Not too long ago I went to have my car serviced. While I was waiting in the lobby, the service technician came and found me and let me know that the two left tires on my car were in need of immediate replacement and two would need replacement very soon. Next, he pulled the presumptive close technique assuming that I would want to get new tires, he asked: “would you like to replace just two today or all four?” Buying tires was not on my list of things I wanted to do that day, but I recognized that it was a safety concern. Within a few seconds, I found myself asking how much would the tires cost? I’m not entirely sure why I asked this question, but none the less there I was asking it. He proceeded to explain to me that he had a “good tire,” a “better tire” and of course the “best.” He told me that the Michelin tire that was already on was the better option and it would cost X dollars. In the past, I have purchased tires from Costco, and in general, I trust Costco more than the dealership, so I said, no thank you I need to talk to my wife about it (the polite way a passive aggressive guy like me says no.) Not one to give up easily he tried the fear close with a financial incentive to sweeten the deal. He said “I would feel really bad if you were to have one of those tires blow out on you on your way home, we are having a promotion on the Michelin tires now that if you buy three tires, you get one free. Will that work for you?” Unfortunately for the dealership, I had decided that I needed more information and more trust. Without that information, the answer was not today, even with a 25% discount.

I am not a car guy so I might get some important things wrong, but one of the questions that I had was: why were the two left tires worse instead of the two front tires? I made the assumption that something must be wrong with the alignment to have those two tires fail before the others. Had the service technician tried first to sell me an alignment, I might have purchased the tires. But instead, he went for the easier sale—tires. When I decided not to buy the tires he did not ask me what concerns I had or what I was thinking; he went directly for offering a discount. The service technician did not try to determine where I was but rather he dumped me into a bucket that fit his world view (people who say no, are concerned with price). Truthfully, the price was not the concern, trust was. Had the mechanic come out and had a different conversation around what he had discovered concerning the alignment of my car before any discussion about replacing tires perhaps a different outcome would have ensued. I can imagine that if he had offered a diagnosis of the cause of the failing tires and the effect of that issue I would have been more receptive to his solution. Next, had the service technician come over and given me the fee for the alignment and then offered to replace the tires at the same time and talked about the benefits of doing so; maybe I would have driven off with a new alignment and new tires along with an oil change.

“Helping, fixing, and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole.  Fixing and helping may be the work of the ego, and service the work of the soul.” Rachel Naomi Remen, M.D.

In dentistry, we often fall into a similar trap to that of the service technician. The trap is one of assumption. We make assumptions because of the stories that fill our heads about what people want, don’t want and don’t value. The service technicians story about me was wrong, even though I asked about cost; the cost was not my primary concern. I can imagine he walked away from the conversation thinking that I don’t value safety, or my vehicle, I was cheap, or that I couldn’t afford the price of the tires. In fact, he just did not have the skill to determine what my concern was and work with me to solve my objections. What is worse, because he did not take the time to connect with me based on my values, this interaction further cemented the false stories that permeate his mindset.

“People don’t care how much you know until they know how much you care.” Theodore Roosevelt

I understand that the actual mechanic is busy being a mechanic and that the salesman (service technician) is the one to sell the recommendation, but how often does that role assignment go sideways? Had the mechanic come to talk to me I could have judged his or her concern for my safety and he would have been able to troubleshoot my concerns. I wouldn’t expect him to have all the financial answers but the two of us as adults could have worked through the result I wanted to achieve and once agreed upon brought in the financial person to make sure I had all of those details solved. Dentists aren’t mechanics, but we are interpreters of value, we know what works and what doesn’t work, and our emotions and passions for and against different options can be persuasive once the patient knows our concerns align with their personal goals toward some positive outcome. To take liberties with the saying: once the patient knows how much we care they will care how much we know. The better the dentist becomes at discovering what the patient values, the more persuasive and compelling the dentist will become. Not in a manipulative way, but rather in a real partnership, where the dentist makes recommendations that they know will match well with the hopes and desires of the individual patient. No longer does one size fit all or even most, but rather treatment becomes tailor made to our patients, something only a dentist/physician can do and that a technician will never achieve.