Enhance Patient Connections During COVID-19

Print & Go Guidance!


By Debra Engelhardt-Nash

Albert Mehrabian, a pioneer researcher of body language in the 1960s, found that the total impact of a message is about 7 percent verbal (words only) and 38 percent vocal (including tone of voice, inflection and other sounds) and 55 percent nonverbal. It’s how you looked when you said it, not what you actually said.

Anthropologist Ray Birdwhistell pioneered the original study of nonverbal communication – what he called “kinesics.” He made similar estimates of the amount of nonverbal communication conveyed between humans. Like Mehrabian, he found that the verbal component of a face-to-face conversation is less than 35 percent and over 65 percent is done nonverbally.

Most experts contend that our facial expressions, gestures, posture, and tone of voice are powerful communication tools.

The COVID pandemic has made this challenging since face masks muffle our voice and hide our faces. Some experts theorize that wearing our masks impedes showing empathy and make it more difficult to establish a relationship with someone new.

We rely on visual cues like facial expression and lip reading to help understand what people are saying. The difference between a serious statement and a joke is often the smile on our face or the tone of our voice.

With the current mandated face mask requirements, PPE, and safe distancing standards, our ability to use body language and visual communication is presently impaired, verbally and nonverbally. At the front desk, we are communicating through a mask AND a safety barrier which moves us further away from our patient. Even our tone of voice is altered because we are trying to be heard through our OSHA required barriers.

When a major reason a patient chooses a dental office and the dental treatment plan is based on establishing a relationship, it is imperative to compensate for the barriers that impede or restrict connecting with patients. We need to find new methods or improve current office protocols to enhance patient communication.

How to Improve Masked Communication

While it’s clear that people rely on both visual cues and sounds to hear and understand, it’s important to learn how to communicate with your patients effectively despite the fact that you’re wearing a mask.

Use Body Language

A great way to improve masked communication is to try and think about the parts of your body that are visible. Your eyes, eyebrows, hands, and your spine (which helps control your body posture). These all help you use body language to communicate with other people.

Use Body Language

Eyebrows: You can lift your eyebrows to show surprise or concern. You can form a “V” to display compassion or worry.

Hands: Hand gestures can convey what you’re trying to express. A “thumbs up” when you understand or agree or making a circle with your first finger and your thumb indicates that everything is “okay.”

Researchers Geoffrey Beattie and Nina McLoughlin at the University of Manchester conducted a study that concluded when hand gestures are used, listeners have a better recall of what was being said to them.

Body Posture: The way you sit, or stand can say a lot about the way you may be feeling. For example, if you are sitting too far away from your patient or leaning back, it might communicate disinterest or detachment. Leaning slightly forward with your hands together in front of you indicates you are interested and engaged in the conversation. Positioning yourself in front of the patient instead of behind them while having chairside conversations can improve communication.

Eye Contact: Since the mask restricts nearly one half of our face, our eyes need to speak for the rest of our features. When discussing their treatment, avoid turning to the computer screen or printed treatment plan and losing eye contact with the patient. This doesn’t mean you are going to be involved in a “staring contest.” Your eyes can convey your sincerity, your empathy, and your confidence. We need to become more aware of patients’ nonverbal communication. Make more eye contact and be more attentive to tone and hand gestures.

Vary your voice tone and pitch. Over-communicate – use more words and ask more questions. It isn’t hard, but it may be different.

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Wearing a face mask will soon become second nature to everyone and many may even forget their facial expressions are shrouded from patients and co-workers when they interact. Continually remind employees of this so they’re more aware of the need to supplement their facial expressions.

Be Intentional In Your Words

When a patient’s visit begins with a sincere greeting and ends with a thank you, that patients is 32 percent more likely to recommend and return than when they don’t receive either. Let your patient know how much you value their choosing your practice.

In today’s digital and COVID world, some offices may rely more on what they write. It may be time to review your patient correspondence to confirm that it is written in “patient speak.” In other words, avoid writing letters or emails about office policies and office requirements.

Modify your letters to patients to eliminate sending them the office “rules.” Change the words “Policy Statement” to “A Letter of Understanding” and the words “Financial Policy” can become “Financial Agreement.”

Use words that build relationships. State your office protocols in a way that indicates how they serve your patients. In today’s environment (actually in any environment), patients want to know what’s in it for them, not what your practice requires to meet its needs. When worded properly, your patients will appreciate that you expressed that your systems were designed to meet their needs. Find alternative, empathetic ways to inform patients that you cannot accommodate their request. “I’m sorry, but that’s our policy” may ignite defense.

Review your current correspondence (digital, and in-office) to determine if you can improve its ability to enhance patient relations. Be certain your written word matches your in-office actions.

Digital Communication

A 2019 study indicates that U.S. consumers prefer companies that offer messaging as a communication channel. In fact, almost two-thirds of respondents would switch to a company that offered text messaging as a communication channel. Seventy-five percent of respondents said they find it helpful to receive texts for appointment reminders.

Digital Communication

The shift to digital communication has undoubtedly changed the way we communicate with our patients. We connect with our patients via email and text messaging. Virtual consultations are popular and facetiming our patients is common.

Although communicating digitally has expedited and improved the way we reach our patients, it has the potential to diminish, or at least change, the way we share information in and out of the office, unless we use the features properly.

Based on the changes in how we currently communicate through technology and the mandated barriers that deprive us of full facial expressions, words may take on more significance in communicating with patients. Correspondence and conversations need to be designed to “speak” our intentions clearly. Since we may not rely on body language and tone of voice when we communicate digitally, our written words matter more.

Have you ever sent an email or text that was misunderstood by the recipient? You thought your message was clear, but it was not received the way you intended. Words must be carefully chosen in digital communication. And certain topics are better understood when spoken than written.

How to Improve Digital Communication

When texting, make your words matter Keep it short and sweet which means be brief but pleasant and relevant. Deliver value to the patient. Provide educational, timely and interesting content. Offer digital services that make it easy doing business with your practice such as text to pay (WEAVE) and applying for financing online (Care Credit).

Treatment Follow-up. Patients retain 20-60 percent of information shared with them during an appointment. Sending texts or emails with relevant follow-up information increases patient satisfaction, treatment acceptance, and patient retention.

Blending digital tools with the human touch is the best way to improve digital communication. It also creates loyalty and generates revenue growth. This hybrid communications approach means patients are happy and engaged. There are a number of patient connection resources that can help your practice, such as Revenue Well, WEAVE, Solution Reach, and others.


Don’t underestimate the impact of communication on patient experience. Public health crises or not, it’s always important to be deliberate and intentional in the design of the patient experience, right down to the minute details, including the substitutes for facial expressions and human touch. Masks, PPE guidelines and social distancing are what’s changed as a result of COVID-19. What remains the same: genuine connections are still required to attract and retain your patients. Challenge yourself and your team to discover more ways to communicate and connect.


Debra Engelhardt-Nash

Author: Debra Engelhardt-Nash has been in dentistry over 30 years. She has presented workshops nationally and internationally for numerous study groups and organizations. She is a founding member and served three terms as President of the National Academy of Dental Management Consultants.

She can be reached at Debraengelhardtnash@gmail.com

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