We talk a lot in dentistry about what questions to ask our patients to help them move toward health. Whether interviewing a new patient, or reconnecting with an existing patient, everyone has their favorite questions. But as important as the questions are, our intention — what we are listening for — is far more important.
We know how to listen with intention. We can listen for information; to gather and record data. We can listen for symptoms, to sort for a differential diagnosis. We know how to listen for commonalities to build rapport.
My goal in conversations with new patients, or those I’ve known for years, is to listen for health. Wherever the conversation takes us, my intention is to remain curious about how what they tell me relates to their health.
Conversations about Thanksgiving dinner, the pandemic, illness in the family, or stressing over holiday shopping, all have the potential to help me learn about how patients care for themselves. I can learn about how they tend to move toward health, or barriers they see to that. I can understand their challenges rather than judging them.
When I review a health history, I am not satisfied with just gathering data about existing conditions or diseases. I also want to understand the patient’s attitudes, beliefs, and knowledge about their health. I want to listen for clues as to what is important to them, and to how they make decisions in all areas of their lives.
If a patient reports a history of diabetes or heart disease, for example, I might ask how they manage that or how it affects their life. Beyond the medical fact of the condition, I want to understand how much control they see themselves having over their health.
I listen for what behaviors they have been able to incorporate, and where they seem to feel powerless. The more I understand about the way they deal with their overall health, the better I can help them manage their dental health.
Some of my favorite questions to ask patients are about how they care for themselves. With new patients I might ask: “What do you do on a regular basis to keep yourself healthy?” With patients I have known for some time I might ask, “How do you account for your good health?” “How are you taking care of yourself while trying to work from home and home school your children?” I listen for how aware they are regarding their bodies, and how willing they are to take time for themselves.
Whenever I hear about any positive behavior change a patient has made, I listen for two things: Motives and Strategies. If a patient quite smoking, changed her diet, incorporated an exercise routine, or any other significant change in behavior I want to know what was important enough to them motivate that change. I see myself as a change agent tasked with helping my patients change the way they think about dental health and often changing behaviors as well. The more I can ground a patient in success they have had in the past, the more likely they are to see possibilities for the future.
The second thing I want to know is what strategies they used to change their behavior. Those strategies can create a platform on which to help them build new strategies for change. Over and over again I have been surprised and delights by how much more creative and more powerful their strategies are than any ideas I could come up with!
If you have ever been awestruck by an intuitive practitioner who seems to have an uncanny ability to engage patients in moving toward health, you have probably met someone who has learned how to listen with intention. It is a learnable skill. Like any skill it improves with practice.
Remind yourself to listen for clues about your patients’ attitudes and beliefs about health. More and more you will begin to hear about their hopes, fears, and values. You will become more curious about what else there is to learn.
When you listen with intention, your intuition will deepen. You will see things more clearly. Your confidence will expand. And you will help your patients discover a path to health.
To read a more in-depth discussion of an application of this topic click here: “Improving Case Acceptance.”
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