Dr. Susan Maples takes a look at the facilitative approach — a 2-way communications style that helps you learn about the patient as the patient learns about treatment.
by Dr. Susan Maples
As a sleep- and airway-astute dentist or hygienist, you have no doubt become a zealot for your patients, anxious to tell them what you see… and definitively what they might do about it. But just as we follow our built-in desires to educate, we bear witness that teaching-and-telling patients what to do usually doesn’t translate to action. (Let’s face it, if this style of education worked, ALL our patients would be daily flossers by now.)
Educate comes from the Latin word educare which means ‘to train or to mold’. It implies a one-way communication style. And while it worked slightly better within the old-fashioned patriarchal medicine model, where every patient believed ‘doctor knows best’, it clearly doesn’t work well in today’s world. Today’s patients are internet savvy, less trusting of medical professionals, and more empowered to make their own decisions.
Become an Ask-it-All, not a Know-it-All.
The good news is we can dissipate personal barriers if we are willing to learn a more facilitative communication style. Facilitation comes from the Italian word facilitare and it means ‘to make easy or easier’. It implies a two-way communication style that supports the patient’s self discovery. And it requires more listening than talking.
For each of us, learning takes place in our minds, not our ears. We must filter the words we are hearing (or reading) through the lens of what we already “know” (believe to be true). In that way, every adult has their own personal clinician inside of them, helping them make hundreds of personal decisions every day.
If our job, as licensed professionals, is to help our patients better understand new, evidence-based concepts, we must first understand what they already believe to be true. That means becoming an ask-it-all rather than a know-it-all, reserving any new information you might have to offer for after the patient’s curiosity is piqued.
Why is this necessary? There is good evidence in cognitive science that the most long-lasting learning is difficult, not easy. By stimulating challenges that help engage the brain, your patient has a chance to ponder the problem before they formulate possible strategies and solutions. You’re priming their mind for learning.
By the way, this concept is true for us too. Think of the many times you really grappled with how to solve a clinical problem before you discovered the solution. Chances are you experienced a huge light-bulb moment once the answer came to you.
So, from now on, whenever you recognize the physical signs of an airway or sleep-related breathing disorder, begin with a few powerful open-ended questions.
Perhaps lead with this: “I’m concerned that I might be recognizing some risk factors for sleep disturbances. Can I ask about the quality of your daytime energy?” Without giving them your established list of screening conditions (such as daytime sleepiness, brain fog, depression, anxiety, memory loss, etc.) you’re letting the patient think first and articulate their own challenges. Ask also about their nighttime sleep quality. Then ask them to describe any weight challenges, allergies, autoimmune disorders, or difficulties in healing/recovery. (Note that offering some airway-related conditions they hadn’t considered is not meant to lead to a list of yes-or-no answers, but to further arouse their curiosity about how these challenges might be related to a sleep deficit.)
Granted, this open-ended style is more difficult than answering a bunch of yes-or-no questions. And that’s the point. Effortful learning makes it last! When a patient is allowed to articulate their own very personal challenges, they will be more apt to ask you for any answers to their problems. Wait for it. After listening, take a minute or two to restate the quandary and explore their own imagined solutions. In that way, their brain becomes super hungry for learning. Finally, you will get to deliver. The process make take a few minutes longer than you’re used to, but it’s worth it.
Of course, this facilitative approach lends itself beyond airway problems. If you’ve ever wondered why you (or your hygiene team members) struggle with case acceptance beyond what insurance allows, it might be time to sharpen your facilitation skills. This, too, takes effortful learning. Our old teach-and-tell education model has become so ingrained in us that the shift requires a new mindset, new words, and a lot of practice. Just like muscle memory, it takes continual repetition to become your team’s default communication style.
As a dentist, your offerings in sleep and airway medicine are extraordinary. Helping your patients extend their lifespan, and their healthspan, will pay you spiritual, emotional, and yes, financial rewards. Perhaps the coolest part about becoming an airway-astute clinician is who you get to become…personally become…to get there. Bravo to you for all your efforts!
Mary Osbourne, RDH, discusses her own facilitative approach — listening to patients and then informing them of your recommendations in her article, “An Invitation to Influence.” Read it at: https://dentalsleeppractice.com/an-invitation-to-influence/