Seek First To Understand

In his highly acclaimed, widely read, book The Seven Habits of Highly Effective People, Steven Covey tells us to try to listen and understand what the other person is trying to tell us. If we do this, we gain different perspective on their point of view.

Too often, we make our minds up about what a person is saying within seconds. If they look angry, we begin to feel defensive. If they are smiling, we relax and assume it's going to be a pleasant experience. It's all just superficial information that we're receiving, and not enough to go on. I'm sure body language experts might disagree, but I've found body language doesn't always tell the story. Digging deeper gives us more information and hopefully, helps us understand the other person a little more.

The other day an elderly gentleman came into our practice with a stack of papers in his hand, a Yankee accent (we're in the South, but I'm from Brooklyn, NY, so I can say that) and a very pissed off, somewhat condescending attitude. I was at lunch so the front desk assistant tried to help him. She then asked the financial coordinator to speak to him, who then asked the insurance coordinator to take a crack at it. When I walked in from lunch, the front desk coordinator had gotten the dentist involved, the dentist had about had it with him and I was getting a very excited version of what had transpired. I headed up to the front desk with a lot of stuff going through my head before I even set eyes on the patient.

Here's what I saw. A very aggravated, 81 year old man, Joe, with a stack of statements in his hand and a hole in his "temporary anterior splint". Through the ensuing conversation, he repeatedly alternated between sticking the tip of his tongue in the hole and shaking the broken piece that he had in a Baggie, at me and demanding I stick it back in. The whole time I kept thinking, "Why is he so mad?"  Our excellent front desk coordinator sat at her computer right next to me and kept pulling up info she thought would help. Thank goodness for that great proactive thinking. Our financial coordinator was busy pulling up any facts she had, and our insurance coordinator was close at hand, too. There's was no making this patient happy. I explained that the splint was a temporary measure that wasn't meant to be a permanent answer. He was confused about the difference between the splint, a crown and a bridge and was sure he had a bridge. The more I tried to explain at that point, the angrier he became. I finally said, "I know you're mad, I want to help you, but I can't help you understand if you won't let me talk." He left, swearing he'd find another dentist. 

After he left, I couldn't stop thinking about the look on his face the whole time he was ranting. I looked way back in his chart notes and noticed that his wife had died 12 years ago and he now lived with his youngest daughter. (A few days later I found out she had just been diagnosed with MS) So, at 69 he lost his wife. I'm sure he'd only retired shortly before her death and was now looking at the rest of his life without his wife. I doubt that's what he had planned for them. Maybe that's not an excuse to be so angry with others, but it helped me understand a little of why he might be the way he is. I also noticed that the temporary dentist who did the splint, referred to it as splinted crowns, since she had splinted the extracted crowns of the teeth onto the splint. That's what made him think he had crowns. It nagged at me that I didn't know any of this before I talked to him.

I decided to create a patient complaint sheet that gave a little more order and information to addressing unhappy patients. First, I didn't want to come into the picture after 3 people had already talked to an angry patient. If you've ever watched them make a fire on Naked and Afraid, one person starts the flame, another one adds kindling to get it to catch, and then they add the big logs to really get it going.  I don't want to be the big log again. On the sheet I created, the first person to talk to the patient logs the patient's complaint and asks them to take a seat so they can get me. If it's a financial issue, the sheet then goes to the finance coordinator to fill out her info, possibly the insurance coordinator for her input, the front desk coordinator for background info, and then I get the sheet. I can go talk to the doctor first if needed, and then approach the patient with the information I wish I'd had with Joe. I know it sounds like that sheet really travels, but all of those people know somethings going on and are doing their part so they only have the sheet for a minute or two before I get it. 

To my happy surprise, Joe showed up again one morning, again with a pile of paper in his hand. The entire front desk group turned to me with a look of "Here we go again" on their faces. I greeted the patient and asked what I could help him with. He said, "If you'll have me back, I've decided to go ahead and have the damned bridge." I told him to give me a minute and went and talked to the doctor. She agreed to do the bridge, but that he must agree not to come in the office angry, rather to talk things out if there was something he needed help with. I asked Joe to come into my office and let him know we'd do it, but he needed to take a different approach to his concerns from now on. He agreed. We talked for quite a while and I discovered that Joe was quite funny and interesting. His wife had indeed died, he was her 4th husband and, as he put it, "The best of the bunch!". He was taking his daughter to the Cleveland Clinic the next week to see about her MS. He'd served in the army and went back to school at night for 3 years to get a degree, in the days before the government started paying for it. (screwed again) He'd worked at IBM for 35 years and never got rich, but he got by. He did editing, so he expected the info he was given to be written out and perfect. I'm starting to understand Joe a little better, are you?  At 81 years old, he believed "I have to stand up for myself, because there's nobody else who will." 

So, don't you have to give a bit of admiration to an 81 year old who still has the gumption to stand up for himself? He's been through a lot of life, and he's still standing up for himself. That's the world looking out through Joe's eyes. Does that mean we have to stand there and absorb his anger? No. We can try first to understand where it's coming from. We can stop taking it personally. He's angry at the situation as he perceives it. Are we so sensitive that we can't put our own feelings aside for a moment to try to understand a patient, or can we realize if we work with patients, they will sometimes be angry, that's a fact of the job. We may not always be able to give them what they are demanding, but we can sure make them feel like we are trying. Just by aligning yourself with them, rather than against them, you are getting somewhere. They feel it if you are truly trying to help, just as they feel it when your back goes up and you stop trying to understand what they want, or how they feel.

It's not always easy, but if it was, would we even need you? If you can't handle the heat, should you be in our kitchen? The real test of an employee is how they respond when the going gets tough. So, first try to understand the patient, then the way will seem much clearer.

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