November 10, 2017

Effective Listening: How to Break Through Patient Sound Barriers

Dental professionals must realize that dentistry is 1st a behavioral art, and 2nd a clinical science. Especially in dentistry, the behavioral aspects of human communication should not be taken for granted. Treatment adherence relies heavily on your communication skills, specifically, your effective listening skills. I can’t stress enough how unwise it is to generalize that if someone speaks, a message is sent; and if another listens, the message is received. That simply is not the case.

Effective listening is a significant predictor for patient satisfaction (Wanzer, Booth-Butterfield & Gruber, 2004)

Appreciate the Complexity & Sensitivity of Human Communication

Many people act as though sending & receiving messages is all there is to human communication. Some of these attitudes are apparent in the statements:

  • “I know how to talk with this patient; I treated him last year.”
  • “How could she have misunderstood me? I told her everything.”
  • “Obviously she wasn’t listening when I went over the treatment information.”
  • “I explained the fees and the treatment, and she still complained to the receptionist.”

These statements reflect a failure to appreciate the complexity and sensitivity of human communication. The result is hurt feelings, misunderstandings, and eventually, a complete breakdown in the communication process.

However, if each person on your team, including yourself, is continually fine-tuning their communication skills, you will each serve the dental team and your patients well.

Fine-Tune Your Ultra Important Listening Skills

Dental professionals, like those in other fields, spend a lot of time communicating. In a classic study, adults in a variety of occupations kept a record of the time they spent in each of the 4 types of communication: talking, writing, reading, and listening. Participants concluded that at least 70% of their day involved one or more of these forms of communication. Recent studies show that percentage as high as 80%.

Percent of Your Day Involving  Communication

Source: Rankin, P.T., “Measurement of the ability to understand spoken languages.” Dissertation Abstracts 1926; 12:847.

Understand the 4 Stages of the Listening Process

Listening makes up a large part of the communication process. In fact, it’s the primary means of acquiring information, feelings, attitudes, and understanding.

Unfortunately, we’re not born with the ability to listen effectively nor does it develop naturally. Rather, effective listening is a learned skill that requires considerable energy, on-going effort and attention. Done properly, listening combines what we hear, our attention, our understanding, and what we remember. Larry Barker, a recognized authority on listening, theorizes that these 4 stages occur sequentially, generally with little awareness, but with rapid succession.


The physiological first stage of the listening process is the audible part of communication that doesn’t involve conscious perception. Unless you’re deaf, you hear.

About 28.8 million U.S. adults could benefit from using hearing aids (NIDCD Epidemiology and Statistics Program, 2016)

A dental patient may acknowledge sound, but without meaning. Listening only occurs when you attach meaning or understanding to the hearing process.


As multiple sounds bombard our eardrums, we may acknowledge some sounds and ignore others. When we listen to a patient, we may block out distracting sounds around us. Other times, we can fake like we’re paying attention even though our mind is a million miles away.

Attention requires the dental team’s concentration, choice and conscious discipline. Team members must want to greet patients when they enter the office. Moreover, clinicians must enter the operatory intending to focus on the patient. In short, paying attention requires your mind, your mouth, and your eyes working in sync.

When it comes to your patients, failing to eliminate or compensate for both external/physical interferences (e.g. a phone, a crying patient, hall noise, loud talkers) and internal/psychological interferences (e.g.anxiety, negative stereotypes, sleeplessness, previous memories, preoccupation) can have significant effects on your patient’s ability to pay attention to your case presentation.

Attention lapses occur just 30 seconds into a lecture segment, 4.5 to 5.5 minutes in, 7 to 9 minutes in, and then at 9 to 10 minutes in (Bunce, Flens, & Nieles, 2010)


This requires the listener to attach meaning to sound. Because people are affected by different perceptions, experiences, language associations and context, words or sounds may have personal interpretations or meanings.

In a spoken message, 55% of the meaning is translated non-verbally, 38% is indicated by the tone of voice, while only 7% is conveyed by the words used (Mehrabian, 1981)

Understanding occurs with time, exposure, clarification, education, and repetition. For example, dental terminology, second nature to you, may sound threatening to the patient. An MOD is general terminology to you, but a patient may think it stands for Miles of Decay.

A strong part of listening ensures that the message sender and the message receiver share the same meaning. A more comprehensive health history or a more thorough verbal interview may better help you understand the patient’s needs.

Remember, unless you’re listening to yourself (a different and distracting yet legitimate topic called intrapersonal communication), more than one person is involved in the process. Listening takes effort, planning, time and foresight.

It’s wise to ask patients how comprehensive your explanations should be. If a patient understands the financial commitment and policy before treatment begins, then the patient will be comfortable during the checkout process.


The final stage in the listening process is recall or information stored in your memory bank, which improves your listening capability. Even partial recall can enhance listening and consequently, patient and team relations.

In a linear one-way listening task, when presented with a list of words, people can remember, on average, 7 items (Miller, 1956)

Remembering important events and dates about each patient helps you personalize your approach. This is best done by noting this information in the patient’s file. By doing so, you’ll help build credibility, rapport, and establish a comfortable communication environment which greatly helps with treatment adherence.

On the other hand, remembering is an important part of the patient’s listening process as well. Using too many words or dental jargon to explain something can make it hard for your patient to listen and remember what you said.

Now, the Question Is: Does Your Team Have Effective Listening Skills?

64% of organizations provide listening training for their employees because they find that employees’ listening skills are ineffective for today’s work environment (What Employers Teach, 1997)

With so many activities and distractions around us, it’s becoming more difficult to focus and pay attention. This fact places a greater need and burden on the listener. A good listener opens doors to new and beneficial experiences. As a dental professional—and a good listener—you play a prime role in touching other people’s lives, educating them and motivating them. Learn to listen with your ears, your eyes, your senses, your mind, and your heart.

If you and your team can learn how to listening effectively, many aspects of your practice will benefit. Not just case acceptance and patient relations, but team communication and management, marketing, and more!

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