Excerpt from “Consensus on Verbal Skills that Help Build a Dental Sleep Medicine Practice”

The LinkedIn Discussion Group, “SleepDisordersDentistry” has just completed an open discussion on “Verbal Skills” that help build a dental sleep medicine practice. The full consensus statement is available at the LinkedIn group.

What was asked

“Building a Dental Sleep Medicine Practice has proven to be both exceedingly rewarding and exceedingly difficult. Obstacles abound; physician resistance, re-imbursement resistance, misinformation about oral appliances, fear of side effects such as bite changes, the learning curve involved, etc.
Let’s share our personal experiences, tips, suggestions, and in particular, “Verbal Skills” that effectively deal with these barriers…
What was said
Tony Soileau posted links to videos he created, directed at the layperson, to communicate sleep issues with patients. Kent Smith shared that he viewed these videos repeatedly to glean phrases that may come in handy in his practice.
Rob Suter feels that inadequate “Verbal Skills” is one of the primary reasons more patients don’t get diagnosed and treated.
“University of Chicago hospital used the Stop-Bang on 1,000 patients and tracked only 8% getting treatment! So 92% with high risk for OSA fell out of the sleep channel at one of our top Academic Hospitals.”
Rob insightfully suggested that if this is the success rate experienced in a top-tier Health Centre, as dentists we have to work that much harder to motivate to therapy. His company, OSA University, softens the term ‘Sleep Apnea’ to “Airway Health.”
“Instead of saying you could die of an MI or have a stroke, focus on things people really care about: Weight, Energy, Cognition, Skin Quality, etc. Those are the things people spend tons of money on and are motivated by.”
Rob shared: “Many DDS teams can’t handle sleep phone calls if they aren’t trained or experienced to collect key pain points and verbalize what OAT or PAP can do to relieve that pain point.”
Steve Carstensen joined in and provided something he learned at the Pride Institute many years ago.
“The first point is to learn what is the Chief Complaint. Nobody wants a “MAD”, they want to “Stop Snoring”, for example. This communication is not unique to medicine, it’s universal human connectivity. We must address others where their concerns lie. For patients, it is the symptoms. For our colleagues, it is a mixture of their commitment to improving their patients’ health and their business. When we take time to learn what other’s hot buttons are, we can shape our responses to keep them involved in the conversation. If a patient calls and says “I want to stop snoring’ and we talk about ‘AHI’, we’re not meeting them where they are. Doesn’t mean our clinical wisdom isn’t important, it just means we are not giving the encounter enough chance to be successful.
If our collaborating physicians perceive that we do care about them, their patient outcomes, and their desire to remain in the treatment loop (no matter what their motivation for that is) then we have a better provider team. Better communication comes with focusing on the other person.”
Todd Morgan stressed the importance of a well-trained team and the “Hand Off” approach he uses in his office. Todd’s assistant acts much like a PA in the sense that they work-up the patient’s Chief Complaint (CC) and History before he sees them. The assistant will then “Hand-Off” the patient to Todd while reciting the CC, prior issues and History. Todd finds that this system saves time and the patients feel like they have been heard!
Kent and his team listen for the “M&M”, or “What Matters Most” to the patient. Kent places the patient’s M&M in the chart note to refer to when following up as the patient’s progress through therapy. The M&M is also passed on to the physician and the financial coordinator (if needed), so the patient is kept aware of why they actually made the appointment in the first place and how far they have come as therapy progresses.
Once again, I would like to thank all those clinicians that took the time to participate in this discussion, this consensus article is intended to provide guidance for those that are new to this area of practice and also to provide valuable insights for those of us that have been at this a while. I look forward to your participation in future SleepDisordersDentistry LinkedIn discussions.

viviano_headshotJohn Viviano, DDS, DABDSM, obtained his credentials from the University of Toronto in 1983. His clinic is accredited by the American Academy of Dental Sleep Medicine and is limited to providing conservative therapy for Sleep Disordered Breathing and Sleep Bruxism. A member of various sleep organizations, he is a Credentialed Diplomate of the American Board of Dental Sleep Medicine.

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