Diffusing Irate Patients in Dental Practice:
Empowering Dentists through Emotional Intelligence
-Written by Dr. DeAngelo S. Webster
This is one of my favorite communication books. I have gifted copies of this book to fellow dentists as well as to my own staff members. We all have people in our lives that may lose their emotional composure. There is no gauratee that those people have the emotional intelligence to control their own outburts, so as leaders, sometimes we need to help them along. Sometimes those people are our patients.
Dentistry is a profession that, like many others, extends beyond its technical boundaries and delves into the domain of human emotions. An oft-encountered challenge is the management of anxious or irate patients, a situation that requires a blend of diplomacy, understanding, and also firmness. In the book, “De-Escalate: How to Calm an Angry Person in 90 Seconds or Less,” Douglas Noll provides a practical toolkit for navigating these treacherous waters.
The Angry Patient – A Stressful Scenario
A dental office can be a stress-inducing environment for many patients. The very nature of dental procedures, often associated with discomfort and pain, can be a significant trigger for anxiety, fear, and subsequent anger. Adding in the financial stress somtimes caused by necessary dental work and you have a recipe which puts some people at their worst. In such instances, it’s crucial to remember that the patients may lack the emotional maturity and reflection to handle themselves appropriately. Dentists, being at the helm of the situation, can play a pivotal role in diffusing such emotional outbursts.
Conflict Management in Dentistry: Strategies from “De-Escalate”
Listen Actively
The foundation of Noll’s methodology is active listening. An angry patient wants to be heard, and they won’t calm down until they are. As dentists, it is critical to listen to their concerns without interrupting. This first step towards pacification is simple yet powerful, sending the patient a message that their feelings are acknowledged. Even if you do not agree with them.
Active listening isn’t just about staying quiet while the other person talks. It’s about giving them your undivided attention, interpreting the words, the tone, the emotion, and responding accordingly. An angry dental patient often feels unheard, brushed off, misunderstood, uncared for, or even scammed. As dentists, we have to break through this barrier.
It’s essential to put aside our judgments or preconceived notions and give the patient’s concerns the weight they deserve. By focusing on their words and showing understanding, we can send a strong message – that we are here to help and willing to take their concerns seriously. Don’t interrupt; instead, allow them to vent their feelings fully. Only after they’ve finished is it appropriate to respond.
- Put aside all distractions (phone, computer, paperwork, etc.) and focus solely on the patient.
- Show that you’re listening by using non-verbal cues such as nodding or maintaining eye contact.
- Resist the urge to interrupt; let the patient express their feelings fully.
- Paraphrase or summarize what the patient has said to show understanding.
Emotional Reflective Statements
A unique tool that Noll advocates for is the use of Emotional Reflective Statements (ERS). An ERS reflects the emotional state of the person, demonstrating understanding and empathy. For example, if a patient is agitated about a long waiting time, you might say, “I understand you’re feeling frustrated because you’ve had to wait longer than expected.” And then stop talking. Let them process and digest that you have acknowledged the emotion they are likely feeling.
Douglas Noll’s concept of Emotional Reflective Statements (ERS) is an effective tool in dealing with heightened emotional states. An ERS is a verbal mirror of the patient’s emotions – a way of showing that we understand what they are going through. It’s a verbal affirmation that we hear their concerns and empathize with their feelings.
Let’s consider a patient who is upset about having to undergo a lengthy root canal procedure and starting to show agitation. An ERS could be, “It sounds like you’re really worried about how long this is going to take.” This statement doesn’t question or downplay their fear but acknowledges it, thereby opening the door to further dialogue about how to alleviate their concerns.
- Identify the primary emotions the patient is expressing (anger, fear, worry, etc.).
- Craft an ERS that mirrors these emotions, such as “It sounds like you’re really worried about this procedure.”
- Ensure your ERS is accurate, non-judgmental, and compassionate.
- Use your ERS to open up a dialogue about the patient’s concerns.
Create a Safe Space
Dentists should aim to make the patient feel safe, both physically and emotionally. This could mean offering them a comfortable seat, a glass of water, or simply assuring them that their concerns are valid and that you’re there to help.
The physical environment of a dental office plays a significant role in patients’ comfort. Does your dental office look and feel like it is out of a stereotypical sitcom where the dentist is a masochist? Or have you designed the space to be comforting and feel safe? Simple gestures like offering a comfortable seat or a glass of water can provide a sense of physical ease. However, emotional safety is just as vital, if not more so. By affirming that their feelings are valid, that their concerns matter, we give patients the emotional space they need to express themselves.
At the end of the day you know your patient is safe in your hands. But they may not necessarily feel that way if they bring pre-existing anxieties or lack of trust to the table.
Being transparent about procedures, involving the patient in decision-making, and maintaining a non-judgmental attitude – all of these contribute to creating a safe space where patients feel empowered, respected, and valued.
- Maintain a clean, comfortable, and welcoming physical environment.
- Offer comforts such as a glass of water or a comfortable chair.
- Show understanding and non-judgment towards the patient’s feelings.
- Be transparent about procedures, and involve the patient in the decision-making process.
Use Calming Body Language
Non-verbal cues can significantly influence the direction of a conversation. Maintain eye contact, adopt a neutral body posture, and ensure your facial expressions convey understanding, not judgment.
The non-verbal cues we project can have a profound impact on how our messages are received. Eye contact can display genuine concern and attentiveness, while a calm, neutral posture can demonstrate willingness to listen without judgment. Facial expressions also play a vital role – a furrowed brow can suggest confusion or worry, while a neutral, open expression communicates understanding and empathy.
Our body language should project a willingness to engage rather than confront. It should signal to the patient that we are here to support and work with them, rather than work against them. By ensuring our non-verbal cues are calming and non-threatening, we can often diffuse tense situations before they escalate.
The simple difference between crossed arms (Defensive stance) vs open palms (Open stance) can say all certain patients need to hear in terms of body language.
- Maintain steady and sincere eye contact to show attentiveness.
- Keep your posture neutral and relaxed.
- Control facial expressions to display understanding and empathy.
- Ensure all non-verbal cues are non-threatening and project a willingness to engage.
Negotiate Solutions
After calming the patient, engage in a dialogue to negotiate solutions. It might involve rescheduling the appointment, discussing alternative treatment methods, or simply offering assurance about the steps being taken to reduce discomfort.
Once the patient’s anger is deescalated and they feel heard and understood, it’s time to negotiate solutions. Noll argues in his book that before the person has been deescalated, their minds are simply not even capable of rational problem solving solutions. That logical part of their brain is turned off while they are emotionally flooded.
When patients are part of the solution-making process, they feel valued and understood. This inclusion fosters a sense of partnership between the patient and the dentist, helping to reinforce trust and ease tension. Negotiating solutions, however, requires maintaining an open, empathetic dialogue, remaining flexible, and putting the patient’s needs at the forefront.
- Discuss possible solutions with the patient, focusing on their needs and preferences.
- Involve the patient in decision-making, reinforcing their sense of value and respect.
- Be flexible and open to alternative options or compromises.
- Keep the dialogue empathetic, and always place the patient’s needs at the forefront.
Empowering the Dental Environment: An Opportunity in Disguise
Handling an angry patient may seem daunting but, when approached correctly, it can be a potent opportunity for growth. By implementing these strategies, dentists can facilitate a shift from a negative, stressful environment to one of understanding and empathy. It not only diffuses the immediate situation but also helps foster a trusting relationship with the patient, significantly enhancing patient satisfaction and retention in the long run. The patient will earn that you as their dentist are not just ‘the dentist’ but a reasonable human being who they now have a shared experience of navigating an obstacle with.
Mastering the art of de-escalation, as proposed by Douglas Noll, empowers dentists to transform the potentially volatile dynamics with an angry patient. Recognizing that the dental office can be a high-stress environment for patients, and leveraging emotional intelligence to diffuse tension can elevate a dental practice beyond mere technical expertise. It’s about handling the human beneath the patient bib with as much proficiency as the dental procedure itself.
Seeing It In Action
Here is a hypothetical story demonstrating the principles in a dental office setting.
Dr. Jane Bennett had just returned from lunch when her assistant, Mark, told her that her 2 o’clock patient, Mrs. Anderson, was in the waiting room. He warned Dr. Bennett that Mrs. Anderson was irate about the extended waiting time. Armed with her knowledge of conflict management and skills honed from the book ‘De-Escalate’ by Douglas Noll, Dr. Bennett braced herself for the interaction.
Upon entering the waiting room, Dr. Bennett found Mrs. Anderson pacing back and forth, clearly upset. Dr. Bennett didn’t interrupt her immediately; instead, she observed her silently, empathizing with her frustration. She then warmly greeted Mrs. Anderson, maintaining eye contact and using open body language to show that she was fully present in the conversation.
Mrs. Anderson vented her anger about the wait, and Dr. Bennett listened without interrupting. She employed active listening skills, nodding and showing empathy. When Mrs. Anderson finished, Dr. Bennett paraphrased her concerns, saying, “I understand you’re frustrated because you’ve had to wait longer than expected. It’s valuable time you’ve lost, and I sincerely apologize.”
To diffuse the emotional charge, Dr. Bennett utilized Emotional Reflective Statements (ERS). She said, “It seems like this situation has caused you a lot of stress, and it’s completely valid to feel this way.” This acknowledgment helped Mrs. Anderson feel understood and validated, which started to soothe her anger.
Next, Dr. Bennett invited Mrs. Anderson into the dental room, a space that she had always ensured was calm, clean, and welcoming. She offered Mrs. Anderson a comfortable chair and a cup of water, small gestures that nonetheless played a vital role in calming her further.
Throughout their conversation, Dr. Bennett was mindful of her body language. She maintained soft eye contact, kept her body posture open, and ensured her facial expressions communicated understanding and compassion. These non-verbal cues were just as important as her words in conveying empathy and defusing the situation.
Finally, Dr. Bennett involved Mrs. Anderson in negotiating a solution. She apologized again for the delay and explained the unforeseen emergency that had caused it. She then asked Mrs. Anderson for her input on how they could improve her experience, reinforcing her respect for Mrs. Anderson’s feelings. They agreed that in the future, they would communicate more promptly about any delays and possibly reschedule if the delay was too long.
In the end, Mrs. Anderson left the office much calmer than when she arrived. Dr. Bennett had transformed a potential conflict into a platform for strengthening their dentist-patient relationship. This approach not only defused the immediate situation but also laid the groundwork for better communication in the future. As a dentist, her preparedness to handle emotional outbursts allowed her to empower the situation, turning a potentially negative encounter into a positive experience for both herself and the patient.
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