How to Discuss Sensitive Topics With Patients

Dimensions’ Brand Ambassador Veronica Bonta, BS, RDH, describes the tactics she uses when a patient gets a little too vocal about hot button issues while in her dental chair, and how to best reroute uncomfortable discussions. 

I think I can spare you all the gruesome details of how bizarre this year has been. We have all been affected in some way by the pandemic and lockdowns. We are all emotionally charged and at our wits’ end. And “all” includes our patients. They are out there dealing with school closings, isolation from family, standing in line for the grocery store, working from home, you name it. They are fired up about politics, social issues, vaccines, the economy, and everything in between. And guess what? They are coming to sit in your chair. 

HOT TOPICS

We likely can all agree that the dental chair can sometimes mimic a counselor’s sofa. We hygienists are often privy to some intimate details and thoughts pertaining to our patients’ lives. Whether it is patients we have known for a long time or ones we’ve just met, many patients tend to feel very comfortable talking to us. Most of us are happy to lend a sympathetic ear when our patients have lost someone or their job or are just mad at their in-laws. Many of us cheer with our patients when they are expecting a baby, taking a trip, or buying a new house. Whatever it is, we are able to listen and provide a nod, smile, or input into matters in their lives. I, for one, will talk about my patients’ dogs all day long if it gets them to keep coming to their recare visits and maybe even start to floss.

It is more than appropriate to speak with our patients about the current state of affairs. After all, we have all been living in an alternate universe for a year. The topics of COVID-19, vaccines, remote learning, lay-offs, politics, and the economy are bound to come up throughout the day. Our patients will count on us to engage and listen, as they have known us to do in the past. However, we have to set some boundaries. 

STAY NEUTRAL

Picture it: It’s Wednesday, 8 am in August 2020. Our practice has two hygienists working and the dentist has a crown prep scheduled in her chair. Our operatories are partitioned but have open doors. My patient is 5 minutes late and the other two patients are seated and beginning treatment. The patient I’m waiting for is someone I’ve been treating for years, we will call him “Bill.”  He is typically really nice and we like to chat about camping and hiking. 

Bill comes marching through the front door announcing that he is late because he forgot his “stupid mask” in the car. He barks at the receptionist, “I’m not sick” when she takes his temperature. He grumbles as I escort him back and ask how his morning is going. He exclaims, “You know these masks don’t work” as I put my surgical mask on top of my N95. He then goes on to complain about the governor, the president, Pfizer, and on and on.

He’s not really yelling, just a little elevated but I know the other patients can hear him. This is not the Bill I know, this is frustrated and fed-up Bill. How do I diffuse this bomb? How do I tactfully stop his venting without being dismissive? At some point in his ramble, I heard him mention something about having to walk his dog while wearing a mask. Click! Lightbulb! And here it comes, my 2020 catchphrase: “Everything is so crazy, I totally get how you feel” followed by “So your dog must be loving all this extra time with you. Have you been going on more walks?” And just like that, we were back to discussing lighter topics. 

It’s one thing to listen about how hard it is to work from home, or how a parent wishes the schools would open, but when the topics get a little more heated, it is best to reroute the conversation. With Bill, he was just getting a little too loud and passionate about his feelings on masks. I couldn’t let him continue and had to choose careful words so as to not fuel the fire. 

BRING IT BACK TO ORAL HEALTH

The reality is that I’ve had several “Bill” situations over the past year and surely there will be more to come. The key to handling moments like this is to be empathetic, sympathetic, and, most important, neutral. For me, I have my catchphrases: “I get it,” “Everything is so crazy right now,” and “I know how you feel.”  I use these to let my patients know that I understand their frustrations and it affords me the option of not having to share my own opinion. Even if I agree with them, I do not want to offer my opinion. I’m not there for that, I’m there to talk about teeth and, ultimately, to coax our conversation back to oral health. 

I’ve been pretty successful in diverting conversations this way. I also rely heavily on talking about new shows and movies on streaming services. Sometimes if I’m having a particularly hard time changing the subject, I will excuse myself from the operatory to grab a box of gloves or something and, when I return, I take control of the room. I usually walk back in blabbing about something mundane and it works.

I hope I’ve shared some helpful advice on avoiding hot button topics at work. It seems there is a light at the end of the tunnel, and, hopefully, we will be back to talking about weekend plans and the best laundry detergent with our patients. Until then, I wish us all good luck!