Are you in control?

PatientAndrew Hepburn, Primespeak business manager for Software of Excellence, discusses how understanding patient behaviour can give dentists an ethical perspective when it comes to new patient consultations

Who takes control in new patient consultations may seem to be a fairly straightforward question. As the professional, surely it is the dentist who always takes control, guiding the conversation and making appropriate treatment recommendations? But now a new technique is turning this concept on its head, using the psychological theory of human behaviour to support its application.

Although people like to say they are always in control, what they actually like and need is the sense of having control. Indeed one of the main pitfalls for salespeople is that they often hang on too tightly to the reins of control. In dentistry we can obviously say that professional recommendation is clearly the remit of the dentist, however, there is also a sense of control that is derived from their superior knowledge and experience in a particular subject. This means that often without meaning to, discussions can be interpreted by patients as a ‘sales pitch’, particularly where elective treatment is concerned.

However, by using human behaviour theory we can think about control in a different way, making it possible to surrender control with one hand, in order to regain it with the other. Firstly, by choosing when where and how you give control, you in fact still retain control in a given situation. Secondly, having allowed a patient to seemingly take control you can then evoke a sense of reciprocation, whereby the patient is more willing to allow you as the professional to retake control of the conversation.

Patient in control

Primespeak is a technique that encourages dentists to use the theory of human behaviour to better understand communication and its objectives are threefold:
•    To make the patient aware of their oral health and the damaging results of existing conditions. This generates concern in the mind of the patient and forces them to take ownership of their dental problems
•    Ensure the patient fully understands the treatment options and acknowledges that the choice of treatment is their decision – this makes patients have a sense that they are in control
•    Ensure the patient feels supported and respected regardless of the treatment they choose. This creates a sense of loyalty to the dentist and the practice.
As professionals, dentists need to fulfil their ethical duty. By using the five laws of patient behaviour as a foundation for guiding patient communication, particularly during new patient examinations, dentists can be more strategic in their effort to build trust, expose conditions, and deepen concerns. The result is that patients see and own their own oral health problems, and are left looking and asking for treatment solutions, rather than feeling pushed into or ‘sold’ solutions.

1. Motivation

This law is focused on identifying whether patients will be more motivated to seek treatment in order to get a pleasing outcome, or in order to avoid pain. Psychologists tell us that the latter is always a stronger motivator and this idea can be used to highlight the consequences of non treatment. The degree of a patient’s concern is always directly proportional to their desire for a solution. Constantly talking about solutions can be interpreted by patients as a ‘salesy’ approach, which is why Primespeak encourages dentists to focus on the problem (and the avoidance of any future associated physical or emotional pain) rather than just the solution.

2. Self-interest

Patients like to feel that they are unique, that their issues are important, and that their opinions are heard. The law of self-interest challenges dentists to ask more questions, really listen to their patients, and demonstrate understanding and empathy – skills that don’t necessarily come naturally to most dentists.

3. Control

If patients feel they are being controlled or manipulated they are less likely to be compliant. Whilst it is imperative to recommend essential  treatment, dentists can avoid rejection by not overtly making recommendations for elective treatment. Every recommendation for elective treatment has the potential to be perceived by the patient as a sales pitch. It is usually the process by which information is delivered, rather than the information itself, that is the trigger for objection. Dentists can avoid this scenario by positioning themselves as supportive friends rather than objective experts, always looking for opportunities to give the patient a sense of control.

4. Momentum

Beliefs have momentum and direction. Challenging a patient’s beliefs head on or making them wrong for their (potentially misguided) beliefs, can be antagonistic and cause them to hold onto those beliefs even more firmly. If dentists can seek to first empathise and align themselves with the patient’s thoughts and feelings, then they have a chance of being able to turn things around.

5. Withdrawal

It is a human characteristic that we often have a greater desire for that which is just out of reach. If we relate this to the new patient examination we can say that when a patient knows they have a problem but are unaware of the solution, they are more likely to want the solution. In traditional selling, the dentist steps forward and suggests a treatment, but this approach can make the patient wary and thus step back. Primespeak takes the opposite track – making the patient aware of their condition and then stepping back without exerting pressure makes the patient step forward and positively request a solution. This counterintuitive approach again puts the patient seemingly in control of the situation which is conducive to them being more accepting of the treatment options put before them.


By using these techniques, the many dentists who are uncomfortable with the idea of ‘selling’ treatment plans can be assured that their professional integrity remains intact throughout the process. It enables them to take a more relaxed approach to new patient examinations, but at the same time delivers results by placing the emphasis on patients to make decisions and take responsibility for their own oral health.

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