Discussing treatment plans with patients

The radiographs have been taken, probing depths measured and it is time to present the plan to your patient. Behind the scenes, you have studied the patient’s case and know the ideal treatment. You’ve gotten faculty input and you are ready to discuss options with the patient. After presenting your ideas, the patient disagrees with your proposed plan and seems noticeably aggravated. How do you communicate effectively to help the patient understand the risks and benefits of treatment?

The first step in effective communication is to listen. Why are they disagreeing with the proposed plan? Listen to what the patient is saying. Do not judge them based on their treatment decisions. They have the right to select treatment options as long as they are properly informed. Listen carefully and ask questions as needed to understand where the patient is coming from. Each patient will have a different set of beliefs that need to be respected and considered when proposing treatment.  What is best for one patient may not work for another due to cost, time commitment or other factors. Actively listen to what the patient is saying to open the line of communication. There is a reason we ask patients each visit what their chief complaint is.

After actively listening, confirmation of patient understanding must occur. We devote years to learning a complex vocabulary that we understand. Reflect back on the first few weeks of oral anatomy class. Mesial, distal, marginal ridge, transverse ridge. These terms are confusing to our patients. Ensure that you have been concise and clear with the proposed plan. A good way to confirm understanding is to have the patient repeat the plan in their own words. If they are able to do this, the patient likely understands the treatment. Remember, comprehension also requires a discussion of the risks of postponing or opting for alternative treatments.

Relay the facts to the patient.  Be forthright and honest with them. Tell them what can happen. Explain where the alternative treatment plan falls short compared to the ideal. Discussing options candidly can help patients understand the current state of their oral health. As future dentists, we are responsible for providing treatment that is beneficial without causing harm. We are also obligated to protect our patients from decisions that are more likely to lead to a poor outcome. Our patients cannot always appreciate when certain treatments are not suited for them. We must explain the truth in an unbiased way even if our patients do not agree with it. At times it may be difficult, but our patients will respect being told the truth.  

Not every patient is going to agree with the ideal treatment plan every time. In my limited experience, patients rarely completely accept the ideal treatment plan. Disagreements can be for multiple reasons including time commitment, finances or past experiences. It is important to listen to patients and ensure that their needs are met. Nevertheless, be careful that patients do not dictate the entire course of treatment. Maintaining an open line of communication with patients is important to make certain they comprehend treatment decisions. Simply listen, share the facts, and respect the patient’s decisions about proposed treatments.   

~Jerad Servais, Minnesota ’18, electronic editor

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About Jerad Servais

Jerad Servais is a fourth-year dental student at the University of Minnesota school of dentistry. When he is not performing duties as an electronic editor for ASDA he enjoys spending time with his wife, family and friends.

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