Soft skills can help you deliver tough news to your patients and their parents

JoAn Majors, RDA, CSP, discusses four techniques to engage and disarm those who need to hear your message

”But my daughter wears her rubber bands.”
“I was chewing ice/a pen cap.”
“It was wrapped in a napkin, so I threw it away by accident.”
“The dog ate it!”

These statements, as well as a myriad of excuses for broken brackets, misplaced retainers, or any removable appliance, can send orthodontists and their teams over the edge. Most orthodontists have heard all of these, and yet somehow there are times that we just need the “soft skills” that can be disarming and create a new opportunity for listening. Better is the conversation that creates different behavior.

Whether it’s patients, parents, or peers, we all have a need to deliver a less-than-easy message to patients and parents. Some of us can remember with dread a manager delivering news to a team member this way: “Can I see you in my office at the end of today?” This is one of those requests that elicits chills, sweats, even nausea. What is it about a simple request like this that creates dread with everyone involved?

Unfortunately, this is the way most people have learned to handle concerns: Take care of business, lay down the law, or just deliver news. I would like to suggest that when it comes to delivering information that might be upsetting, starting with the right questions and the correct attitude can change everything about the conversation and the outcome.

Four suggestions will allow even the most timid at heart, as well as the brutally honest, a way to offer uncomfortable information while maintaining integrity, having empathy, and disarming the recipient.

It is important to remember a few parameters and realize that it doesn’t matter if the conversation is between a doctor or clinical team, to a patient, or parent. Starting with a question allows the other parties to listen and participate at their rate of speed, not yours.

You must be willing to wait for the answer. This allows the other party to actually choose to engage in the conversation with you. Choosing to engage in a conversation that might not be favorable is something for which we could all use a little more skill. It’s definitely the soft skills that allow us to be able to fall back on a system or navigate a tough conversation rather than to rely on our own natural abilities. The following four techniques for communication with increased soft skills can be used with the orthodontist and or manager to patients, parents, peers, or business vendors.

1. Ask permission to coach

When you have an issue with a patient, parent, peers, or practice vendor and need the individual to listen and participate in certain actions following the conversation, you need to engage the person in the process. You can call the person to your office or respectfully have the conversation in a location that is appropriate for your desired outcome. Find something to compliment before delivering the tough news at hand.

For example, “Susan (or mom), you are (or Susan is) one of our favorite patients. We enjoy when you share your stories about skating competitions, and we would like to see you (or her) be successful with your (or her) braces as well. Do I have permission to coach you on how other compliant patients do this successfully while in school?”

Most people say “yes” because this is less brutal, and it gives you the freedom to discuss her inability to wear her bands successfully or diligently. By having said “yes,” Susan is now involved and engaged in the process. It is a symbiotic relationship; it’s a connection and results in an agreement not a reprimand.

Another example; “Ashley, you are one of our best team members when it comes to friendliness to our patients. Do I have permission to coach you i another area?” Again, she will most likely say “yes” because this is less confrontational, and it gives you the freedom to discuss her constant tardiness, inability to put her personal phone away and get off Facebook on office time, or whatever the issue is. She is also involved in the next process.

2. Ask permission to be honest

When a doctor or team member wants to confront an issue with a patient, parent, peers, or practice vendor, the procedure
works similarly although the words are different. Timing is important, and you never want to make someone look or feel bad or foolish. This will not serve you well, so be discreet in the practice conversations.

For example, one might say to Susan or to her mom, “Susan (or mom), do I have permission to be honest with you?” She will respond with less concern about the outcome because of the level of respect in the request. Besides, who would say, “No, I want you to lie to me?”

Another example, for approaching a team member, “Ashley, do I have permission to be honest with you?” Again, this becomes disarming and less than confrontational than blurting out that you don’t understand her inability to be on time and eat breakfast before she arrives rather than in the morning huddle. It shows that you are concerned that it might create a change in policy for all the team if she can’t work out the timing with her daughter’s daycare schedule. In this case, she’s not “in trouble” but instead engaged in an outcome.

Often people will seem puzzled that you asked permission. Don’t fill in the silence. Wait for their response. No matter how uncomfortable this might seem, it will create the results you want by allowing both parties to listen differently.

3. Leave out the limiting terms

When speaking to someone about their habits, behaviors, or personal life, it is of extreme importance to leave out the limiting terms. For instance, if you are going to discuss a sensitive area, it is normal to want people to like you, so you can use less impactful words such as we, little, just, sort of, and kind of.

Let’s take a doctor-to-patient and administrator-to-team-member scenario. Dr. Likeme says, “Susan (or mom), we have a little plaque around these brackets.” Her thought, if “we” have the plaque, and it’s “a little,” then the solution is, you need to brush better! The administrator or doctor says to the team member, “Ashley, we have a little problem with your tardiness.” The thought that follows, if “we” have the problem and it is “little,” don’t call me out!

How about this? “Susan (or mom), you (or Susan) has plaque around these brackets; I’m concerned about this, and you should be too.”  This allows the patient or mom to own the plaque and concern. For the doctor or administrator and team member, “Susan, there is a problem with your continued tardiness; I am concerned and believe you should be, too.”

These scenarios allow the person to hear the concern. These should only be shared after asking permission to be honest. We have already proven that this question allows the party to be engaged at a different level. It also cuts down on a person’s self-justifying or defense mechanism.

4. Assume innocence — don’t use accusatory language

When delivering tough news in or out of the dental office, do not assume you know everything about the individual or the behavior being displayed. It is often more than meets the eye and the main reason we should start by assuming innocence. When you ask for permission to coach or be honest, presume that the other party has no idea there is a problem or a concern. In other words, assume innocence.

Taking the high road and assume that Susan and/or her mom really don’t fully comprehend the short- and long-term effects of her not wearing her elastics or having plaque around the brackets. Initially, this is only upsetting because you have the age-old belief that you already covered this. You think they should have heard and comprehended this. Research shows the average patient has a dental IQ of a third grader, and that means one mention or initial review of something in a written policy is often not enough. The hard truth about soft skills is that if you take the time to reframe what you need someone to understand by using a question; it becomes about them and not about you!

Just because Ashley is routinely tardy doesn’t necessarily mean she is doing it to disrespect you, her teammates, or the practice. Don’t assume that you know why this is happening. Ashley could be having marital concerns or a new diagnosis that is causing her to have trouble getting kids to daycare. Ashley could have a concern that you should investigate before you use accusatory language that certainly won’t create a culture of trust and understanding. We have to understand the generational shift happening in our practices, and this takes intentional communication.

Assuming Ashley is innocent is much more productive for everyone. If your team member is not doing what is expected in the workplace, assume innocence and ask permission to coach, and then ask if he or she can fulfill the request. Just ask. It is not only the question, it is the cure for misguided and bad relationships in the practice and in life. If you wonder what is happening, then just ask. But when you ask, don’t ask with an attitude of insolence. In our signature Soft Skills and Science courses, the Cycle of 6, the second step is to be curious like a small child! They assume innocence until we teach them not to trust or to be suspicious.

Finally, remember like all important conversations in the practice with patients, parents, or peers, document the conversation, use exact language, and advise you will be documenting it. It’s even appropriate to have the other party initial that you spoke about this.

These four techniques will cut down on the defensive mechanism we all use when we know bad news is coming! Focus on the fix, not the flaw; this can help you encourage others to greatness!