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Bridging the expectation gap

Post date: 11/12/2018 | Time to read article: 4 mins

The information within this article was correct at the time of publishing. Last updated 03/04/2019

Dentists see a lot of patients every week, for a number of different reasons.  With a focus on appointments and treatments being carried out efficiently and on time, it can be easy to end up with a communication gap between what a patient expects and the realistic outcome.

At some point during their career most dentists will have heard a patient say “I just want all my teeth to be straight”, or “Can you whiten my teeth and make them the same colour?” The amount of dental work required in these situations, however, can vary, so it’s up to the dentist to fully communicate and educate their patient on what’s required and what’s actually possible.

Ensuring your patient knows exactly what to expect from the moment they walk into your practice is the key to building good relationships and your reputation among your current and prospective patients.

A brighter smile

With cosmetic dentistry on the rise and a good smile becoming increasingly desirable, patients are often looking for a quick fix or simple solution to their dental problems.

The internet provides patients with a wealth of information about the procedures and options available to give them the teeth they want. This gives patients unrealistic expectations about what’s possible, posing a real problem for dentists. If a patient doesn’t get the results they were expecting, they are more likely to complain.

If you feel something they are requesting is not realistic, you need to stop and talk. Dentists should never rush into providing patients with treatments just to make them happy, as it is likely to cause problems down the line.

Cross the bridge

With complaints and claims in dentistry on the increase, it’s up to dentists to be transparent and completely honest about what the outcome of any treatment or procedure is likely to be; this should be discussed with the patient and compared to their own expectations.

The GDC requires informed consent from all patients before a treatment is carried out, and to get this you need to ensure patients are aware of the procedure, any alternatives available and the potential risks involved. Through joint decision-making, dentists should be preparing patients for a treatment or procedure by working closely with them to put a treatment plan in place, and communicating with them about every step involved.

Being open with your patients will build a good rapport and encourage them to be open with you. Talking through any concerns or issues they have allows you to be more honest with them in terms of what they can expect – a perfect smile isn’t always realistic.

Take a breath

It’s so easy to be defensive if a patient complains about the dental work you provided. If you do find yourself in this situation and you’ve made an error or suffered a system failure, it’s important to take a breath before reacting.

The first thing to do is calmly listen to what your patient says and understand what the problem is and why they are upset. Just feeling like they’ve been listened to and their feelings are acknowledged can go a long way towards preventing a patient taking things any further.

Once you’ve heard what the issue is, it’s a good idea to show regret for how they are feeling – an apology is often all a patient wants if their expectations haven’t been met.

Hopefully, with good preparation and two-way communication, you will always end up with happy patients whose expectations are met time and time again.

Case Report

Patient dissatisfied as they did not get the treatment they expected

A patient was suffering with pain from her wisdom tooth and was unable to attend her usual NHS dentist due to missing a couple of appointments. After some searching she found a local, private practice that was open for late evenings and weekend appointments, which would be able to accommodate her.

An appointment was made via a telephone call to one of the practice receptionists, and the patient explained the symptoms she was experiencing. She also explained she would like an examination and a scale and polish, as she had not visited a dentist for a while. The receptionist booked the appointment and provided an estimate for the emergency appointment only.

The receptionist did not explain that routine treatment is not provided during the emergency appointments. She also failed to advise the patient that any treatment during the emergency appointment would be charged in addition to the minimum standard fee.

When the dentist saw the patient he diagnosed pericoronitis associated with the lower right wisdom tooth. He established there was some debris trapped underneath the operculum and the opposing wisdom tooth was causing a degree of trauma to the soft tissue as it had over-erupted. The patient explained this was the third or fourth time she had suffered with pericoronitis and the dentist discussed the possibility of extracting the tooth or the opposing tooth in the future. He suggested this should be explored in detail during her next examination appointment and for her to arrange one as soon as possible. He then proceeded to irrigate the area and slightly adjusted the opposing tooth.

The dentist was surprised to receive a complaint and request for a refund from the patient the next day. The patient was upset she had been charged more than she had expected and then did not receive the examination with a scale and polish she had hoped for.

When the dentist called Dental Protection, it was established the patient had not been provided with clear information about the treatment she received and the costs incurred. The member realised he presumed the patient had been provided with the information by the reception team and that he failed to explain to the patient why she had been charged £20 on top of the £49 emergency treatment fee.

On reflection, he appreciated his miscommunication and refunded the patient. During his next practice team meeting he  advised the reception team that they would be using a scripted appointment booking system to mitigate the chance of this occurring again, and that all patients would be presented with an itemised treatment plan and estimate before embarking upon treatment.

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