Are you # 1, 2, 3, or 4 when communicating clinical information?
Because of the unique listening and learning styles of individuals, dentists should be proficient at varying their style of communication to best suit the needs of their patients.
1. The paternalistic approach is a classic. The dentist assumes the role of the parent and relates to the patient as an immature, inexperienced individual. The patient becomes compliant with the directives of the dentist, who has the clinical information and knows what is the best treatment. As such, the dentist uses his or her clinical knowledge and values to make decisions, giving the patient little or no autonomy. In essence, the dentist becomes the patient’s guardian. Although not considered appropriate in most situations, there are patients who do require very careful guidance because they may be totally overwhelmed by making any decisions for themselves.
2. The informative approach assumes that the patient is very inquisitive, perhaps even scientific in their thinking and analysis of the information presented to them. The dentist’s goal is to provide relevant clinical findings and treatment choices to the patient and let the patient make the decision about what dental treatment he or she wishes to receive. In this approach, the patient is autonomous in their choices based on her or his values. The dentist only presents the factual objective information and does not include personal values in the decision process. The patient relies on the dentist’s clinical knowledge and technical expertise to execute the desired therapy.
3. In the interpretive approach, there is a cooperative interaction between the dentist and patient in which the patient’s values are elucidated and then the appropriate treatment choices are developed that meet the patient’s desires. The dentist does not dictate the patient’s
values, but tries to help the patient articulate and understand them. The dentist becomes a counselor, helping create patient autonomy through self-understanding by the patient.
4. The deliberative approach makes the dentist’s role as teacher and partner by helping the patient chose the best health-related values that can be realized for the patient’s health. After presenting the clinical findings, the dentist explains the values related to the treatment options, and expresses his or her opinions about why some choices are more worthwhile to overall health. The dentist expresses his or her values only to help patients develop their own self-awareness of their choices about health-related issues. It is a dialogue that becomes the goal, with mutual respect preserved.