Page 26 - GP Spring 2020

Psychology and Patient Management

By Michael Acquista, DDS

I used to joke with my patients who state that with a new patient and looking them in the the gum, then we’ll wait for a moment, so
their dog is their best friend and makes them eye while saying their name, smiling and the gum will be numb so you won’t really
feel better when they are stressed, I would saying I want to help you to stay healthy, or feel it when I give you the rest.” Then, “I am
ask these individuals about the pets, who anything warm and fuzzy, will be remem- going very slowly so you will barely feel it;
do they go to when they are stressed? The bered. First impressions only happen once, if anything bothers you, just make a sound
poor pets have to deal with all these cra- so don’t miss your opportunity. and I will stop and let it wait a moment for
zy humans! That’s a big price for them to it to get number. Okay, almost done, you did
pay, but is it really worth it? Sure enough, At the end of the visit say thank you, it, terrific, rinse.” Sometimes if they are in-
a recent study showed that the stress levels complement the patient for anything they dicating they are anxious or uncomfortable,
of pets are in sync with their owners. It is did well, and tell them what to expect from I will stop injecting for a moment, and their
the same with our patients; when we are your treatment, post-op instructions, and inner voice telling them that it hurts will be
stressed, we stress our patients, and when that they can call anytime if they have a challenged by their rational mind that says it
they are stressed, we experience stress. If question or problem. The last person they doesn’t. The power of suggestion: gently,
you think about it, this is not a good thing, interact with should also thank them for tiny pinch, barely feel it, if you feel it we
however, there are ways to change that. their payment and wish them a nice day. will stop and wait for it to numb and you
won’t feel it. Sometimes I will give them
We want to be happy and we want our Now let us discuss the power of sugges- a second injection, (letting them know it is
patients to be happy and to tolerate the stress tion. When evaluating how likely a person already numb and they won’t feel it) and say
of having dental work. What can we do to is to be hypnotized, we assess suggestibili- I want to be sure that they are very numb. I
increase the likelihood of having less stress ty. The more stressed and fearful a patient tell them that believe it or not, phobic pa-
while dealing with the everyday stresses of is upon walking into your office, the more tients are some of my best patients; once
our daily routines? Lots of things and they they are in need of help to mitigating the they are good and numb, they are very
work! fear they have. Your body language, de- cooperative, and I reiterate how well they
meanor, and expression can help or hinder did at the end. I am suggesting to them
First of all, think about the primacy/recency significantly. It is important to assess each that they are great patients and they may
effect in psychology. It states that in learn- individual patient and be aware of their de- think I’m joking, but they desperately want
ing, we tend to remember the first and last meanor, personality, body language, and it to be true and they are highly suggest-
information presented best, I would say this method of communication. Some people ible. Bam! They have been conditioned
also applies to the office experience. Ev- are unemotional, quiet, and repressed. If and motivated to be a good patient and
eryone appreciates it when they receive a you can show that you care, they may open they’re starting to believe it.
little personal attention, and first impres- up. Tell them that you appreciate their can-
sions mean a lot. When a patient walks dor and that good communication makes The patient is looking for your approval
into your office, someone should say hello it easier for you to figure out what may be of their behavior in the chair during treat-
to them, address them by name, which they the problem. I tell my colleagues, just listen ment. I tell them that I need their help and
like to hear, and ask them how they’re do- more to your patients; they will often tell compliment them for their compliance and
ing. Continue by saying something about you what the problem is!” Oftentimes, pa- teamwork. Patients whom you compliment
the weather, or family events. All of this tients revert to childhood when in the chair will appreciate the compliment and be a
personal attention is appreciated. When and they want to please you, or at least are better patient. “Thanks for making my work
the patient comes into the treatment room, more suggestible. In the previous exam- easier, I enjoy taking care of you.” I am
make sure you smile, make eye contact, ad- ple, I complimented the patient for being also conditioning myself to enjoy my work!
dress them by name, and chit chat for just a good communicator, and subtly motivat-
a moment to break the ice. If you ask how ed them through a compliment, to be more Okay, how about cognitive dissonance
they are doing, be prepared for the distinct open in the future. Now they like me and and reverse psychology? When I give an
possibility that they will have a list of wor- will do more to make my life easier in the injection to an apprehensive patient, I tell
ries, complaints, medical problems, or let future. The power of suggestion is incredi- them that now that they got the anesthetic, I
downs with family that are bringing them ble! When I tell a patient to swallow, I im- want it to work and the longer we wait, the
down. Laughter is the best medicine, and mediately swallow myself, very often, and number it will get. Then, I leave the room
if you can get them to laugh, their unhap- I think to myself, “Why did I do that?” I and wait. At first, they are apprehensive, but
piness, negativity, stress or sadness will couldn’t help it- it was the power of sug- they want to wait for the numbness to take
be temporarily dismissed. After listening gestion. Next, the phobic patient- what affect. If you wait for about 10 minutes, not
to a laundry list of complaints, I will say, is the greatest fear (they teach this in the only will it get numb, but the patient will
“And what’s the bad news?”, and hope for a military)? Fear of the unknown. Let them transition from apprehension to impatience
laugh. Don’t try this if there are real issues know what is going on and what you are do- about getting things finished. Now you
like a husband with cancer or a divorce, in ing, but not in a lot of detail. “I will be giv- walk into the room and the patient WANTS
those cases I will say, “I’ll add you to the list ing you anesthetic very gently; just a tiny you to get to work!
of those I’m praying for”. Shaking hands pinch and a couple of drops at first to numb

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