3 baked-in-the-cake patient-enabling behaviors

Have patients ever said they missed an appointment because you didn’t remind them?

How about the patients shopping for home care products in your office to take home by the bag full at no charge? Then there are the confessors asking for forgiveness and absolution for not flossing. Dental hygienists themselves have created or contributed to these behaviors in both overt and subtle ways. Dental hygienists, like the loved ones in a family, can unwittingly become the codependent enablers for the patients they serve.

Baked in the cake

Many of the behaviors and choices in our clinical practices are baked-in-the-cake, meaning they are such an integral part of the clinical tradition, we don’t question them. Look at these three simple everyday behaviors:

• Preschedule appointments and send reminders

• Expect patient compliance

• Supply home-care products

Each behavior is usually done with a desire to help and be of service to our patients. Yet they create codependency because the hygienist and/or practice becomes the responsible party-not the patient. It’s time to examine and question these behaviors to understand why they exist and if they should continue.

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Codependency is a term most often used to describe the family members and other loved ones of a chemically dependent person. The family enabler, in a desire to help the person with the addiction, ends up owning the problem instead of the person with the addiction. Enabling is removing the natural consequences of the addict's behavior. Professionals warn against enabling because evidence has shown addicts experiencing the damaging consequences of the addiction on their own lives have the most powerful incentive to change. 

People with a predisposition to be a codependent enabler often find themselves in relationships where their primary role is that of rescuer, supporter and confidante. Studies show codependency is often considered an addiction in itself. Many health care providers become codependent enablers. The same desire to help and serve others can easily go over the line and create patient dependency.

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Prescheduling and appointment reminders

For many years, it has been a tradition in dentistry to preschedule the patient’s next appointment. The reason is to ensure the patient comes back. However, it really means we don’t trust our patients to care for themselves. We need to be the person responsible. So in whose interest is prescheduling? If we dig a bit deeper, we’ll see our own business security rests on having a full schedule. This is codependency at work again.

Customer service is the act of taking care of the customer's needs by providing and delivering professional, helpful, high quality service and assistance before, during and after the customer's requirements are met. Customer service is meeting the needs and desires of any customer and defined by the customer. Prescheduling and reminders can be a customer service behavior if that is what the customer wants. But we don’t have customers; we have patients. What is the difference? Perhaps it lies in the word we so often seek from our patients: compliance.

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Compliance vs. enrollment

The definition of compliance is:

• the act of conforming, acquiescing or yielding;

• a tendency to yield readily to others, especially in a weak and subservient way;

• conformity; accordance;

• cooperation or obedience.

Do those sound like healthy behaviors? We don’t think so. A healthy relationship is interdependent. This means each person in a relationship takes care of themselves. Have you ever found yourself going through a half or full day without going to bathroom? Are you taking care of yourself so you can be in healthy interdependent relationships?

Home care product supplier

Do you give out a toothbrush, floss and other items to your patients each time you see them? You probably have patients that only change their brush when they get a new one from you, and they can probably sell you back floss by the case. Do you question why you do this? Where did you learn that behavior? Should it continue? Customer service or enabling?

What do you think?

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Rather than answering those questions, we want to give you food for thought and discussion. How do you feel when you think about the possibility of being an enabler in codependent relationships? You are a caring, helping professional. Yet has it gone over the edge?

We fill these Modern Millennial Hygiene (MMH) articles with more questions than answers because that is true hallmark of an MMH-asking questions and continuing to search for the answers. We’re interested in hearing your thoughts and ideas.

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