Of all the issues that create stress for dentists cited in my survey in March 2020, ‘patient expectation’ was probably the most triggering. Over a third of participants stated that this one thing had been the most significant factor in changing their perception of dentistry. If we explore this below the surface, it’s easy to understand why.

When a patient states what it is that they want, without regard to our knowledge, experience or expertise, it can lead us to feel that they have demanded we do what they want. We can feel undermined and a degree of self-doubt can be triggered. This is not necessarily because we don’t know our stuff, but because it makes us second guess ourselves, and in the moment, we are irritated with the patient for ‘making us’ do this.

There’s also another feeling that can come up for us, which is being disrespected. This can show up in many different ways. One of the most upsetting is when a patient doubts our integrity. As I’ve experienced, an accusation that “you’re just trying to make money out of me”, feels both insulting and disrespectful. Their belief that you are not focussed on their best outcome, but are only suggesting a course of action to line your own pockets only adds to your sense of righteous indignation, and your inability to voice it, is probably the most frustrating of all.

So what needs to happen in these situations?

Well, on a practical level, when patients ask for the seemingly impossible, or they just ‘don’t get it’, it may help to take the view that they are just asking? In their state of anxiety and lack of knowing any alternatives, they could be asking about the only option they know about, or the one they have been told about by their friends or family. How many times have you heard ‘but RCT is really painful, so and so told me not to have that’? Answering from a place of providing information as to why their option may or may not work and offering alternatives, instead of being irritated by the question, will help build a stronger trusting relationship with the patient. The treatment usually is carried out smoother too!
You may have been asked tens of times by other patients but to that patient, it is personal to them. So understanding their point of view will help you both.
Frequently, we expect patients to have an understanding of what is basic and obvious to us. They wouldn’t be asking if they knew the answer and they deserve answering with that in mind. Also, we all have a different level and way of understanding. If we listen to that individual patient, we can understand what it is that they are asking and respond in a way that is appropriate to them. This way, they feel listened to and respected, and open to building a better relationship.

Next time a patient demands something of you, pay attention to your initial internal response and see how that affects your response to your patient

How does your idea of patient expectation affect you?