After completion of this chapter, the student will be able to do the following:
• Define the key words associated with patient relations
• Discuss verbal, nonverbal, and listening skills, and explain how each can be used to enhance communication
• Discuss how facilitative skills can be used to enhance patient trust
• Define a relationship of trust between the dental professional and the patient
• Discuss the importance of first impressions, chairside manner, and attitude, and explain how each can enhance patient relations
Patient relations are important for all dental professionals. The dental radiographer needs good interpersonal skills to communicate with patients and establish trusting relationships. Communicating with dental patients may be the most demanding professional challenge that a dental radiographer encounters. The purpose of this chapter is to discuss specific interpersonal skills that enhance communication between the dental radiographer and the patient and to review the importance of patient relations.
Skills that promote good relationships between individuals are termed interpersonal skills. (The term interpersonal is defined as “between persons.”) The dental radiographer must have effective interpersonal skills not only to establish trusting relationships with dental patients but also to promote patient confidence. Technical skills alone are not sufficient for providing optimal patient care. Interpersonal skills must be used in conjunction with technical skills to enhance the quality of patient care.
Communication is a crucial interpersonal skill. Communication can be defined as the process by which information is exchanged between two or more persons. Effective communication is the basis for developing a successful radiographer–patient relationship.
Verbal communication involves the use of language. The dental radiographer’s choice of words is important when talking with the dental patient. Certain words detract from the professional image of the dental radiographer. For example, the term pull sounds less professional than extract, and the word fix sounds less professional than repair or restore. Some words used in the dental setting (e.g., cut, drill, scrape, zap) are associated with negative images and must be avoided. In addition, excessive use of technical words may cause confusion and result in miscommunication. The dental radiographer should always choose words that can be easily understood by the patient.
Careless use of language can contribute to miscommunication between the dental radiographer and the patient. The use of unnecessary words (e.g., “you know,” “it’s like,” “I mean”) may make it difficult for the patient to understand exactly what the radiographer is saying. Excessive use of slang can also increase the chance of misunderstanding.
The delivery of speech is important in verbal communication. The dental radiographer should always speak in a pleasant and relaxed manner. In the dental clinical setting, the use of a soft tone of voice is preferred by patients, as it is soothing and effective in conveying warmth and concern. The use of a loud tone of voice is not appropriate and is often associated with fear, anger, or excitement. The dental radiographer should avoid speaking in a rushed or tense manner as well.
Nonverbal communication involves the use of body language. Nonverbal messages that the dental radiographer conveys through posture, body movement, and eye contact are important when working with patients in the dental clinical setting.
Nonverbal messages can be substituted for verbal messages. For example, a nod of the head indicates agreement, whereas a shake of the head signals disagreement. Nonverbal behavior can also be used to enhance communication. For example, if the statement “It’s nice to see you” is accompanied by a smile, consistency exists between the verbal and nonverbal messages; the verbal message is enhanced by the nonverbal message. When nonverbal messages are consistent with verbal messages, the patient is more likely to relax and trust the dental professional. When nonverbal messages are not consistent with verbal messages, however, the patient is more likely to respond with apprehension and mistrust.
Posture and body movement are important nonverbal cues that convey the attitude of the dental radiographer. An attentive posture and leaning slightly toward the patient, with relaxed, still hands, are nonverbal cues associated with interest and warmth. Conversely, a slumped posture and leaning away from the patient, with arms folded across the chest and fingers tapping, are nonverbal cues that signal indifference and coldness. Patients are more likely to understand and remember information presented by an interested health professional than by a professional whose nonverbal cues signal indifference.
Eye contact is another nonverbal means of communication that is important in the dental setting. When listening to a patient, the dental radiographer should always maintain direct eye contact with the patient; the eyes should not wander. Direct eye contact is associated with interest and attention and plays a powerful role in the initiation and development of interpersonal relationships. A lack of eye contact is often interpreted as indifference or lack of concern.
Listening involves more than just hearing; listening refers to the receiving and understanding of messages. When listening to a patient, the dental radiographer must receive and understand the information being presented. Careful listening results in better communication and less chance for misunderstandings. The radiographer with good listening skills understands what the patient has said and, in turn, is able to communicate that understanding to the patient.
The good listener communicates attention and interest. When listening to a patient, the dental radiographer can use nonverbal cues such as a nod of the head or facial expressions to convey appropriate emotional responses. To communicate interest, the dental radiographer can paraphrase what the patient has just stated to confirm what has been heard.
To enhance communication, sometimes the dental radiographer may want to summarize the feelings of the patient rather than paraphrase the information that has been presented. When a patient is fearful and upset, the dental radiographer conveys interest and concern for the patient when he or she can summarize and emphasize the patient’s feelings.
When listening to a patient, the dental radiographer should give undivided attention to the patient. The dental radiographer should never interrupt or correct the patient, finish the patient’s sentences, look at a clock or watch, or distract the patient by fidgeting or playing with objects.
Facilitation skills are interpersonal skills used to ease communication and develop a trusting relationship between the dental professional and the patient. (The term facilitation is defined as “the act of making something easier.”) In a trusting relationship, the patient feels cared for and understood by the dental professional. In the dental clinical setting, trust involves the belief in the patient that the dental professional will interact in a beneficial way and not in a harmful way. A trusting relationship facilitates the delivery of patient care by reducing worry and psychological stress in the patient. When a patient trusts the dental professional, the patient is more likely to provide information, cooperate during procedures, comply with prescribed treatment, and return for further treatment.
Facilitative skills that enhance patient trust include encouraging questions, answering questions, responding with action, and expressing warmth. The dental radiographer must encourage each patient to ask questions. Many patients may be hesitant to ask questions because they may be feeling intimidated by the dental professional or apprehensive about the dental visit. Inviting a patient to ask questions enhances communication. In addition, the dental radiographer must be prepared to answer the patient’s questions directly. Whenever a patient asks a question, the dental radiographer should respond with accurate information in a direct manner and use language that can be easily understood by the patient.
The dental radiographer must be prepared to respond with action or carry out patient requests. For example, if a patient requests a glass of water, the dental radiographer can respond by providing a glass of water to the patient. The patient feels cared for when the dental radiographer responds to such requests with the desired action. In addition, the dental radiographer must respond to patients with warmth, which can be communicated through voice and facial expression. The dental radiographer who responds to patients with warmth is friendly and smiling and shows interest in the patient. Warmth communicates that the professional cares for the patient as a person.
In dentistry, the term patient relations refers to the relationship between the patient and the dental professional. Patient relations are important to all dental professionals: the dentist, the dental hygienist, and the dental assistant.
The relationship between the patient and the dental professional begins with first impressions. The patient’s first impression of the dental team most often involves the dental auxiliary, specifically the auxiliary’s appearance and greeting.
The professional appearance of the dental auxiliary is important. The dental auxiliary should always wear a clean uniform and be well groomed. Strict attention must be paid to personal hygiene, including handwashing and maintaining fresh breath. In addition, the dental auxiliary should never eat, drink, or chew gum while working with patients (Boxes 12-1 and 12-2).
In many offices, the dental auxiliary is the first dental professional to meet and greet the patient. The dental auxiliary should always greet patients in the reception room before escorting them to the treatment area. Patients should always be greeted by name. The dental auxiliary should address the patient using the patient’s proper title (Miss, Ms., Mrs., Mr., Dr., Rev., etc.) and last name. If uncertain about the correct pronunciation of the name, the dental auxiliary should find out the correct pronunciation from the patient. The dental auxiliary should always introduce himself or herself to the patient, using both name and title. A typical first greeting is given below:
The relationship between the patient and the dental professional develops as the professional works with the patient. Chairside manner refers to the way a dental professional conducts himself or herself at the patient’s chairside. The dental auxiliary must develop a relaxing chairside manner that makes the patient feel comfortable and at ease.
The dental auxiliary must also convey a confident chairside manner. The patient must be confident about the auxiliary’s ability to perform radiographic procedures. The dental radiographer must avoid comments such as “Oops!” and other statements that indicate a lack of control. The patient must feel that the operator is in control of all procedures being performed. One way to convey operator confidence is to explain to the patient exactly which procedures are about to be performed and then answer any questions the patient may have about the procedures.
In most dental offices, the dental auxiliary is responsible for performing radiographic procedures. However, some patients may be apprehensive about allowing a dental auxiliary to perform such procedures because they are accustomed to the dentist performing all procedures, including radiographic procedures. As a result, these patients may object to a dental auxiliary performing any services for them. In such cases, the dental auxiliary must try to establish a relationship with the patient by explaining the concept of the dental team. The dental auxiliary can educate and orient the patient to the dental team members and their respective roles and responsibilities. The dentist may then reinforce such information and reassure the patient before the dental auxiliary performs the radiographic procedures.
Patient relations and management skills with regard to persons with specific dental needs is discussed further in Chapter 24, specifically patients with physical or developmental disabilities, as well as pediatric, endodontic, and edentulous patients.
The attitude of the dental auxiliary will affect patient relations. Attitude can be defined as “a position of the body, or manner of carrying oneself, indicative of a mood.” The attitude of all dental auxiliaries must be professional and should include such attributes as courtesy, patience, and honesty. The dental auxiliary must be courteous and polite toward all patients at all times. Patience, which includes both tolerance and understanding, is important, especially when dealing with an uncooperative or difficult patient. Honesty is also a vital part of a professional attitude. Some procedures are uncomfortable in dental radiography, and the dental auxiliary must be honest and inform the patient of the potential discomfort.
• Communication is an important interpersonal skill and the basis for developing a successful radiographer–patient relationship.
• Verbal communication involves the use of language. The dental radiographer’s choice of words is very important; words that detract from the professional image of dentistry and words associated with negative images must be avoided.
• Nonverbal communication involves the use of body language and includes messages conveyed by posture, body movement, and eye contact. A patient will respond positively toward the dental professional whose nonverbal cues signal interest and warmth; a patient is less likely to respond to a dental professional whose nonverbal cues signal indifference and coldness.
• Communication also involves listening skills. The dental radiographer with good listening skills understands what the patient has said and is able to communicate that understanding to the patient. The good listener communicates both attention and interest.
• Facilitation skills make communication easier and develop a trusting relationship between the patient and the dental professional. Facilitative skills include encouraging patient questions, answering patient questions, responding to patient requests, and communicating with warmth.
• Patient relations refers to the relationship between the patient and the dental professional. The dental auxiliary must develop a relaxing and confident chairside manner that makes the patient feel comfortable.
Frommer, HH, Savage-Stabulas, JJ, Patient management and special problems. Radiology for the dental professional, ed 9, St. Louis, Mosby, 2011.
Johnson, ON, Thomson, EM, Patient relations and education. Essentials of dental radiography for dental assistants and hygienists, ed 8, Upper Saddle River, NJ, Pearson, 2007.
________ 1. Skills that promote a good relationship between individuals are termed facilitation skills.
________ 2. Technical skills alone are sufficient for providing optimal patient care.
________ 3. The excessive use of technical words may confuse the patient and result in miscommunication.
________ 4. The delivery of speech is important in verbal communication; the dental radiographer should speak in a pleasant, relaxed manner.
________ 5. Nonverbal behavior cannot be used to enhance communication.
________ 6. If verbal messages are consistent with nonverbal messages, the patient is likely to respond with apprehension and mistrust.
________ 7. Patients are more likely to understand a dental professional whose nonverbal cues signal indifference.
________ 8. Eye contact plays a powerful role in the development of interpersonal relationships.
________ 9. Listening involves only hearing.
________ 10. When listening to a patient, the dental radiographer can use facial expressions to convey appropriate emotional responses.
________ 11. Interpersonal skills are skills that are used to make communication easier and develop a trusting relationship between the patient and the dental professional.
________ 12. When a patient trusts the dental professional, the patient is more likely to comply with the prescribed treatment and return for further treatment.
________ 13. The appearance of the dental auxiliary is important.
________ 14. In many offices, the dental auxiliary is the first person to meet and greet the patient.
________ 15. A patient should always be greeted by his or her first name.
________ 16. It is appropriate for the dental auxiliary to chew gum while working with patients.
________ 17. The dental auxiliary must develop a fast-paced, confident chairside manner.
________ 18. In most dental offices, the dental auxiliary is responsible for performing radiographic procedures.
________ 19. The attitude of the dental radiographer affects patient relations.
________ 20. The dental radiographer does not need to be courteous if a patient is uncooperative or difficult.