COMMUNICATION SKILLS IN THE DENTAL PRACTICE : A REVIEW
individual , to enable the patient to understand what is the forthcoming treatment and whether / how it will change the quality of his life . This kind of approach strengthens the relationship between doctor and patient and makes the patient trust the doctor and strictly follow the recommended treatment . 4 A major role in understanding the information presented to the patient is the way in which communication is carried out . According to some authors , 65 % of information is transmitted nonverbally and only 35 % verbally . 5 It has been shown that when those two methods of communication complement each other , the information given can be accepted as a complete message . To be successful , the dentist should be familiar with the various methods and techniques of communication , because it is a part of good medical and dental practice . Ethics describes the different models of behavior between doctor - patient . The most popular and implemented ones are : - Paternalistic model ; - Autonomous model ; - Partnership model . In the paternalistic model the doctor chooses the treatment based on his medical experience and knowledge , provides information to the patient , so that he is able to conduct his therapy . This type of treatment is based on medical evidence . The responsibility for the decisions lies with the doctor . The autonomous model is based on obtaining an informed consent . The information is also transmitted by the physician to the patient , but it contains details that are important for the treatment from the patient ´ s point of view . So , after being fully informed , the patient understands the information and is involved in the decision to conduct the therapy . In a partnership model , the information flows in both directions . Making a decision is being influenced by : important medical details ; the value system of the patient ; his lifestyle and his needs ; his everyday life . All aspects of the treatment are discussed with the patient and he participates in the medical decision-making process , bearing part of the responsibility . Initially the model of partnership was introduced in the treatment of chronic diseases and of diseases with different alternatives for treatment , all evidence-based . 6 The goal is that both individuals become actively involved in the decision-making process , based not only on medical information , but also tailored to the individual characteristics of the patient . The roles of the doctor and the patient in the partnership model are determined by their mutual work and the parity of both parties . In the English literature , this is called “ equipoise ” 7 or “ balanced solution ”. On the one hand , this balance relates to the different but equal treatments of a disease . On the other hand , equipoise means that the physician and the patient have the same influence on the medical decision-making process . 8 Knowing the different patterns of behavior , dentists can choose the most suitable method of communication with the patient , which affects the quality of service . The quality of the health service depends on how well it meets the individual needs of the patient . In the complex system of modern health insurance the best way to achieve high-quality care is to use a patient-centered approach . This includes respect for the dignity and uniqueness of the individual , based on the ethical and moral standards of health care . 9 Thus the patient is granted his right to receive quality health care . 3 There is evidence that if patients take an active role in their own health care , this leads to more accurate decisions , improved treatment outcomes , higher patient and physician satisfaction and more efficient use of resources in the health care system . 10 Harter suggests a sequence of steps for the patients ’ involvement in the process of making decisions regarding subsequent health care . 6 With this approach of including the patient in the decision-making process , conversation has a strictly defined structure and elements : 1 . Informing the patient about the necessity of decision-making ; 2 . Show equivalence in conversation ; 3 . Inform about the different choices ; 4 . Consider the patient ’ s expectations and questions , understanding the problem ; 5 . Define the patient ´ s desires ; 6 . Discuss the variety of options ; 7 . Carry out a decision ; 8 . Define ways to implement the decision . In the dental practice the dentist should comprehend and use the art of communication in order to implement these steps successfully . The results of a study conducted by Gerbert show that , according to the patients , the most important skills of the ideal dentist are : professional competence - 86 %; 71 % are for the use of universal precautions ; 63 % stress the continuous training of the physician ; 54 % want painless treatment ; 47 % expect the dentist to soothe the patient and 47 % - to be polite with the patient , 11 i . e . the majority of the responses are related to the ability of dentists to communicate properly . The above-mentioned issue is the topic of a survey by Sahm , Bartsch and Witt at University “ Julius Magnus ” in Würzburg , Germany . The first study showed that 42 % of those treated are anxious to speak about personal subjects , while this desire decreases with the increasing age of the patients . 12 Witt and Bartsch expanded the study in 1993 , using video equipment , followed by questioning the patients to examine the impact of the information and communication during the initial orthodontic conversation . The conclusion was that due to the use of multiple medical terms , patients understood only a third of the information . The authors assume that the amount of information that patients have understood is related to the satisfaction with the
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