, and being unable to respond appropriately to them. EQ is an intuition of appropriate behavior and response to any situation. Individuals that have a high EQ are able to process information and act in a manner that is becoming and effective. EQ is also our ability to understand, interpret, and respond to the emotions of others. The premise of the book Emotional Intelligence by Daniel Goleman is that we are hardwired to connect with others. We can pick up on others’ emotions much the same way we catch a cold. Dentists have to be able to develop and foster personal psychological insight.

I first met my patient Robert to consult about a loose front tooth. Robert is a tall, thin, extroverted, and restless man. As I walked in the room, he was sitting sideways on the edge of the dental chair. His gaze was riveted to a picture of periodontal disease on the wall. He stood up to shake my hand and I introduced myself.

“Hey Doc, where am I on this chart?” he asked. He pointed dejectedly to the bottom of the picture and said, “I think I’m down here.”

I explained that I wasn’t quite sure yet, but we were about to find out. He sat down and stretched his slender legs and settled into the chair.

“Why are you here, Robert?” I queried.

He gingerly lifted his fingers to his lower lip and pulled down to reveal his blackened, crooked lower front teeth.

“This is why,” he said, his voice lowering. “I have been like this for a while; it’s time I do something about it and I’ve finally got some insurance.”

We talked a bit more, and with each passing minute it was clear Robert was relaxing and feeling more comfortable with me.

“Why fix this now, Robert, if you’ve been like this for a while?” I asked, curious of his reply.

“Like I said, Doc, I got insurance so I might as well use it, and it’s beginning to hurt a bit,” he blurted.

Something about his quick reply didn’t seem right to me, and I probed further.

“Okay Robert, that sounds good, but is there anything else?”

He glanced back at my dental assistant, seeming to wish we were alone, and then grew quiet and leaned forward in the chair. “Um, my brother was over the other day for dinner. We’re not that close, but it was my daughter’s birthday. He had his teeth done, and my daughter told him his teeth...” he paused, reliving the event in his mind.

“She told him his teeth look great.”

Robert clenched his jaw tighter and looked up.

“It killed me Doc; I’ve looked like this way for a long time and this is all she sees me as.”

He leaned back slowly in the chair and inhaled deeply, held his breath for moment and blew out, his cheeks puffing.

“I want her to say that about me, her Dad.”

His eyes filled with tears and he apologized for his emotions.

Robert was definitely motivated to get his teeth fixed, and possibly would have done it whether or not I knew about his daughter’s comment. But, EQ shifts the relationship to a place where we can sense each other’s emotions and connect. Dentistry performed at this level is fulfilling and sustaining. It becomes holistic and meaningful to both the practitioner and the patient. As a parent, I can understand Robert’s desire to have his children proud of him, and certainly his view of dentistry can transform from a routine commodity to a path to self-esteem. It can be a life-changing event.

Additionally, it is critical for dentists and team members to develop their empathetic skills. Empathy is sensing other's emotions, and moreover, understanding their perspective. Empathy drives connection! When you empathize with another, you have to connect with something inside you that knows that feeling. Perhaps the best definition of empathy could be stated as feeling the pain and joy of another in your heart. When EQ and empathy are used in conjunction, we are in control of our feelings and emotional triggers, and we can be at our behavioral best for what our patient may present.

EQ and empathy are key components in psychological reciprocity. The Law of Psychological Reciprocity states that people are instinctively compelled to return the same attitudes and behaviors that we exhibit toward them. When we listen to others, they listen to us. If we create value, they want to return value to us. When we understand people, they trust us. If we see people as they are, they see us in them. When patients sense they are in the presence of a caring dentist they are more themselves, connected and open to recommendations and treatment plans.

The essential element of any successful dental practice is the doctor-patient relationship. The dentist who acknowledges this will be on the fast track to a successful career. In contrast, the dentist whose focus is on technical proficiency and ignores the behavioral side will often meet frustration when patients leave their practice. People skills and the ability to forge connections and emotional ties with patients will trump the dentist who boasts of his clinical skills but is behaviorally incompetent. Patients who choose our services deserve no less than our best both clinically and behaviorally.

Dr. Lynn Carlisle, founder of the website In Spirit of Caring (ISOC), describes the effective dentist as a triathlete who possesses the heads, hands, and heart to excel in emotional and clinical competency. EQ and empathy mirror this triad. I see you (head-EQ). I feel with you (heart-empathy). I can help you (hands). Dentistry is a behavioral art first and a clinical science second. The skills of a complete dentist must include heightened emotional awareness and connectedness and a deeper psychological understanding of oneself and patients.

Gone are the glamorous days of air travel; instead, you get the obligatory safety announcements and maybe a bag of peanuts. Our profession can be more. It must be more. As dentists, we must realize that the dentistry and career of our dreams is not through the mouths of our patients, but rather through the heart.

About the Author

Dr. Chokka is a graduate of Loma Linda University and has been practicing dentistry since 1993. He is a Multiple Office Owner Dentist in Southern California and a graduate of the Sirona Speakers Academy.  Dr. Chokka has presented at the California Dental Association and Academy of General Dentistry annual meetings, and has also authored articles for Dental Economics and Inside Dentistry.  He is a Pacific Dental Services Supported Owner Dentist where he is a lecturer, speaker, advisory board member, and consultant. He can be reached at chokkas@pacden.com.