Difficulties in building rapport with patients after COVID-19

building rapport whilst wearing PPE

As wearing more PPE becomes the norm, Laura Hunter-Shaw explores how we can still build rapport with our patients.

Common things we hear every day as dentists, especially as a new dentist in a practice, is ‘I hate the dentist, it’s nothing personal’. As if it’s a reflex to walking through the door. We laugh it off, smile and change the subject quickly to distract from the fact you know they are currently trying to spy any sharp objects on the sides and map out potential escape routes from the room.

According to statistics from the Oral Health Foundation, over half of UK adults have a fear of the dentist. And 12% of these suffer from extreme dental anxiety or phobia. Along with the fear of pain and a previous bad experience; the sounds, uncertainty and lack of control are all recurring themes people cite as to why they do not want to visit us. Out of context, I don’t blame them.

As a profession, we have spent years trying to make the dental environment less scary and more accessible for patients. We try to repair the bad reputation that school dentists have given us in the minds of so many. We spend thousands of pounds improving the ‘patient journey’. Practices create a friendly atmosphere by wearing brightly coloured scrubs, covering our walls in posters and spending time getting to know our patients. We become experts in building rapport and trust in a short space of time. Our quickest and simplest tool is a smile. As a young dentist, I find that what I lack in clinical skills and experience, I make up for with a friendly demeanour and ability to make patient’s feel at ease. At the end of the day, this is the bit that patients remember. It allows you to complete the treatment that you love to do.

How COVID-19 has changed things

The emergence of COVID-19 is jeopardising all this progress. As if being in pain, and being treated with ‘advice, analgesics and antibiotics’ over repeated telephone triages hadn’t already lost some of your confidence in the profession, the potential protocol for reopening dental practices might be enough to put you off for life.

Treating every patient as if they are positive for COVID-19, it is difficult to be anything other than brief. You might replace the once bustling, relaxed waiting area with your own angst and the need to remain in your car. No reassuring smiles from others in your position.

You then usher patients into an eerily quiet building and into a surgery – already set up for ‘worst case scenario’ to prevent the need for finding other equipment if things don’t go to plan. The nurse who has comforted you this far, then leaves you in a surgery with a dentist and nurse, whom you have most likely never met before. Both possibly already wearing a full gown, mask, gloves and visor.

Not much chance of building rapport or trust at this point. I think it is safe to say that if this was a horror film, my heart would already be racing. That’s before they decide the fate of your tooth!

With ‘the good old days’ pre-COVID seeming like a distant memory and unlikely to return anytime soon, we are going to have to rely on the relationships we have built up until this point and new ways of connecting with our patients. At this point I think things could go either way. The pandemic may have cemented your patient’s relationship for life, or traumatised them beyond repair.

The following are my tips for improving patient experience with the new standard operating procedure.

1. Clinician to contact patient the day before via phone or video link

As per the updated standard operating procedure, we require all patients to contact the practice the day prior to their appointment to confirm their COVID-19 status. It would be beneficial for the treating clinician to do this and preferably by video link.

Not only will the clinician be able to assess the patient’s medical history and presenting complaint for themselves, cover the anticipated protocol and discuss any other concerns, but they get a head start on that all important rapport, which is otherwise lost.

This is likely to reduce the anxiety of the patient and improve treatment outcomes.

2. Cover instruments until patient is in the room

We all know that a luxator just looks like a big chisel to patients and their perception of a needle is slightly warped. Nobody needs to see that when their senses and anxiety are already heightened.

It’s not going to delay anyone by covering instruments until the patient is in their chair.

3. Display a photo of the clinicians so the patient knows what they look like

If the clinician is unable to do a video link themselves, why not have a photo displayed to show patient’s what they look like under all their PPE. This has gone down well in hospitals so why can’t we do the same?

Choose a funny photo – give the patient something to smile about. You will see them breathe and their shoulders relax.

4. Use of music during treatment

We know that distraction is a great technique for reducing anxiety in a dental setting.

Why not ask your patient who their favourite artist is and put it on in the background? It gives them something else to focus on and will make them feel more relaxed.

5. Be empathetic

We know that people are scared. Scared of the virus, scared of the dentist and scared of the unknown.

It is our job to make this difficult time just that little bit less daunting – even when they can’t even see us smile.

GSKFind out more about Dentistry’s Back to Practice campaign. 


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