Effective communication is a vital skill for any member of the dental team. It not only helps contribute to improving patient satisfaction but also helps to reduce the risk of complaints. Unfortunately, a breakdown in communication can be an underlying factor in complaints even if it is not highlighted by the patient as their main concern.
Complaints which do include direct concerns about communication commonly include areas such as an allegation of inadequate oral health advice being provided and failure to inform a patient of the presence of periodontal disease or caries. However, complaints also focus on the communication of treatment decisions, for example whether it was appropriate to prescribe antibiotics, and regarding the level of service provided by the practice such as late-running appointments and the practice complaints procedure not being followed.
There are many factors which can lead to a breakdown in the communication between a patient and a member of the dental team for example:
- Physical factors such as a visual or hearing impairment.
- Emotional factors whereby a patient may be unable to process information due to a heighted state of anxiety.
- Language barriers which may occur if English is the patient’s second language.
However the communication difficulties occur, they can lead to problems between the patient and the relevant member of the dental team. A failure in communication can lead to valid consent not being obtained for procedures, or failure to meet a patient’s expectations, as well as more general misinterpretation or confusion for patients. It can be difficult to get things back on track if a patient feels they’ve been misinformed.
Good communication is a two-way street between the patient and the dental team. Listening to patients and understanding their wishes and expectations is as important as what you say. By making the effort to communicate clearly and concisely with patients, practices can minimise the risk of a complaint and doing so can often help to resolve complaints at an early stage.
Dental professionals also have an ethical obligation to communicate effectively with patients, as set out in principle two of the GDC Standards for the Dental Team. As part of these standards, patients can expect:
- “To receive full, clear and accurate information that they can understand, before, during and after treatment, so that they can make informed decisions in partnership with the people providing their care
- A clear explanation of the treatment, possible outcomes and what they can expect
- To know how much their treatment will cost before it starts, and to be told about any changes
- Communication that they can understand
- To know the names of those providing their care.”
It is also important to be mindful of patients who may require additional communication when they arrive at the practice:
Patients with a learning disability
Try and keep questions simple, and only ask one at a time. Give the patient enough time to respond and remove distractions from the surgery, such as background music.
Ask the patient to bring in a family member or carer who knows them well. They may often be able to provide advice on how to communicate with the patient. Provide the patient with a written treatment plan. If the patient consents, this can be shared with a carer or someone with legal responsibility.
Patients with a sight impairment
It is important to greet the patient as soon as they enter the room. Introduce yourself and explain your role. Speak directly to the patient and respond verbally as opposed to, for example, nodding or shaking your head so the patient knows you are listening to them. Explain what you are going to do before doing it for example, ‘I am just going to guide you towards the chair.’
Consider using a large print format if giving the patient written information and if possible, read any written information to the patient so they are fully informed.
Patients with a hearing impairment
Often, patients can be embarrassed about a hearing impairment so do not assume that a patient has heard your discussion. Speak slowly, clearly and ensure that the patient has fully understood what has been discussed. It may also be useful to provide all information in writing.
Patients who are unable to speak or understand English
The use of professional interpreters from a translation service may be required when treating patients for whom English isn't their first language. When using an interpreter, speak to the patient rather than to the interpreter.
Be aware of the potential problems that can arise from using a family member as an interpreter, as there is no guarantee that they are able to interpret correctly. Speak slowly and clearly, avoiding jargon. If a patient does not appear to understand, try rephrasing a question, and consider using pictures to help communication.
Patients with severe anxiety
People with anxiety often find it difficult to concentrate, so reassure the patient and provide additional explanations as required. Initially, it may be useful to have a discussion in a non-clinical environment which may reduce the patient’s anxiety but, obviously, any clinical examination would need to be carried out in an appropriate environment.
The original version of this article was published in BDJ Team titled "Communicating effectively with patients" on 20th November 2020. It is reproduced here with permission.
This page was correct at publication on 15/12/2020. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.