Part One of this post was posted by Mary Osborne on Dec. 17.
We can assume if they are in a dental office that they have some value for health. Deeper questions flow from that assumption: What important aspects of this person’s life will be affected in a positive way by having good oral health? What aspirations do they have that would be negatively impacted if they avoid doing dentistry? Exploring those issues can help them clarify what our dentistry will help them achieve that is personally relevant to them.I don’t think of understanding patients’ values as some obscure, esoteric concept. I think of practical issues, such as what they like to eat, and how they like to spend their time. Questions that come up for me are: What has motivated them to choose healthy foods, or exercise, or make any significant change in their lives? Who influences their choices and why? What are their hopes and their fears? What is valuable enough to them to cause them to move beyond financial concerns, discomfort, inconvenience, or other perceived barriers? What must we include in our conversation to allow them to trust that we have their best interest at heart?
Our values tend to drive us toward some things, and away from others. When you are clear about what is important to your patients you can offer them information about two key elements of choice as described by Dr. Bob Barkley. The first is their Probable Future. It is important for patients to understand what is most likely to happen, given their current conditions, if they do nothing. Our responsibility is to let them know — as clearly, honestly, and specifically as we can — what we believe will happen in the future if nothing is done to intervene. Only when patients fully grasp their Probable Future can we help them visualize their Possible Future. This process goes far beyond a treatment plan. It is outcome based, not procedure based. It helps the patient see possibility where they may have seen inevitability. It is a long term plan for health; specific in its goals, and compelling in its vision. It is not our plan. It is their plan, for their future, based on their preferred outcomes.
Their values create the context for our recommendations. Ideally every recommendation we make for a patient — from bitewings to implants — would be placed in the context of what we are learning about their values: “Based on what I am hearing from you I suggest . . .” “Based on your goals as I understand them my recommendation is that we . . .” Without that context we can make a logical argument for why one should have treatment. Within that context we can have a conversation about why that unique individual would have treatment.