The patient? Or yourself?
One of the most difficult parts of treatment planning is not understanding the patient. It is understanding yourself.
Each of us is a great soup of biases, influences and needs.
We might like a procedure. Or not. We might be comfortable financially and much later in our career. Or we might be early in a career and worried about money.
However one of the most difficult things to be free of, is our very strong desire to treatment plan ourselves.
When we see a case, it is so easy to forget about the patient. And to see instead a set of teeth, and apply an algorithm to them. In many cases, we are trained more on the logical, mathematical side of our brain in dentistry, so generally it is not our comfort zone to get to know the patient as deeply and to understand their emotions.
However, without a deep understanding of the patient, it is much harder to achieve a successful treatment.
For instance, if a patient has a strong aversion to implants, and has had a friend have one fail, and is worried about metal in their mouth, and you convince them to try an implant without exhausting other options, they may be extremely unforgiving of an implant complication. On the other hand, a patient that has had three root canals fail, and hates the procedure, may be extremely unforgiving of a failed root canal therapy.
In both cases, the failure was not necessarily the procedure, because all procedures have complications. It was an unwillingness to listen to the patient and acknowledge their concerns, whether emotional or not.
Now this gets more complicated for us dentists, because we often have strong feelings about teeth that are well beyond that of the general population (to understand this better, read up on false consensus and psychological projection which forms the basis of most treatment planning).
Our own desire for treatment for ourselves, often severely complicate our ability to listen to the patient.
If we feel like we would die with our front tooth missing, we often have trouble treatment planning an extraction of a front tooth, even if to save it would be irrational and highly failure prone.
Similarly, if we are feeling financially stressed, then it will feel extremely difficult to discuss more expensive treatment options even if they are clearly better.
Your best treatment planning will not happen until you mind is completely free of what it is you want, and becomes totally focussed on what the patient wants. And by what the patient wants, I never mean a procedure. Always an outcome.
This does not mean you offer foolish options like all on four instead of a fissure sealant. Or that you won't refuse a patient treatment if you think it is a bad idea.
However it does mean you have the best chance of choosing procedures that will balance all the needs of the patient, not just one.
Please read the following if you get a moment.
https://en.wikipedia.org/wiki/False_consensus_effect
https://en.wikipedia.org/wiki/Psychological_projection
What are your biases? If you found this helpful, please like, comment or share.
In our treatment planning course we study very carefully how to focus on the patient's goals, and ignore our own financial fears or procedural worries.
