By Jane Schmucker

It’s happened to almost every professional.

You enter the room with a patient, ask politely how he or she is doing, and find yourself on the listening end of a tale that just won’t stop. A story filled with death and divorce, sickness and sadness, and so much hard luck and woe that you can’t give short shrift to it. And some of it you might actually need to know — my insurance has changed since my husband left, for instance.

But you have patients waiting in every room.

Simple statements of empathy are the best, says Stacey Whalen, director of Patient Support Services: Bringing Smiles to Patient Care, a collaboration between Columbia University’s College of Dental Medicine and School of Social Work.

“I’m so sorry you're going through this.”

“Wow. I'm really sorry to hear that. It must be tough.”

“It sounds like the past few months have been really tough for you.”

Whalen urges empathizing, then validating, and finally summarizing in response to a long story of terrible life events.

“The person on the other end is a human being,” she says. "There’s more to the patient than just the mouth.”

Elderly Patient
Stock Photo

And it’s important to the dental practice to make the time to be listening too. Patients who are engaged with their providers are more likely to return to the practice, Ms. Whalen says.

In some cases of life-changing events, it’s helpful for dentists to remind patients of any appointments that they offer outside the traditional 9 a.m. to 5 p.m. workday.

Nevertheless, there are some patients who will keep right on talking. So boundary setting is important, Ms. Whalen says. One of her suggested phrases for that point: “Well listen, let’s get started on you so you can get home to relax.”

That’s likely a good response for the overwhelmed mother who’s trying to take care of troubled teenagers and elderly parents in declining health, all while keeping a marriage and a career afloat.

But that line can fall flat with some of the longest talkers — older retirees, often widows or widowers, who live alone and actually look forward to going to the dentist because it’s an outing with people who will listen. They are not eager to get home to relax. Some of them are home too much of the time with little to do besides grieving the losses in their life.

Dr. Christina A. Demopoulos
Dr. Christina A. Demopoulos

Dr. Christina A. Demopoulos, an associate professor at the University of Nevada - Las Vegas School of Dental Medicine, says she aims to embed effective communication strategies in the courses that she teaches.

She has quite often heard those long, long stories from patients in the midst of a horrible life experience or from seniors with some dementia, and says she feels listening to them is part of the job.

“You can’t have your hand on the doorknob waiting to leave a room just because the patient presented with an emotional or traumatic event,” she says.

She says dentists might have to rearrange their schedules sometimes in order to spend extra time with a patient going through an awful time. She thinks other patients will be okay with that.

She has a longtime office manager whose job is largely to listen. If the need for a long conversation is there, the office manager will even take the patient in a private room with a cup of coffee while another staff member fills in at the front desk.

“I understand that you can't spend an hour talking with a patient in a dental chair,” Dr. Demopoulos says. “But dedicating some uninterrupted time can be life-changing for those patients. We may be the only person they confide in about the emotional or physical stress that they face daily.”

It’s important, she says, for dentists to know where to refer patients for counseling or other help.

It’s also key to remind patients who are upset about life’s happenings just how important it is to their overall health to do everything they can to maintain their oral health.

“They may not perceive their teeth to be important when they are worried about the health of a loved one or how they will put food on the table for their young children,” Dr. Demopoulos says.

Dr. Leena Palomo, an associate professor at Case Western Reserve University’s School of Dental Medicine and a practicing periodontist in the greater Cleveland area, recommends establishing a protocol for handling such long stories.

“These other things in life, they do make a difference,” she says.

In Dr. Palomo’s office, it all starts at the front desk. She has a longtime office manager whose job is largely to listen. If the need for a long conversation is there, the office manager will even take the patient in a private room with a cup of coffee while another staff member fills in at the front desk. “It is part of her job description,” Dr. Palomo says.

That policy allows the patient to be fully heard and the office manager to then summarize what the patient is going through to the hygienist who can be extra vigilant for signs of stress. Dr. Palomo emphasizes that recent studies show the link between oral and systemic health is much closer than previously thought.

“That’s why I think it is very important to hear what the patient has to say,” she says.

Nevertheless, Dr. Palomo, of course, is busy.

So if the office manager can take time to hear the patient’s whole story, that typically prevents such conversations from occurring in the dental chair itself. By the time Dr. Palomo enters the room, the story has been shared and, if necessary, noted on appropriate records.

Author: Contributing writer Jane Schmucker is a veteran journalist who has covered health and business topics. Now freelancing, she reported and edited for more than 22 years at The Blade (Toledo, Ohio). She has also worked on the rewrite desk for USA Today in Arlington, VA.

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