BY Kara Vavrosky, RDH
We've all had those patients who come in with a negative attitude. From the moment you greet them, they make it clear they would rather be anywhere else than with you. Whether it's a snide comment or an angry demeanor, you know this isn't going to be the most pleasant experience for either of you. Fortunately, it doesn't have to be this way. Rather than letting this patient ruin your day, it is actually possible to turn things around and have you both leave with a smile.
When dealing with negative people, it's important to know that negativity is rooted in fear. In the particular case of a patient, it's the fear of judgment and fear of the unknown. This causes them to put up a defense mechanism that manifests itself as negativity to the outside world. Knowing this allows you to get in the proper mindset on how to deal with this person and turn their negativity around.
Fear of judgment
It's not a coincidence that some of the most negative patients are also the ones who obviously exercise poor home care. The negative attitude can be attributed to a worry or fear that you will judge them. This is a natural response on their part. As much as they may try to fool us that they brush and floss at home, deep down they know they don't take care of themselves as much as they should.
To help alleviate their fear of judgment, always show genuine concern for the patient as a whole person. Find something in his or her appearance to compliment as you walk to your operatory. This can be something patients are wearing, how their hair is done - anything so they will see you are looking at them in a positive light and are not judgmental. Before reviewing a patient's medical history, take a moment to ask an open-ended question about how the day is progressing. Ask any question that gives you insight into their attitude right at that moment, yet doesn't lead to an answer of simply "fine." This gives a better perception of their current moods so you know how to proceed during the rest of your conversations and the best way to address suggestions during OHI.
Once you start working in their mouths, find something they are doing right instead of only pointing out problem areas in their home care. For example, begin by pointing out how well they are "brushing the outsides of your back teeth" and then suggest they "brush with the same energy and great technique on the insides of your teeth" (or wherever they are not doing that great of a job). Don't forget to demonstrate! By showing you aren't judging them, you will start see patients loosening up and any negativity begins to lift away.
Fear of the unknown
To further turn around any negativity in a patient, it's important to address the fear of the unknown. It's easy to take for granted everything we do during an appointment since we do these things all day, every day. Patients only go through an appointment twice a year, if that. They are not always familiar with the ins and outs of everything that goes on during an appointment, and this causes their fear of the unknown.
Combating this fear of the unknown is really simple. Explain to the patient what you are going to do next. Then more importantly, explain why you are doing it. Not only will the patient know what you are doing to them, they will understand the reasoning behind it. This also opens the door to have a positive conversation about the importance of proper home care.
For eample, as you are setting down your instruments and getting ready to floss, tell the patient, "I'm going to floss next." This seems elementary but small statements like this makes a patient feel more in control. As you start flossing, you can expand and explain, "I'm flossing not only to check myself and my work, but flossing is important to get the areas that a toothbrush cannot reach." This then leads to a conversation about the patient's flossing habits.
By addressing the fear of judgment and fear of the unknown with patients, you will start to see a notable change in their attitudes. Of course there will always be those patients who have a less than positive attitude no matter what you do. It's important to understand they have other things in their lives that are causing this attitude and to not take it personally. For most, though, just addressing their fears will be the difference between a positive and negative time together. RDH
Kara Vavrosky, RDH, runs the popular Facebook page, Dental Hygiene with Kara RDH, and is also the founder of DentalHygieneAnswers.com, a question and answer platform for dental hygienists. Kara serves on the Clinical Advisory Board of GoodMouth, a toothbrush subscription service, and the Advisory Board of Support Clean Dentistry, an initiative to raise awareness of cleanliness in the dental office. Kara currently works for a one-doctor, family-oriented practice in Portland, Oregon.
