How many times have you had a client tell you that they don’t need radiographs and that nothing hurts? This response from a client demonstrates that the client believes that care is only needed if there is pain and radiographs are not important to their dental care. How can we encourage client’s ownership of their oral health? When we want to make a positive change in another person there are ways that this can be done without confrontation or criticism which often create barriers that inhibit clients from seeing value in their treatment or care. With Co-discovery, we can increase client awareness by empowering self-motivation toward ownership and improved oral health.
The term Co-discovery came into my world a few years ago and I was unsure of the impact it would have on my life as a Registered Dental Hygienist or the clients I serve. It has been an evolution of growth on all our parts as I have changed and so have my clients due to incorporating Co-discovery into my hygiene care. On this Co-discovery journey, I listen more and talk less, I ask open ended questions, I get clearer answers from my clients so that I can meet their needs and expectations and the clients become active in their care and own their dental needs.
Co-discovery is a development of a partnership in discovery and co-diagnosis with the client to help the client discover their own needs and be a part in the decision-making process instead of the dental professional telling the client what they “need”. We as clinicians can be the facilitators of discovery. The desire for health must come directly from the client and cannot be forced upon an individual. This process allows the clinician to discover the client’s values, attitude, beliefs, fears, limitations and aspirations. As clinicians, stepping away from the expert role and into a role of co-therapist with the client leads to creating an exceptional learning experience. Instead of creating barriers the dental team creates bridges by empowering the client toward ownership of their health.
In dental and dental hygiene school, the model of care we were all taught was one in which the client has a passive role. We are the clinicians who use our authoritative role to give a diagnosis to the client and they are expected to follow the recommendations. There is no collaboration- we are telling and not asking. In the best-case scenario, we can get cooperation and compliance but rarely do clients commit to their care. With commitment, the client is making a choice based decision to follow their oral health goals based on their values, goals and vision for their oral health for today and the future.
A clinician must approach the appointment with the client with several things in mind. According to Bob Barkley, DDS- Co-discovery is about creation of the optimal learning experience. Creating an optimal learning environment is critical to the client being empowered to make choices about their oral health needs. It also requires that a clinician have a positive influence on the patient. There is great responsibility to help the client become informed without judging or possibly negatively impacting an outcome. The ways we can positively influence a client is through humble inquiry, suggestion, story-telling which leads to creation of experience.
Humble inquiry implies a desire to build a relationship that will lead to more open communication. It also implies that one makes oneself vulnerable and thereby, arouses positive helping behavior to the other person. It is about an attitude of interest and curiosity. It focuses on the relationship and enables both parties to assess whether their relationship goals are being met. Humble Inquiry maximizes one’s curiosity and interest in the other person and minimizes bias and preconceptions about the other person.
Suggestion is powerful since what we believe so strongly influences our reality, using the power of suggestion in a positive way is one of the best things you can do for your client’s well-being. Once we anticipate a specific outcome will occur, our subsequent thoughts and behaviors will actually help to bring that outcome to fruition.
Story telling allows us to digest information more easily because it connects that information to emotions. Storytelling is important because it is effective at teaching in a way that people can easily remember, and at helping people relate to one another.
Creation of experience is the culmination of humble inquiry, suggestion and storytelling. These acts are meant to forge a more lasting and meaningful connection between the client and clinician.
To understand the client’s need and concerns the clinician can ask open ended questions. The client must feel understood. This leads to the discovering of the values and choices the client makes toward their needs. It is with these questions our clinical assumptions get diluted by the client’s needs and wants and we move into a model of patient/client-centered care.
To get the client involved in their oral health it is sometimes as easy as giving them a mirror and asking them what they see, what they like and what they don’t like. Using a mirror to show plaque that has been disclosed can have a huge impression for greater self-care. Giving the client copies of intra-oral images with a marker and having them note any concerns they see can have a profound invitation for Co-discovery. Anything a dental professional can do to invite the client toward discovery, optimal oral health and positive clinical outcomes can assist a clinician in partnering with the client. These questions are an invitation to collaborate, but some also ask the client permission to show them something that a clinical eye might only see.
The following are effective questions to engage the client in Co-discovery:
- What would you like to change about your smile?
- What are your oral health goals?
- How does that sound to you?
- Where would you like to go from here?
- What is your concern regarding the treatment?
- Tell me about your previous dental experiences?
- What would be helpful for me to know to work well with you?
- Can I show you what I see?
It is with Co-discovery that we can have the relationships with our clients that we have always dreamed about. One where the client is a partner with the dental professional in meeting their oral health goals. Co-discovery will be essential as health care moves from needs-based care to health-centered care.