Dear Barry – talking techniques: the better option

dear barryDear Barry – how can I encourage my patients to choose the best treatment option instead of the cheapest?

When talking to a patient about treatment options, the first thing to do is to be in rapport with them.

Rapport creates trust, a sense of being like, and, once established, is likely to increase the chances of your patient agreeing with your ethical recommendations.

The second thing is the way you are presenting the treatment options to your patients.

I am lucky enough to have a treatment co-ordinator that I have trained in the right language skills, knowledge and understanding.

She talks to our patient and ascertains what sort of treatment will be right for them.

It is important with treatment options to keep an open mind and not to allow stereotypes or judgements about a person’s financial circumstances to affect the way treatment is presented.

All patients should be treated the same and given the same opportunities to select the treatment that is right for them.

When communicating with patients, it’s important to recognise that different personalities like to receive information in different ways.

Some people want all the detail while others just want to know the basics.

Similarly, people have a tendency ‘towards’ or ‘away’ from something – we call this a direction filter and it is one of several characteristics, or metaprograms, that helps us build up an idea of a person’s personal preferences.

A patient may want a tooth fixed because they don’t want to feel embarrassed (they move away from the broken tooth), or they want to feel good about smiling (the end-result).

Towards example

Take a look at these two conversations to see what I mean:

Dr: Tell me, what is important about your smile? Why is it important to have a nice smile?

Patient: So that I feel confident and happy when I smile.

Dr: If you broke a tooth, would that affect your confidence and smile?

Patient: Yes.

Dr: Why would you want me to fix it?

Patient: To feel confident and happy again.

This patient is more ‘towards’, they are favourable towards confidence and having a nice smile.

Away example

Now look at the same conversation with an ‘away’ personality:

Dr: Tell me, what is important about your smile? Why is it important to have a nice smile?

Patient: I don’t want to feel embarrassed. I don’t want people to notice that I don’t have a nice smile.

Dr: If you broke a tooth, would that affect your confidence and smile?

Patient: Yes.

Dr: Why would you want to fix it?

Patient: I would feel conscious about smiling if I had an ugly, broken tooth and I would not feel confident.

This ‘direction filter’ helps to understand a person’s motivations and goals, which is useful information when offering treatment options.


I observe the way my patients speak and I reflect their values when I present their options.

This way of communicating is far deeper than pure sales and the patient feels cared for and understood.

Another thing to consider is the way that you phrase a patient’s options.

The word ‘but’ can be very powerful in presenting ideas as we have become conditioned to ignore anything that precedes it.

Look at this sentence: ‘You have a broken LL6 that could be restored with a filling but a better option would be protect and crown it.’

The patient has already disregarded the first option and is focused on the crown because the ‘but’ has negated the first part of the sentence.

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