10 steps back to practice after COVID-19 – communication

communication with PPEAdded PPE can add barriers when communicating with patients. Barry Oulton explains how to keep communication at the forefront of care in dentistry.

My time is now split equally between being a clinical dentist and training other dental professionals in the art of communication and influence. On my courses, I often joke that I have never been complimented by a patient on the tertiary fissures in my composites. Whilst I might love the cosmetic beauty of a carefully stained fissure, virtually all patients are judging the quality of my dentistry based almost entirely upon their experiences along their journey with my practice. 

Communication is the cornerstone of patient care. Patients trust dental team members with whom they connect. The current era of COVID-19 has brought some challenges when connecting/communicating with patients. And personal protective equipment (PPE) brings unique challenges to the art of communication.

PPE can significantly hinder effective communicationShrouding the body in plastic, masking the face, and shielding the head stops more than the COVID virus. It muffles sound and removes visual cues. It hides our facial expressions, a tool for displaying empathy. Smiling, one of the easiest and most instinctual ways to connect with another person, is no longer an option.

Opportunity or problem?

You could very easily see this situation as nothing other than a problem. Others talk of it being a hinderance or prevention to developing the relationships that you feel your delivery of dentistry depends upon. 

However, whilst the new normal presents us with a challenge of how we communicate with our patients whilst wearing PPE, I would encourage you all to begin to see this time as an opportunity to revise the way that we do things. Improve on the areas of communication that we can improve upon. So that when the dust settles, and it will, we have an even more robust, effective journey for wowing our patients.

Patient communication

My aim with this article is to give you some ideas to consider in order to have your patient communication as good as it can possibly be during these COVID-19 days and beyond. You may agree with all of my ideas or just a few. Either way, the time you take to finesse your patient communication now will pay dividends over the next few years. Who knows, you may even say that COVID-19 was the best thing that ever happened to your practice? Whether you do or not, it is down to the actions you take during the next three to six months. 

So, for a moment, take a step back, pause and have a good look at your entire patient journey. Whilst we are all a little unsettled about the effects of PPE, it is only involved in one part of the journey. I would argue that building the relationships with patients before and after the PPE time is as important. If not more importanthan the time we are interacting with patients whilst fully covered up. Strengthening the relationships in this way will pay into the ‘trust/emotional bank account’ and will reduce any negative effects of the PPE visits. 

Consider your framework for communicating with patients in the following times:

Before the PPE appointment

  • Use technology, old and new, to your advantage
  • Personal phone calls, especially from clinicians, demonstrate care and consideration. simple call to say hello, check in with them, explain their forthcoming appointment, your SOP. Also answering any questions about treatment or dental concerns will go a long way in increasing trust.

Video calls

When you consider the way we would communicate face to face before COVID-19, other digital platforms offer us a really good alternative. Being able to see your face without all the PPE on helps maintain that human connection. After all, moving forward, this way of communicating will become an integral part of the digital patient journey, and offers flexibility and convenience to patients, without the need to attend the practice. 

Perhaps you could ask your patients which method they would prefer to be communicated with – phone call, email/letter, text, or another form of secure media.  

Handwritten notes

Very few people now receive personal, handwritten mail anymore, let alone from their dentist. Going the extra mile makes a real difference to a patient’s experience and the building of trust.  

Pre-treatment emails with a reminder of the new SOP along with photos of team members that will look after the patient sent out prior to the appointment may help to humanise the PPE appointment and remind the patients that we are still human underneath it all.

On the PPE day

  • A reminder call from reception and to check that the patient understands what the journey will be like upon arrival
  • Photos of the team on display in the reception area. This is so patients can put a face and a name to the team members
  • When team members introduce themselves, they point to the board. Say: ‘This is me and I’m looking after you today’
  • Laminated photos of each clinician in the treatment room used in a similar fashion
  • Whenever possible have team members working with patients that they already know and have had good experiences with. 

Rapport is the key to the best outcome. 

Rapport is defined as a close and harmonious relationship in which the people or groups concerned understand each other’s feelings or ideas and communicate well. If you have rapport with someone, you communicate with trust and empathy. People like people who are like them. Therefore, building rapport is about being more alike, more similar to the other person.

Whilst your mouth and head may be covered during your entire interaction with your patient, you still have every opportunity to build rapport and help make the patient feel comfortable and build trust. 

How to build rapport wearing PPE 

Albert Mehrabian says we communicate with our words (7%), tonality (38%) and physiology (55%). 

To build rapport you want to be as similar to your patient as possible. Match their tone of voice, their volume, words that they use, energy levels. Have similar movements, gestures and posture.  

Think about a time when you have met someone who is opposite to you when it comes to volume. Quiet people are put off by loud ones and vice versa. 

Simple tips

Be mindful of language patterns. Words that cause concern and those that relax and direct the subconscious mind to have positive thoughts. 

Train your teams on the language of influence and be aware of your buts (visit www.theconfidentdentist.info for free pdfs).

Listen to understand. Show genuine interest in your patient and talk briefly about their appointment today. Whilst we are to keep the time in the chair to minimum, it’s vital to be the friendly and caring person they would normally find underneath the PPE. 

Make good eye contact. Remember, both before and after COVID-19, your face sits behind both a mask and a face shield. When we wear this much protective equipment, we rely on our eyes alone. When you are with patients, ensure that you are sitting at eye level – do not stand over them. Make good, gentle eye contact. You may want to practise ‘softening your gaze’ by raising your eyebrows and tilting your head slightly.

Speak loudly, but gently. Masks may muffle your voice, and many elderly folks have baseline hearing loss. It’s helpful to speak in a somewhat louder voice. But do not yell; try to remove the harsh tones despite the higher volume. 

Around one in six people in the UK have hearing loss rising to 71% of those over 70. 

Thank them for them attending today, especially today! Give a compliment and create a moment of genuine gratitude. You will not only knock their socks off, you will probably feel great too. A shared moment like that easily compensates for the PPE wearing. 

Practise. It may sound contrived, but once you have a sense of what you might say to a patient, it is worth practising wearing PPE and having a conversation with one of your colleagues. Ask them for feedback: ‘Can you hear me clearly? Am I too harsh? Am I conveying compassion with my eyes?’

Post PPE appointment

  • Reassess your follow up care
  • Follow up phone calls or digital platform calls – at best with the clinician
  • Maintain contact via newsletters – now more important than ever. 

The strategies above reflect a few that have worked in our experience. Ultimately, this is an era when communication is extremely challenging. We have to find ways to meet our patients where they are. This is through heightened attention to our behaviour and compassion. A little extra effort goes a long way in bringing humanity to our care. Particularly at a time when it is needed most. 

View the other 10 steps back to practice after COVID-19


Barry is launching the next intake for ‘The linchpin associate’ 12-week live training course via Zoom. Protect your position, percentage, pay and pride. Starts the week beginning 20 July. For more information visit www.thelinchpin.co.uk.

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