Mini habits

A mini habit is a very small positive behaviour that you force yourself to do every day. The phrase was coined in popular culture by Stephen Guise in 2013 in his bestselling book with the subheading “smaller habits, bigger results” (1).

The application is in areas such as learning a new skill or setting goals – for example ‘lifestyle changes’ or increasing efficiency/ productivity at work. These attempts often end in failure as the goal becomes too daunting – it requires “you to fight against your subconscious brain (a fight not easily won)” (1).

When related to Dentistry and in particular learning or implementing communication skills the concept is a very good fit. These skills can seem abstract and often don’t flow in a linear pathway – practicing effective listening is not the same stepwise process as the prosthetic phase of a dental implant.

In order to show the application to communication skills in Dentistry I will post a series of mini habits that I find helpful – some obvious, some less so – the cumulative effect of all these ‘baby-steps’ helps me to be an effective provider of patient-centred Dental care.

I would also really value any thoughts or ideas you have in the comments section.

“A terrace nine storeys high

Rises from hodfuls of earth;

A journey of a thousand miles

Starts with a single step.” (2)

 

References;

  1. Guise, S. Mini habits: Smaller habits, Bigger results. 2013
  2. Lao Tzu (translated by DC Lau). Tao Te Ching. Penguin. 1963

 

 

 

Resources – my top 5

  1. People Skills – Robert Bolton. Written in 1979 it shows it’s age in some ways yet also demonstrates that these skills are universal and constant. I have seen so much material lifted from this book in more modern best sellers – this is one of the originals and still the best. If you had to pick 1 core book to read and own, this is it.
  2. Communication Skills for Dental Health Care Providers – Young.  Textbook available from ADA Library. It is up to date (2015), covers a lot of ground and well sourced and referenced. It is also quite dry and academic.
  3. Emotional Intelligence – Daniel Goleman. As Dentists we are familiar with academic intelligence – we all possess it (a pre-requisite to entering Dental School) and use it in tandem with hand-eye coordination to practice our Hard Skills. This book expands the view of different types of intelligence – the theory put forward very persuasively by Goleman is that high Emotional Intelligence is the key quality that enables people to excel in life, both in relationships and in the workplace.
  4. Empathy, why it matters and how to get it – Roman Krznaric. Australian born author – also has a blog and award-winning Youtube clip ( https://youtu.be/BG46IwVfSu8 ). Fascinating examination of a key communication skill that is often mentioned but poorly understood.
  5. Seth’s blog. ( http://sethgodin.typepad.com/ ) Marketing guru – sign up for free to get a post every day to your inbox. Quirky style, not exactly what you think – he is not a conventional marketer. Seth approaches marketing from the perspective of checking your own mindset and then examining the relationship with your customer – he advocates a position of generosity of spirit and ‘radical empathy’.

Honourable mentions;

  1. Thinking Fast and Slow – Daniel Kahneman. Nobel prize winning economist – quite an academic piece (referencing many groundbreaking studies by himself and colleagues) but very compelling. An exploration of our sub-conscious, biases and choices – we are not the paragons of reason that we assume ourselves to be!
  2. Getting to Yes – Fisher and Ury. Interests and BATNAs – all of this and much more in the core textbook for Negotiators.
  3. Difficult Conversations – Stone, Patton and Heen. Acknowledges that Difficult Conversations will be part of all aspects of life and that we often handle them badly. Step-by-step guide to navigating these conversations and turning them into productive problem solving experiences. Too many steps in my view but many new ways of looking at old problems.

Deconstructing Dentistry

Imagine being asked “what do you do all day, what is it that makes you a Dentist?” – most of us, I think, would answer with variations of examinations, diagnosis, cleans, fixing/ replacing broken teeth, enhancing smiles etc. What we are talking about here are the Hard Skills – the skills we attend Dental School to learn and what differentiates us from Lawyers or Accountants.

This answer, while true, does not give the whole picture. There are other skills we use at all times, often on a more sub-conscious level, which are the unsung heroes of Dentistry – the so-called Soft Skills which are in essence communication skills.

While we use these skills at all times, and indeed are expected to use them at a high level – “effective communication in all forms underpins every aspect of good practice” (1) – how much consideration do we give to developing these Soft Skills as we progress through our Dental careers? When was the last time you went on a communication skills related course?

When I did my Dental degree, we had no formal teaching in communication skills – I can only think that “it was assumed that students acquire good communication skills and appropriate attitudes by a sort of osmosis” (2).

Thankfully things have changed – at UWA I was privileged to be involved in teaching their communication skills module for the last 5 years – however the vast majority of any Dental degree involves learning and understanding Hard Skills, practicing in labs and then transferring to patients. Students strive and strain to complete quotas of Hard Skills before being let loose on the public with a license to drill.

Beyond graduation, a glaring issue is that there are few formal courses with an emphasis on the Soft Skills (a notable exception being the excellent Mastering your Risk series from DPL (3)) – it does seem that as Dentists we are left to rely on osmosis, assuming you have a competent mentor type figure from whom to model your skills.

Let’s then address another question – “if you surveyed a cohort of your satisfied patients, for example those who have recommended you to their friends, what would they say makes you a great Dentist?”

I am going to suggest something quite controversial – to be a truly excellent Dentist, in the eyes of your patients, it is not your Hard Skills proficiency that will define you but your capabilities in the Soft Skills department. The famous quote used in customer service really applies here – “people will forget what you said or did, but they will never forget how you made them feel”.

They are unlikely to appreciate or tell their friends that you carved perfect surface anatomy into a molar restoration, or that you used the latest generation dentine bonding materials. That is the technical stuff we sweat on, and no doubt may ultimately affect performance – however patients neither know, care or understand much about these aspects of their care.

In saying that, they may also not consciously appreciate that you listened empathically when they had a concern or that you patiently gave them plenty of breaks when they were feeling nervous – these are feelings that patients process at a deeper level.

However, the feelings generated when somebody tries to genuinely understand their perspective or gives them a sense of control when feeling vulnerable are powerful. These feelings create a compelling sense of well-being and security – which is much more likely to bubble to the surface later, over coffee with a friend, and come out as a simple “I really like my Dentist” when asked for a recommendation.

What sets the outstanding practitioner apart is their exceptional rapport building skills and ability to demonstrate that they care. Through what they say,  and do they create strong positive feelings that in turn inspires loyalty and creates a resilient relationship. I have heard the expression many times from excellent Dentists – “my patients have become like my friends”.

The good news is that these communication skills can be learned – they’re like any other skills except we have a head start because we already use them every day in many different contexts. It is not a case of you have it or you don’t – it is simply a matter of the slow process of conscious effort required to learn, practice and refine any skill – like riding a bike!

We are all as individual as our fingerprints and in the same way there is no fixed formula regarding how to communicate effectively. It will vary from person to person depending on personality, culture, life experience and the context (practice environment and patients) that you encounter. It is important to note that it is not simply a matter of copying how somebody else communicates effectively – you must find your own formula that is congruent with you.

There are many resources ( http://commhealth.com.au/resources-top-5/ ) out there that approach this area from different angles. Now, with the internet, it is simply a matter of identifying a deficiency and finding a resource to help.

In terms of application of communication skills to Dentistry, I have done the hard yards of study, research, practice, trial and error in my years as a Dentist, Dispute Resolution Practitioner and Teacher.

From all of this I have distilled the theories most relevant to Dental Practice and created an interactive skills-based course that will enable you to walk out the door and apply immediately in your practice.

Not only that – the unique aspect of this course is its bespoke nature – we work from a basis of core concepts, but the material, learning, reflections and applications are directed solely by where you want to go and the areas you identify that require some fine tuning.

The course is based on the fact that we are assuming communication competence, you already use these skills all the time (it’s not like learning to place an implant for the first time) – we will expand on the base that you already have and take your skills and competences to a whole new level of awareness and excellence.

References;

  1. AHPRA; Dental Board; Code of Conduct 1.2; Professional values and qualities.
  2. Lloyd, M. and Bor, R.  (2009). Communication Skills in Medicine. Elseiver.
  3. https://www.dentalprotection.org/australia/events-elearning/workshops