Advice: Know your patient – tips to avoid complaints

A QUICK look at the Health and Safety Executive’s website is enough to frighten many of us. It goes into great detail about potential hazards and what we can do to avoid them.

Unfortunately their lists of “managing risks in the workplace” don’t cover patients – their wishes, desires, beliefs and attitudes. Nor does it explain what to do when something goes wrong.

Yet dealing with the fall-out from a patient complaint can often be just as challenging as dealing with the consequences of more tangible issues, such as a missed trip hazard or wobbly step-ladders.

The HSE are big on prevention, as we all are. Sadly patients don’t come with those little warning pictograms indicating specific things to avoid that may cause problems. We need to use our wisdom, knowledge and intuition. Too often these are learned through experience, something that Oscar Wilde described as “the hardest kind of teacher, because it gives the test first and the lesson afterwards”.

Know the signs

Recently a client forwarded an email from an associate who had received a patient complaint. The associate commented: “I’m not surprised they have complained, they seemed quite a confrontational individual”.

Clearly, the dentist concerned had enough insight to recognise the potential for confrontation, so I do wonder whether they might have avoided it with a risk assessment.

In my experience, patient complaints or expressions of dissatisfaction are often preceded by certain indicators or behavioural patterns. These may include patients who:

• want to tie you to a budget
• have a deadline and try to commit you to their timescale
• ask for treatment by name, e.g. “I need Invisalign aligners, bleaching and bonding”
• appear to know more about the treatment they want than you do
• frequently change their minds
• tell you that money is no object
• are perfectionists and frequently seek reassurance
• call you by your first name at the first appointment
• tell you they were referred by someone that you can’t place.

The list could go on, and I’m sure that any reader of this with experience of close calls would only add to it. The question we often ask ourselves is: “Why didn’t I see it coming?”

How can we avoid getting into these situations where something has gone wrong that, with 20:20 hindsight, could have been avoided?

Know your patient and yourself

If there was one statement that I would have every clinician and team member chant, mantra-like, every morning before they start work it would be: “Know your patient. Know yourself. Get the best for both”.

To know one’s patient takes time and effort – there is more to a dental pre-assessment than a brief medical and dental history. There are countless books written on communication techniques and I would urge you to read widely.

Most important is to start every conversation with an interest in the patient (every patient, not just the new ones). What has brought them to see you? Why now? The joy of obtaining information from open questions, gradually unravelling their motivations, concerns and desires is something to cherish. Let your curiosity flourish, the more that you know the better.

Avoid quick sales

I do fear the consequences of increasing focus being placed on marketing to attract patients by promoting branded rather than generic treatments. There is a potential for the “sale” that can follow to be too rapid. Sales trainers might say there is no such thing as “too rapid” but when one sees patients described as “prospects” or even “qualified leads” who are already “pre-sold” I have concerns for the outcomes.

Some people might describe me as old fashioned, but if it improves outcomes and reduces the number of disgruntled patients, then so be it.

Getting the best for both

Every dentist has ambition to perform to the best of their ability (of course they do) but sometimes that can cross a line and one runs the risk of wanting the treatment more than the patient. Replete with knowledge following a course or armed with a new piece of equipment can influence the most discerning of clinicians. When things work out well that’s fine, but not so when they go wrong, the patient suffers buyer’s remorse and the dentist has to go another extra mile to remedy things.

That’s where the third part of the morning mantra comes in: “Get the best for both”.

Without knowing both your patient and yourself, it is impossible to know what “the best for both” can be. The temptation to either accept a patient’s demand or to impose your choice, even with the best of intentions, can lead down a road along which retreat is difficult or impossible.

I am reminded of the words of Norman Vincent Peale: “Part of the happiness of life consists not in fighting battles, but in avoiding them. A masterly retreat is in itself a victory.”

Alun K Rees is an experienced dental practice owner who works as a coach, consultant, troubleshooter, analyst, speaker, writer and broadcaster. Find out more at www.dentalbusinesscoach.co.uk