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Trojan Today Classic: “Working Together for Effective Communication” by Belle DuCharm

Originally published August 2004 in Trojan Today.

The patient is on time, but the dental assistant is busily talking about her weekend getaway. The doctor was supposed to sign the lab slip; now the courier is here and the doctor is in surgery. Mr. Brown wants veneers on #7-10 predetermined by his insurance company, but the assistant forgot to take periapicals and intraoral photos of the area. 

How do you handle such situations? Tell the patient that someone will be with him shortly while you buzz the light system again? Walk to the back office and glare at the assistant? Forget a signature on the lab slip and hope that all the instructions are complete on the slip? Tell the courier to come back at another time? Call the patient and reappoint him for records? Send in the predetermination with the old x-rays? 

There are many choices. Ignoring problems, fixing them yourself, complaining under your breath, as well as getting angry and impatient are responses to stressful situations and may appear to solve problems on a short-term basis. Long-term effects are likely to follow. Anger and resentment build with time, and repressed anger can lead to physical and emotional problems such as headaches, digestive disturbances, high blood pressure, and depression. Losing a valued employee to burnout is the price many practices pay for unresolved, long-term, stressful work environments. 

Asserting yourself effectively is probably one of the most challenging communication skills to develop. If you do not have the right attitude and verbal skills, you will do more harm than good. Experience is both the best and worst teacher; I have learned how to avoid putting someone on the defensive which only incites more uncooperative behavior. 

The first step in asserting yourself effectively is to realize the problem you are experiencing is your own. For example, the dental assistant who hasn’t seated the patient doesn’t see it as a problem that the patient has to wait a few minutes. The doctor doesn’t care if the lab slip isn’t signed in a timely fashion. The fact that you don’t have the proper records to do a predetermination for veneers is not a concern for the assistant. Instead of blaming, judging, or attacking the other person, how about expressing your own concerns and feelings and then asking for help?

Try this approach: 

Describe the problem. 

What is the situation or behavior that is bothering you? Is it that the assistant is talking to another co-worker, or is that the patient was on time and now has to wait? Describe to the doctor that the courier for the lab comes to this area only two days a week; by not signing the lab slip, the case won’t be back at the seat date. Are you assuming that the assistant and the doctor know what records you need to file for a pre-estimate? The doctor and the assistant should be told that Mr. Brown wants the veneers but needs to know what his insurance will pay. Without records that demonstrate the need, it is unlikely there will be coverage. 

Verbalize your feelings. 

Explain to the other party how the problem affects you. Remind the assistant that patients are told to be on time. When they are left in the reception room too long, they begin to doubt the importance of customer service and they complain about the wait.

Be specific with a solution. 

State what you would like to see done. In a firm but pleasant tone, ask the assistant to “please seat the patient as soon as you see the light system signal. If you cannot seat the patient immediately, please tell me why so I can tell the patient there will be a wait.” 

Describe the consequences.

Finally, articulate the positive consequences that will happen if the other person fulfills your request. The patient will be happy and more likely to recommend his relatives and friends to the practice. The schedule will stay on time so that everyone will get a lunch break.

Suggested Tips for Effective Assertiveness: 

Speak up immediately. 

Don’t wait for hours, days, or weeks, before approaching the other party about your problem. If the problem is addressed when it happens, resentment and frustration will not build to an explosive outburst. Be direct. For instance, explain to the doctor that the lab slip needs to be filled out and signed immedi­ately or you will have to interrupt him during another procedure. The lab could make a mistake if something is left off the slip, or the delivery date of the case can be delayed if the lab slip is not signed when the courier arrives.

Be pleasant.

A friendly tone _of voice and a smile will make others more willing to do what you would like them to do. Saying “Thank you for your help” works wonders.

Be calm.

Staying composed will help to maintain your credibility and to attract the sympathy of the other party. Saying “I need your help with this problem” has worked well for me.

In conclusion, continue to deliver your message until it is received, and the results are to your satisfaction. It takes patience t o see results sometimes. Consistency helps the learning process so don’t give up. Sometimes the system needs to be changed or rules need to be added to your Office Policy Manual for the entire team to understand. For instance, if neither the doctor nor the assistant is aware of what diagnostic tools you need to do a predetermination, make a written system to direct them. Write down what you need to file predetermination for the major services that you provide and put it on the agenda for the next staff meeting. Place a copy in the Procedural Section of the Office Policy Manual. 

Remember to keep smiling!

Belle M. DuCharme, RDA, CDPMA brings to the profession of dentistry more than 40 years of practical experience. 

FMI: 877.900.5775 or 760.632.6348 or E-mail:


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