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This week I am honored to welcome a legend in the dental field, Lynn Carlisle. Lynn started practicing in 1968. After 40 years of practice, Lynn was still noticing that he had frustrations within his practice. Effective communication with his patients and his team members became his passion and sparked a new interest in learning.<\/p>\n
Over the course of his career, Lynn has been on the board of the Panke Institute, served as the president of the Bob Barkley Foundation and as an associate member of the Center for the Studies of the Person. He is also the author of two highly acclaimed books –\u00a0In a Spirit of Caring <\/em>and In<\/em> a Spirit of Caring Revisited<\/em>\u00a0and his newest book, Motivation Interviewing in Dentistry. <\/em><\/p>\n From training with Dr. Pankey, Bob Barkley, Carl Rogers and Art Combs, Lynn has fashioned his own methods that brought out the best of all four teachings that he then applied to his practice. Lynn\u2019s discoveries and methods made him a pioneer in relationship-based dentistry and have revolutionized dental practices. After retiring from his dentistry practice, Lynn has devoted his time and wisdom to help dentists grow and develop themselves and their practices.<\/p>\n Welcome to Practicing with the Masters<\/em> for dentists with your host, Dr. Allison Watts. Allison believes that there are four pillars for a successful, fulfilling dental practice: clear leadership, sound business principles, well-developed communication skills, and clinical excellence. Allison enjoys helping dentists and teams excel in all of these areas. Each episode she brings you an inspiring conversation with another leading expert. If you desire to learn and grow and in the process take your practice to the next level, then this is the show for you. Now, here\u2019s your host, Dr. Allison Watts.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Welcome to Practicing with the Masters<\/em> podcast. I\u2019m your host, Allison Watts, and I\u2019m dedicated to bringing you masters in the field of dentistry, leadership, and practice management to help you have a more fulfilling and successful practice and life.<\/p>\n When Lynn started practicing in \u201968, and he was in practice for 40 years, he did say that he had some frustrations with his relationships with his patients and team members and that\u2019s how he became interested in communication and helping.<\/p>\n So he began studying with Dr. Pankey, Bob Barkley, Carl Rogers, and Art Combs. He took those people\u2019s work and if you guys don\u2019t know, Carl Rogers and Art Combs, are they psychologists? Is that right?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 They’re not specific…<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, I\u2019ll talk about them some I think.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, yeah, they’re not specific to dentistry but he applied all of their work. You know Pankey and Barkley were in dentistry but he took their work and Carl Rogers and Art Combs and applied their work to his dental practice. So then he became a pioneer in relationship-based dentistry.<\/p>\n He\u2019s the author of some highly-acclaimed books which I’ve read both of and enjoyed them thoroughly. The In a Spirit of Caring <\/em>and In a Spirit of Caring Revisited<\/em>. I know that you are in the process of writing Motivational Interviewing in Dentistry<\/em>.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 How close is that to being out?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s a good a question.<\/p>\n [Laughter]<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Summer?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Actually Bill Wathen just finished reading it and giving me some good feedback. I\u2019m now at the stage of trying to decide whether to find a publisher to do a traditional publishing or to do an e-book, or to self-publish. But I would guess it will be ready sometime between the fall to early next year.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 This is not a fast process.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, I can\u2019t even imagine. I\u2019m totally impressed with people who write books. I’d love to do that one day but I know you were on the board at Pankey and you were president of the Bob Barkley Foundation. Then an associate member of the Center for the Studies of the Person.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yep.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 After many many years in dentistry and now being retired, he has taken all of this wisdom and all of his stuff that he\u2019s kept in his basement for however many years it\u2019s been and is using it to help dentistry. So he\u2019s got a website called In a Spirit of Caring where he shares this pure gold, these articles, and all this wisdom that he\u2019s had. He\u2019s able to share it now on the web. So I enjoy your website thoroughly. If any of you guys are interested in that, we can pass on the website information to you. Do you want to say anything about In a Spirit of Caring or just want to move forward?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 About my website?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well I think it\u2019s a goldmine for relationship-based dentistry and for dentists that are interested in that. There\u2019s probably over 600 articles on it by the pioneers in relationship-based dentistry and Allison has an article on it. Lee Ann Brady has an article. I\u2019m trying to not just have us old people that are on it.<\/p>\n If you’re interested in this, it is a goldmine. That\u2019s my partial statement and you can either type in, Google \u201cin a spirit of caring,\u201d and it will take you to it. You can wander all around and see if it fits for you. It is a membership website and I would encourage you to do it.<\/p>\n I\u2019ll also keep everyone up to date via the website on the status of my book. Then probably I\u2019ll talk about the workshop we\u2019re going to be doing on motivation in Santa Fe, New Mexico May 1-3. So all of that stuff is on there.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, perfect. Thank you for that. So as we start, is it okay if I just start with a question?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, sure.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I didn\u2019t know if you had some way you wanted to introduce this but I was thinking before we got on the call and I know we talked a couple of days ago, I was thinking, I think the biggest question I would have and I\u2019ve sort of talked to you a little bit about this, but what is the difference between motivational interviewing and what we\u2019re already doing with our patients? Like when we sit and we ask them questions and we think we\u2019re listening to them. Can you talk a little bit about what the difference is between that and what we\u2019re already doing? Or maybe when we think we\u2019re doing motivational interviewing?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019ll talk about traditional dentistry but I have a hunch a lot of the people on this teleconference are already fairly far along in becoming adept at the people part of dentistry. So I\u2019ll compare it to traditional dentistry. Traditional dentistry is generally doctor-centered. I talk about the biggest difference in motivational interviewing or the person-centered approach. It\u2019s, traditional dentistry is very doctor-centered. The doctor is the expert, the all-knowing person that really lectures their patients. Often they don\u2019t listen that much.<\/p>\n Motivational interviewing and the person-centered approach is about 180 degrees from that. I\u2019ll read a definition that Bill Miller and Steve Rollnick, who are the developers of motivational interviewing wrote. It says, \u201cWhat is motivational interviewing? It\u2019s a form of collaborative conversation for strengthening a person\u2019s own motivation and commitment to change. It is a person-centered counseling style for addressing the common problem of ambivalence about change by paying particular attention to the language of change.<\/p>\n \u201cIt\u2019s designed to strength an individual\u2019s motivation for and movement toward a specific goal by eliciting and exploring the person\u2019s own reasons for change within an atmosphere of acceptance and compassion.\u201d There\u2019s a lot of words in this that are a little unfamiliar to dentistry but the words come from the work of Carl Rogers and then a student of his, Art Combs.<\/p>\n Carl Rogers, in the 40s, believe it or not, from his own personal experience, he was a psychologist, he found that he could be much more effective as a psychologist if he listened to people instead of telling them what to do. Telling them what to do is the Dr. Phil approach. I don\u2019t know how many of you watch Dr. Phil but he\u2019s the classic doctor-centered therapist. Where Carl Rogers is a 180 degrees away from that.<\/p>\n The words in here really come from Carl Rogers. They talk about eliciting and exploring the person\u2019s own reason for change within an atmosphere of acceptance and compassion. That frequently doesn\u2019t happen. In the book I\u2019m writing on motivational interviewing in dentistry, I wrote about dentists, an example from social psychology. Two of my biggest challenges in talking about person-centered approaches to dentists are one, dentists don\u2019t think it\u2019s important. That they think that if they’re technically excellent, that\u2019s all they need to do.<\/p>\n But the other one is in social psychology they call it a self-serving bias. The self-serving bias, they give examples of research that\u2019s been done. For instance, in medicine they did a research study that found that, these aren\u2019t exact, but they found that 60 percent of the physicians put themselves in the top ten percent in their ability to communicate. Another one found something very similar with college professors, where a similar percentage put themselves in the top ten of being outstanding professors in their field.<\/p>\n Then there was another one that was kind of funny that 60 percent of people put themselves in the top ten percent as far as looks. So I would say to answer Allison\u2019s question is the big difference is that motivational interviewing and the person-centered approach is centered on the person or the patient. It\u2019s not centered so much on the doctor. Motivational interviewing and I go into great detail about that.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I was kind of alluding to what you said was that I think we have, at least for me, the deeper I go into this, the more that I know that I don\u2019t know. Even as I started reading the book, I\u2019m thinking, \u201cWell, I do this.\u201d Then the more I read the book, the more I thought, wow, this takes a\u2014I don\u2019t want to use the word incredible\u2014but it takes quite a bit of presence and intentionality.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, being fully present and attuned to the patient and not what\u2019s going on inside yourself.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes. So I think that, I mean there are people who are very well along that path of being that way but a lot of us have a lot of stuff going through our minds in our daily practice life and I don\u2019t think we\u2019re fully attuned a lot of times. So yeah, it just seems like it takes\u2014and that intentionality. I can’t remember, that thing about ambivalence?<\/p>\n You mentioned that on your other call but I really think that\u2019s worth talking about. Can you get into that and explain that in a way, where it talks about you want to change but you don\u2019t want to change and how you ask questions based on the\u2014you don\u2019t want to steer them toward the not wanting to change.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 And that\u2019s a major point that Miller and Rollnick make about M.I. that is different than a lot of the other traditional approaches. Miller and Rollnick put a lot of faith and trust in the person, that the person we call the patient, that as Omer Reed says, really knows what\u2019s best for them and they\u2019ll really make the decisions that are best for them if\u2014and it\u2019s a big if\u2014if they\u2019re in a climate of acceptance and compassion as I mentioned in the description of motivational interviewing.<\/p>\n That\u2019s a big difference with motivational interviewing. They talk about ambivalence as a way to look at it. They say that people really aren\u2019t stupid. They aren\u2019t resistive. They do want to be healthy but they can be ambivalent. A good definition of ambivalence is I want to do this like, to use a very generic example, they want have a healthy mouth. They don\u2019t want to have bleeding gums. They don\u2019t want to have a lot of decay. They want to look good. They want to feel good. They want to be pain free.<\/p>\n So they want, most people want all of those things. But in yet, they don\u2019t want to pay the money. Or they really don\u2019t like to brush and floss and those kind of things. The example I use in my book, a personal example, is that when I retired, I retired, I practiced in Fort Collins, Colorado for the 40 years or so. Then when I retired, I moved to Carbondale, Colorado which is in the mountains, near Aspen, for two reasons.<\/p>\n My wife\u2019s mother was failing and she wanted to be near her and I\u2019d always wanted to live in the mountains. So I moved here but when I moved here I had an old bridge that was probably 30 years old and it was wearing out. I knew it was wearing out. I was getting some gum recession. The shade match was off. It was just worn out. And I knew it needed to be replaced but I put it off for, oh, two, three, four years probably.<\/p>\n The reason I put it off, I did exactly what used to really irritate me about my patients because I put it off because I didn\u2019t want to get an anesthetic and have fat lips. I didn\u2019t want to have the high speed hand piece rattling my head. I didn\u2019t want all of that gooey stuff put in my mouth. So I came up with all these reasons why I didn\u2019t want to have the new bridge in. It\u2019s kind of like on the one hand, I wanted to have it done and then on the other hand I didn\u2019t. That\u2019s about the best definition of ambivalence that I can come up with.<\/p>\n But I think for the people listening to this, that\u2019s a really key thing to remember. I mean, you can really get kind of disgusted that patients don\u2019t do what you want them to do even though you think it\u2019s in their best interests and it really is. But they don\u2019t. But instead of just being resistive and not interested or a croc as some people say, that they’re just ambivalent about it.<\/p>\n With M.I., motivational interviewing, helps you explore that ambivalence with the patient. There\u2019s a lot of different ways that motivational interviewing can help you do that. So that is my best description of ambivalence.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well in one of the examples that they talked about and I\u2019m probably a third of the way through the book but they talked about\u2026<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 This is Motivational interviewing in Healthcare<\/em> book.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 By Miller and Rollnick.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Not mine.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right, not yours yet. I\u2019m waiting. I\u2019m ready to get it anytime.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 But one of the examples they gave is when a patient you ask them on a 1 to 10 scale, how much do you want to change? Or something. And the patient will say a 5 or whatever.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, how important is it to you? Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, then if they say a 5 instead of saying, \u201cWhy aren\u2019t you a 10?\u201d You say, \u201cWhy are you a 5 instead of a 1.\u201d Then they give you the positives instead of telling you the negative. The way they spin it is so different from what I\u2019m used to that I thought, \u201cWow, this is really neat.\u201d<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 With motivational interviewing, there\u2019s a lot of good concrete evidence-based. They\u2019ve done a tremendous research on motivational interviewing. There\u2019s a lot of good, concrete ways like what Allison just talked about of working with patients to help them. You’re really there more as a facilitator to help them discover. What we\u2019ve talked about with ambivalence is a good example of that.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So over your years of doing this, why do you think it\u2019s so important to have this kind of practice or to have these skills?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 For dentistry?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Uh-huh.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I was influenced by Carl Rogers in the early 70s and I spent about ten years in concentrated study with him and his colleagues. Bob Barkley was influenced by Rogers\u2019 work when Barkley was working with preventive dentistry and the five-day plaque control program. He discovered, and most of us that worked in preventative dentistry then, discovered that the way we\u2019d learned to do it and growing up in school, dental school, didn\u2019t work worth a darn with patients.<\/p>\n So he became a student of behavior. That\u2019s how he found Rogers\u2019 and Combs\u2019 work. So that\u2019s the facilitative part of it. But for me, I didn\u2019t use motivational interviewing in my practice because I didn\u2019t read Motivational Interviewing<\/em> until about two years ago. I really wish that I’d had it when I was in practice. It would have filled a lot of the voids or gaps for me. But this is how I’d answer your question about why motivational interviewing is important to dentistry. I wrote about this actually as a promotion for this workshop we\u2019re doing in May.<\/p>\n I wrote, \u201cAlthough we know how to avoid most dental caries, periodontal disease, and other oral health problems by simple homecare and preventative techniques, patients often do not follow through.\u201d And that\u2019s what I talked about earlier, that\u2019s the ambivalence part.<\/p>\n \u201cBut instead of the tell, show, then do approach that\u2019s so prevalent in dentistry, M.I., which is the abbreviation for motivational interviewing, focuses on awakening the patient\u2019s own reasons to change their dental care habits and say yes to the treatment recommendations.\u201d So it\u2019s, motivational interviewing is really a kinder, and gentler, patient-focused way of doing what I just said.<\/p>\n And dentistry, I think every dentist that\u2019s ever practiced dentistry has, including me, has lamented, \u201cWhy don\u2019t my patients do what I recommend? It would help them so much.\u201d Again, we\u2019ve talked about this but most information we have as dental professionals is generally pretty simple in concept and implementation but it\u2019s the dental professional\u2019s delivery of this valuable information needs help. It\u2019s a pretty big gap because of their education, inclination, and interests have paid little attention to closing this gap.<\/p>\n That\u2019s why I\u2019m so evangelical about motivational interviewing is that there\u2019s really, in my opinion, never been anything like this in dentistry. Even what I wrote about in my book, I always felt like it was a deficiency in my book. I wrote a\u2014and I send this to the new members of my website\u2014a checklist for developing exceptional doctor-patient relationships. I go into Carl Rogers and Art Combs\u2019 work about this but this is about five or six pages long and this book I\u2019m writing is going to be probably 200+ pages long.<\/p>\n That\u2019s the difference between what I wrote about ten, fifteen, twenty years ago and now and what motivational interviewing has. Because for the people listening, to really learn motivational interviewing will be a tremendous help in helping your patients improve their healthcare habits and say yes to your dental treatments.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I found, definitely to the extent that I\u2019m\u2014I wouldn\u2019t say I\u2019m doing what M.I. is teaching\u2014but to the extent that I am able to have this relationship-based thing where I do believe the patients know what\u2019s best for them. They do rely on us for a certain amount of information but the extent that I use these skills and practice this way and communicate this way with my patients, I’ve had a much more rewarding practice and I\u2019ve had a much more\u2026<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I can definitely say people accept more treatment when you take the time to listen on the front end to what they really want and help them get what they want. Instead of trying to give them what you think they need.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes. Here\u2019s a good example of that, another example that\u2019s very similar to your experience. I’ve recently, in the past month or month and a half, I’ve had an extended conversation with a dentist in Brazil. How he found my website, I\u2019m not really sure. It might have been Googling. But he has said that he was really at the point of considering leaving dentistry and that somehow he got ahold of my website and started reading the articles there and I think he\u2019s read my books also.<\/p>\n But he said it changed his life and he\u2019s gone from being burned out to being excited about practicing dentistry. That\u2019s an example and he did this all on his own. He has, he said there\u2019s no one else that he knows of in Brazil that\u2019s practicing this way or that\u2019s interested in it. So that\u2019s an example of what can happen when you really learn how to be relationship-based in your practice.<\/p>\n Bob Barkley said that he really felt like building good doctor-patient relationships was really more important than the treatment your render. I don’t know if I\u2019d go that far but I\u2019d say it sure is equal to the dental treatment. I think what he meant was that you really can’t help your patients become healthier and achieve comfort, function, health, and aesthetics as L.D. Pankey said unless you\u2019ve developed a relationship with them and they come to trust you.<\/p>\n Because you really, I mean you can do maintenance kind of dentistry but if the person we call the patient has more complex problems that involve more treatment, more expense, they really, and that\u2019s the lament I talked about of, \u201cWhy don\u2019t they do this?\u201d It\u2019s because they don\u2019t really trust you to do this and they’re ambivalent about the cost of it versus maybe going on a vacation or buying a new car or buying a sofa or you know, the list is endless on that.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, and don\u2019t you find, I think one of the things that I love about it, there was a turning point in my practice a few years ago and actually I spent time with Herb Blumenthal who teaches TMJ and that kind of stuff at the Pankey Institute. I had him come into my office but there was something about that and all the work I had done\u2026<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, he\u2019s\u2026<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The director of education, isn\u2019t he? At Pankey?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I don’t know if he is or not but he does a lot of work with TMJ and he may used to have been. I don’t know how much he\u2019s still involved there. But you know, there was a turning point where I felt like I could, I knew where my responsibility and the patient\u2019s responsibility ended. Like, I didn\u2019t feel like I was responsible for everything.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 There\u2019s something in this kind of relationship where the patient is not blaming you for\u2026<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Like they take responsibility for the decisions and they take responsibility for the\u2014so I think there\u2019s an added benefit there in terms of it being less likely to have patients who have buyer\u2019s remorse.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, it\u2019s like it\u2019s not a tug of war anymore.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, and less likelihood of being sued and that sort of thing.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, absolutely.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s an added benefit. But you were talking a little bit about the how of it. Can you get into a little bit of the how? Like how do you help pull out their own reasons for things? Their own motivations for things?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah. I\u2019ll tell you kind of a funny story. We\u2019ve talked about, in reading the book Motivational Interviewing in Healthcare<\/em>, much of it was very familiar to me. The language was a little different but much of it was very familiar because of my experience with Carl Rogers. And actually, Bill Miller in his psychotherapy training was trained in Rogerian client-centered therapy. So that comes through this a lot. There\u2019s some differences that I\u2019ll talk about.<\/p>\n But I read about ambivalence and I had never thought about ambivalence. With ambivalence, like I talk about, patients really don\u2019t want dental treatment. I mean, why would you? Because of all the things I mentioned myself. And dentists generally are among the worst patients you can have because they know all of this stuff can happen to them. But what they do want, is they want to be free of dental disease and dental problems and that\u2019s an example of ambivalence.<\/p>\n When I read the book, I thought, \u201cOh my gosh, that really helps me understand the classic lament better.\u201d Which I had. But the other thing I really enjoyed was they talked about the righting reflex. Not as in writing, handwriting, but correcting people. They said that traditionally\u2014and they talk about not just healthcare but they talk about counseling. They have correction officers that are using M.I. and there\u2019s a lot of different fields that come under the heading of helping professions.<\/p>\n But they talked about righting reflex and they said almost every helping professional wants to help their patients and correct their problems, whether they’re psychological problems or dental problems or any other kind of problems. And this is important, they’re going to do it whether the patient wants it or not. It\u2019s the, righteousness is another way of talking about that.<\/p>\n Then they talked about the expert\/savior trap. They said that when you come from the expert stance or the savior stance of trying to save patients, whether they want to be saved or not, it sets up resistance in patients or clients. That they\u2019ll overtly or covertly resist what you’re saying because it\u2019s kind of like whether you’re doing this physically or not, it\u2019s like if you\u2019re coming from the expert\/savior stance and a righting reflex, it\u2019s like your forefinger is wagging in their nose saying, \u201cYou should do this.\u201d And all of us that have gone through dental school have experienced that in the dental school environment.<\/p>\n So those three things really helped me but with Miller and Rollnick, they just came out with a third edition of Motivational<\/em> Interviewing<\/em>. In this third edition, they\u2019ve gone from being very concrete, skilled method-oriented to being more process-oriented. They’re still much more skill-oriented than the traditional Rogerian approach, but they talk about four processes of M.I. This is the answer I think to the question you asked.<\/p>\n The first one is engaging. They talk a lot about reflective listening, which is their term for active listening. They say that\u2019s the foundation of everything that follows. They talk about the core interviewing skills. They use the acronym OARS, the O is for open-ended question. The A is for affirmation. The R is for reflection and the S is for summarizing. Summarizing means that you reflect back to the patient what you think they\u2019ve heard.<\/p>\n They don\u2019t talk too much about building trust but that\u2019s what engaging is all about is you start building trust with your patient. You let them know, and that\u2019s the title of my book, that you really care about them and you want to help them get better. For everyone listening to this, in the workshops I do, I ask people to do a little visioning exercise to remember a time in your life when you really felt cared for and the person was concerned about. Then I ask people to put words to that.<\/p>\n Generally those words are the core conditions that Rogers talked about of empathy, unconditional positive regard, and genuineness or congruence. So engaging is the foundation and they use these interviewing skills, Rogers never did this. He never talked about specific skills but for learning this, if you can learn these skills, the core interviewing skills, or OARS, that will be the foundation for everything you do.<\/p>\n My opinion is, if you don\u2019t do anything else, if you learn how to do that, it will make a tremendous difference. But then Miller and Rollnick leave Rogers and they talk about three other processes. One is focusing, which they call a collaborative process. In this, you start, you know it\u2019s a great word, focusing the patient more and help them clarify what their health values are. And you start helping them to do some critical thinking about what they really want to do with, in our case, their dental health.<\/p>\n They talk about three styles of focusing. One is directing, which we\u2019ve talked about. That\u2019s the Dr. Phil approach. The second is guiding which motivational interviewing uses guiding a lot. The last one is following, which is more the non-directive Rogerian process. Then here\u2019s something else that I really enjoy because I thought, \u201cMy gosh, we as dentists have all this great information that can help people.\u201d<\/p>\n How can you give them this information? And they talk about the EPE Process. That\u2019s when you have information or advice to give that you think will help the client, you ask permission, which seems ridiculously simple. But think, how many times have you really asked for your patient\u2019s permission to give them some information? Generally most of us just give it to them whether they’re interested or not. So EPE is elicit, you ask their permission. And the P is you provide the information. Then the last E is that when you’re done, you again ask them, \u201cHow\u2019s that sound to you? Does that makes sense?\u201d about whatever the information is.<\/p>\n So that\u2019s a very brief description of the focusing process. These are in their Motivational Interviewing<\/em> book and then the book for dentistry I\u2019m writing. The book is really divided into four parts. The four parts are engaging, focusing, evoking, and planning. So there\u2019s a lot in the book I\u2019m writing and the Motivational<\/em> Interviewing<\/em> about how to focus. It\u2019s just wonderful for us dentists who like techniques and tactics. You get that in the bucketfuls in Motivational<\/em> Interviewing<\/em>.<\/p>\n Then the third one is evoking. They call that evoking the patient\u2019s motivation to change. Again, they say it\u2019s important to understand patient\/client\u2019s ambivalence. Then they talk about recognizing and responding to change talk. They recommend using OARS for that but there\u2019s a particular way you listen for change talk. They talk about sustained talk, which is talk of just staying in the old way. Change talk is when they really first start, considering, \u201cWell, you know, maybe I can do a better job of taking care of my teeth and gums. Maybe I can start implementing some of the things that that hygienist has been telling me every time I come into the dental office.\u201d<\/p>\n So there\u2019s a specific way of listening for that talk. They talk about preparatory change talk that they call DARN, that\u2019s desire. You listen for the patient\u2019s desire. Ability, they talk about, \u201cWell, yeah, I can do that.\u201d The reasons, the reasons would be, \u201cI won\u2019t wake up in the morning with blood on my pillow and every time I brush my teeth I won\u2019t spit and have all the blood in it.\u201d Then need, \u201cWell, you know, I really need to do a better job to get healthier.\u201d<\/p>\n Then they talk about mobilizing change talk, that they call \u201ccalling the cats.\u201d That\u2019s listening for patients\u2019 commitment. \u201cI will do this.\u201d Activation, they\u2019re talking about specific ways they’re going to do that, \u201cWell maybe I can get that sonic toothbrush they talked about.\u201d Or \u201cmaybe I can change my toothpaste to that one they talked about.\u201d Then they talk about taking steps, which are what I just talked about.<\/p>\n Then they talk about evoking hope and confidence. They feel like one of the helpers, or in our case, the dentists really prime role is to give the patients hope and confidence because like using periodontal disease as an example. If it\u2019s the first time they\u2019ve heard that they’re really getting into trouble periodontally, you just don\u2019t dump that on them and not give them any hope or confidence that they can improve.<\/p>\n Then another thing they talk about is developing discrepancies. That\u2019s the values clarification process and ambivalence. They talk about, \u201cWell, you know, my health is really important to me. My dental health is really important to me.\u201d But then they don\u2019t act on it. They don\u2019t do the home care as an example.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Does that mean\u2014I\u2019m sorry, Lynn.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sure.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Does that mean, developing discrepancies, does that mean you\u2019re figuring out what the two sides of the ambivalence are? That you’re seeing that their value is this but they’re not acting on it? Is that what that means?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 And the developing discrepancy is to help them recognize, to use ambivalence as an example, that they are ambivalent about this. There\u2019s some specific ways they have of that where you can help the patient start saying that, \u201cWell you know, I said it\u2019s important, but I think you’re right. I really don\u2019t do much on that, do I?\u201d<\/p>\n They say developing discrepancies helps them, you talked about this, they start becoming responsible for their own health. You talked about shared responsibility earlier, that\u2019s a result of helping them developing discrepancy. Does that answer your question?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, that is a lot of information.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019m in information overload.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I can see why you’re having a workshop because I\u2019m thinking, \u201cOh my gosh.\u201d<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s true because when I was writing the motivational interviewing book, I was thinking, \u201cOh my God, this is a lot of information they have.\u201d So along the way in the book, I kind of took timeouts and talked about\u2014and it\u2019s like Bill Wathen mentioned to this after he read my manuscript\u2014it\u2019s really important to just take this a piece at a time, at your own pace. If you try to do this all at once, and it\u2019s one problem I have with motivational interviewing, exactly what you said.<\/p>\n You can go on overload and Rogers and particularly Combs talked about that it\u2019s the person or the helper or the dentist and their beliefs and not methods and techniques are most important. It\u2019s important to keep that in my mind. But they talked about the beliefs that are most important in a helping relationship. That the helper cares about the person, they’re person not thing centered, they’re other centered, not self-centered. They have a positive view of people. They’re empathic. Nonjudgmental. Self-confident. They truly want to help the person. They’re authentic or congruent in their communications.<\/p>\n Again, there\u2019s a lot of things behind that. But really what they’re saying here is if you believe those things and if you do those things, then the methods and techniques that you use will kind of fall in line. But what Miller and Rollnick do, and they aren\u2019t quite where Rogers and Combs were, they’re getting there, but they aren\u2019t quite where Rogers and Combs are with that. But they talk about the spirit of motivational interviewing. They’re talking about that more and more. That\u2019s what I wrote about in my Spirit of Caring<\/em> book. So they’re getting there.<\/p>\n But the last thing and then I\u2019ll shut up is the planning stage. They call that the bridge to change. That\u2019s when the patient starts using more change talk than sustain talk. This is wonderful for dentists because then you can help them with the plan, to develop a plan, which is in Barkley\u2019s co-diagnosis process, I don\u2019t know how many that are listening in use that process but when I was writing the book, I kept referring to how this would work with Barkley\u2019s co-diagnosis process which I used for most of my dental career. So I\u2019ve written an e-book on this, on implementing the co-diagnosis process in your practice.<\/p>\n But I went back and I looked at what I’d written and what Barkley had talked about. He wrote that, he developed the co-diagnosis process in the 1960s. I went back and I thought, \u201cHoly cow. He almost followed this, what I\u2019ve just talked about here with these four processes.\u201d I said it\u2019s like he\u2019d read Miller and Rollnick but he was something like 20 or 30 years ahead of their time.<\/p>\n Then they have ways to help them develop the plan, to strengthen their commitment and to help evoke their intention. So all of that, I don\u2019t know how far you are in their book, but they really do a good job of I would say just like we talked about, don\u2019t get overwhelmed with this. Just take it a little bit at a time. As I said earlier, I would particularly focus on the engaging or reflection, EPE, and recognize.<\/p>\n The other thing I’d encourage people to do, is like tomorrow if you’re seeing patients, just kind of be aware of how you’re talking to patients. Ask a question of yourself, \u201cAm I being the expert when I do this? Am I trying to save them? Am I trying to right their behavior?\u201d Just see what you do.<\/p>\n The other thing I’d say is that motivational interviewing is not a quick fix because of what we\u2019ve just talked about. It takes a while to learn how to do this. For most dentists, as I said, it\u2019s 180 degrees from the way they do these. In my book, I use the analogy of it\u2019s the old thing of how do you get to Carnegie Hall? The answer is practice, practice, practice. Well it\u2019s the same way with M.I.<\/p>\n You really have to work at this but the great thing is, like particularly with reflective listening, you can mistakes all over the place. This is wonderful for us perfectionistic dentists. That it\u2019s okay to make mistakes. If you make a mistake, patients will say something like, \u201cNope, that\u2019s not it.\u201d So you try again and when you listen well, listen with real understanding, then they\u2019ll kind of nod their head and say, \u201cYeah, yeah that\u2019s it.\u201d<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 But don\u2019t you think in our attempt to even try to truly listen we\u2019re still differentiating ourselves from most the doctors and dentists they\u2019ve been to?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, absolutely.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, it is so unusual. It\u2019s like that example of when you did that interview with Bill Wathen for his Baylor College of Dentistry program?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Uh-huh.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s what you talked about, don\u2019t you agree?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I mean, you spent that whole hour or however long it was talking about that. And it does differentiate you because healthcare professionals, in our case, dentists, rarely do this.<\/p>\n It\u2019s really, it\u2019s like someone mentioned one time that a lot of businesses now are using active listening or reflective listening. They’re specifically training their employees, particularly the people that answer the phone how to do this. Banks talk about relationship-based banking and car dealers talk about building relationships. But rarely will they do it in a true person-centered way. If people start using M.I., it automatically differentiates them from car dealers, from other dentists, from physicians, you know, just go down the line.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 And I\u2019ll just say one more thing.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sure.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Then, right, we can open it up?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yep.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I just wanted to add to what you’re saying. I think that it\u2019s not only differentiating us but it\u2019s creating loyalty. You said the other day even, in the face of all the changes happening in dentistry, the corporate dentistry and the insurance, and all that stuff, that it\u2019s creating loyalty and creating patients that aren\u2019t going to leave you for the cheaper place or aren\u2019t going to leave\u00a0 you for the\u2014you know. They aren\u2019t going to leave you so easily.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, and I believe that 100 percent. It takes a lot of trust to make the commitment to do this because what\u2019s happening with corporate dentistry, Obamacare, and the insurance companies reducing their copayment amounts, it\u2019s almost forcing healthcare professionals to do more in less time because they’re getting paid less so they have to speed up and go faster, faster, faster.<\/p>\n It does take time to develop these relationships and as long as you’re the captain of your own ship, you can really determine how you run your practice and what you do. But if you start working for someone else, you start losing that ability. But I think we\u2019re at the question stage now.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, we are. I\u2019m going to try opening up the full line and see how\u2026 not too noisy. So everybody, you guys are unmuted. If you want to ask a question, we can try it this way. Okay, Edward, you’re unmuted. Go ahead.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 Yeah, I have a question for Dr. Carlisle. This is a wonderful information, I just want to get the title of the book so I can order the book for M.I.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 There\u2019s two books I’d recommend. One is the one we talked about Motivational Interviewing in Healthcare<\/em>. That was written about 2008 I think. And Miller and Rollnick have changed the way they talk about M.I. Then the other book I recommend, The Motivational Interviewing<\/em>, 3rd<\/sup> edition, which just came out in 2013.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 They’re much more process-oriented in that book. So those are the two books I’d recommend, the Motivational Interviewing in Healthcare<\/em> is about half as long as the Motivational interviewing<\/em>, 3rd<\/sup> edition.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 I see. How about your book? You have In a Spirit of Caring<\/em>, that book?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 You can go on Amazon.com and type in \u201cIn the Spirit of Caring Revisited.\u201d<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 Revisited, okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I wrote the first In a Spirit of Caring<\/em> 20 years ago this year as a matter of fact. Then I read it maybe five years ago and thought, \u201cYou know, I think all of this still applies to what\u2019s going on now, maybe more.\u201d But there were some things I wrote about in there that didn\u2019t happen, so I kept the body of the book the same but along the way I’d comment from a 21st<\/sup> century perspective. It\u2019s just an e-book, it\u2019s not in paperback.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 Right, sure. Thank you so much for the information. That was wonderful.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well thanks for being on this call.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 Yeah, I learned so much. Thank you.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Thank you. Does anybody else have a question? Oh, go ahead.<\/p>\n Lisa:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 You were talking about using this and all the different processes, especially at the end when we talked about having loyalty and the changes, corporate, I really started thinking about our team members and right now our office has been transitioning. We have several new team members. I’m wondering if you had worked with anybody about using this process with their team members and seeing the fruit of that?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 In your relationships with team members? Is that your question?<\/p>\n Lisa:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, in my relationship with our team members and also bringing them along into new ways of thinking.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Lisa:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Because our office is different than what they\u2019ve experienced in the past. And definitely when we hired, we hired for their character and their heart and for their desire to have things be different.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Lisa:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 And even if\u2026 they really don\u2019t have the skills to be able to operate that way.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I think everything I’ve talked about applies in your relationships with your team members. You know, if you think about what we as dentists do, I had and have a massive righting reflex. It would come out, I talk about the closer something or someone is to you, the harder it is to change your behavior with them. I would say the same thing about spouses and kids.<\/p>\n It\u2019s a lot easier to do this in your practice with your patients than at home with someone you live with almost 24\/7. But it applies 100 percent like particularly with the engaging, the reflective listening, I use it all the time in all sorts of different ways.<\/p>\n For instance, going through a checkout line at the grocery store. You can do little bits and pieces of active listening or reflective listening. You can practice this really in any encounter you have with a human being. The hardest part is to become aware of what you’re doing because so much of what we do in our life is just automatic. That includes communicating with people.<\/p>\n So when you’re going to change these behaviors it really takes a lot of work to stay fully present and to be aware. That\u2019s what a lot of meditation is about. Is just sitting and being quiet and then just observing your mind chatter and to recognize that a lot of this mind chatter is just that. It\u2019s not really that important although we make it seem like it is. But yes, you could use this with your team members.<\/p>\n The other thing, you need to practice this. I feel like I’ve just backed up my information truck and dumped it on you with this but in this teleconference, that\u2019s about all you can do is an information exchange. Then if you do workshops like the one we\u2019re going to do, then in the workshop, there\u2019s a lot of opportunity to actually practice this. But then when you leave the workshop, you still aren\u2019t there yet because you have to practice, practice, practice.<\/p>\n Like with this workshop, they\u2019ll be six follow-up teleconference calls to ask questions and to say, \u201cWell, I did this and it really didn\u2019t work out that well. Can you give me some feedback on what I can do differently?\u201d Then the next one after that, study groups are a great way to learn this because you have kind of built-in follow up.<\/p>\n Then the last one, and Miller and Rollnick have done a lot of research on this, is really one-on-one coaching. To have someone come into your office and just watch how you actually do it because it\u2019s the value indicator versus value of what we talked about with the self-sustaining bias. You might think you do a pretty good job but then when you have someone come in and watch and coach, then they can give you feedback, hopefully in an M.I. way that will help you see, \u201cOh yeah, I see. Yeah, okay.\u201d<\/p>\n The best way, which is harder now, is to tape yourself. But with all of HIPAA and everything, it\u2019s harder. You have to get express permission and it has to be a written document and all of those things. But I was just appalled when I first started doing this when I taped myself. I wasn\u2019t anywhere close to where I thought I was. But yeah, you could use it almost in any way with anyone.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Lisa is my office administrator. Maybe we should do a book study, Lisa, at our office on this next.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, you could use the book or when mine comes out. Like with my In a Spirit of Caring<\/em> books a lot of study groups used it as kind of a teaching tool.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Study groups, I have a huge bias about study groups. I think that\u2019s one thing dentistry does really well. It\u2019s a wonderful way to learn. I had a study group for years and actually still do. We don\u2019t meet technically as much but I think I learned more with my study group than anything else I did and I did a lot. But it\u2019s a wonderful way to learn.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 How do I get involved with the workshops that you have, you were talking about?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 If you go to my website, In a Spirit of Caring, there\u2019s information on the website about the workshop. As I mentioned, it\u2019s going to be in Santa Fe May 1 to 3. I\u2019m going to co-facilitate with Kam Venner who\u2019s a colleague Ph.D. colleague of Bill Miller\u2019s. They both teach at the University of New Mexico in the psychology department. That department has done probably most of the research on M.I.<\/p>\n So you\u2019ll get from me, you\u2019ll get more of the history of the relationship-based, person-centered approach. You\u2019ll get the Rogers part. But Kam will do more of the traditional M.I. training and the research that they\u2019ve done. Then a great thing is Bill Miller, who\u2019s the co-developer of M.I., he lives in Albuquerque and he\u2019s going to come up and spend most of an afternoon with us. He just volunteered that out of the blue. I was just blown away.<\/p>\n But I will say that I don’t know if I\u2019m going to be able to get the three of us together in the future because it\u2019s been a little challenging to get three of us in Santa Fe May 1 to 3. So I would encourage you to take advantage of us.<\/p>\n Edward:\u00a0\u00a0\u00a0\u00a0 I see.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What days of the week is that, May 1? Okay, so it\u2019s Thursday, Friday, Saturday.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We\u2019re going to start at 5:00 Thursday evening and we\u2019ll have heavy hors d\u2019oeuvres then we\u2019ll start the workshop that evening. That\u2019s mainly to check in with people to see why they’re there, what they want out of the workshop, and to talk a little bit about themselves and their practice. Then I will probably talk some about the history of the person-centered approach in dentistry.<\/p>\n I probably, I might repeat myself a little bit with what I’ve talked about today, this evening. But that will get that out of the way so on Friday morning we can just hit the ground running and really get into the nitty-gritty of this to do the exercises. They\u2019ll be some demonstration interviews that Kam does, that I do, and that Bill Miller, probably Bill Miller does, to show you.<\/p>\n Then on Saturday, it will be another full day that wraps up at 5:00. Then people, I think most people will\u2014Santa Fe is about an hour from the Albuquerque airport. So I think most people will leave on Sunday.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s for doctors and team?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh yeah, yeah. Maybe I didn\u2019t make that explicit enough. In the blurbs, marketing blurbs, I talked about dental professionals but it\u2019s great for anybody like in hygiene. This is absolutely in the wheelhouse for a hygienist because it helps them become dental educators again instead of just a profit center where they’re just cranking out prophies or scaling and planings or those kinds of things.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 If you guys have trouble finding Lynn\u2019s website, you can just email me and I\u2019ll send you a link. But I just Googled it and it\u2019s InASpiritofCaring.com. Actually, in a spirit of caring, if you just Google that, it\u2019s InASpiritofCaring.com but right in the middle of the page and then over to the right there\u2019s the link for the workshop.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 And there\u2019s an article I think under \u201carticles\u201d right in the middle of, lower middle, of the page.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay. All right. Any other questions?<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I did have one, Allison. This is Ryan Coulon here. I\u2019ve been listening and I kind of just want to hear some advice and hear what y\u2019all have to say just tying this whole topic into the whole money thing. In other words, you have a patient who\u2019s really taking ownership of their healthcare. You can tell they really do want to change and it\u2019s always kind of hit with the preliminary statement, \u201cI just don\u2019t know if I can afford it.\u201d That sort of topic.<\/p>\n What is your recommendations in terms of how much of the money topic do you get into with the patients versus kind of keeping it more doctor-patient relationship and letting the front desk or the treatment coordinator or somebody else deal with the money side of things? How do you address that when they bring that up and what does that say about their real motivation?<\/p>\n They’re saying \u201cI want to change\u201d but it\u2019s with a \u201conly if it costs a certain amount of money.\u201d Is that an indication that maybe they’re truly not fully onboard to want to change and they’re just saying that? What is your take on that from that side of things?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 You\u2019re asking Allison that or me?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No, he\u2019s asking you. I\u2019ll comment too if you want me to.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Either way.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I would ask you some questions, do you use the Barkley co-diagnosis process?<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No, I don\u2019t.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That would probably be my strongest recommendation, that you really learn how to do that and you become adept at it.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I can work with you on that, Ryan.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Because if you do that and really learn that and if you do it in the M.I. way like I’ve talked about, then you\u2019ve done all these things that I’ve talked about. You\u2019ve engaged them, you\u2019ve helped them focus on how important their dental health is to them. You\u2019ve evoked and listened to change talk and you\u2019ve helped them do more change talk. Then you\u2019ve done some planning with them.<\/p>\n The Barkley co-diagnosis process does all of that in spades. It\u2019s on my website as an e-book but the best way to learn that is like Bob Frazer and Mike Schuster do specific workshops on that. I do them, particularly for study clubs. It\u2019s a great way with a study club to learn how to do that. You use it, don\u2019t you, Allison?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I do. Yeah, actually I did\u2026<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 You do some coaching about it.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So that would be my, to really learn how to do that. That for me and I think that\u2019s\u2014I talk about crossing the threshold with this and the thing that helps you cross that threshold from going from the traditional way of practicing to the relationship-based way of practicing is to really learn and use the Barkley co-diagnosis process.<\/p>\n Again, it will probably take you three to five years but if you don\u2019t start on it right now, then it will be however long it takes you to start using it plus three to five years. So on my website, there\u2019s an e-book about it that really goes into detail. It gives you questions to ask. It gives you forms you can adapt. But the best way of learning it is to work with Allison or me or Bob Frazer or Mike Schuster.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Your e-book, Lynn, is that something you have to be a member to get?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 But it costs a whopping $1.00 on my website.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, and I think your membership site is like $49.00 for three months.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 When the recession was going on, I made all of those $1.00 to help dentists who were feeling very poor. Your first name is Ryan?<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, sir.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 How did you feel about me saying that?<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What\u2019s that?<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Do you think that\u2019s something you\u2019d be interested in or does it sound too much?<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No, I\u2019m definitely interested in it. To be honest with you, completely honest with you, I don\u2019t have a clue what the Barkley co-diagnosis is.<\/p>\n Lynn: \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019m not familiar with it at all. I may be incorporating some of those things into it already, but I don\u2019t know what it is to know whether I am or not.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 How long have you been in practice?<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I’ve been in practice for about eight months.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Well, there you go.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What happens now is people don\u2019t know Bob Barkley, they don\u2019t know of his work, they don\u2019t know who he is. It\u2019s people like the Pankey Institute teaches a version of his co-diagnosis process but I think they’re kind of losing that some. The other, like Spear or Kois or LVI, they really don\u2019t teach that much. But to me, particularly if you want to be a relationship-based dentist, and I go into a lot of detail on this on my website.<\/p>\n My website is really a good low-key way of learning about this because you can read about a lot of this at your own pace and you don\u2019t do like what I’ve probably done on this teleconference is backing my information truck up and dumping it on you and overwhelming you to the point of thinking, \u201cThis is just too much.\u201d But I’d encourage you to do all of those. If you join my website, I will kind of help walk you through that when you do that.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Then this workshop, I\u2019ll tell you, if you can learn this at the stage you’re at now, it will prevent you years of angst. What happens, the longer you’re in practice, the harder it is to change. Particularly something that\u2019s 180 degrees from the way you\u2019ve learned. So I hope I haven’t blown you away so much that when this call is over you\u2019ll think, \u201cI don\u2019t think I\u2019m going to do that.\u201d It takes a while.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, no. It\u2019s been very very good information.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019m sure Allison would be glad to help you. I’d be glad to help you with this. But at some point, you need to take the workshop like I talked about. Then you need to really start applying it in your practice. Make the mistakes and you\u2019ll gradually learn more and more until one day you think, \u201cYou know, I think I\u2019m doing this.\u201d<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It is transformative for your dental practice.<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes, sir.<\/p>\n Lynn:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019m highly biased but\u2026<\/p>\n Ryan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Right.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A little disclaimer there.<\/p>\n Lynn: Yeah.<\/p>\n Thanks for listening to Practicing with the Masters<\/em> for dentists, with your host, Dr. Allison Watts. For more about how Allison Watts and Transformational Practices can help you create a successful and fulfilling practice and life, visit transformationalpractices.com<\/a>.<\/p>\n <\/div> <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" This week I am honored to welcome a legend in the dental field, Lynn Carlisle. Lynn started practicing in 1968. After 40 years of practice, Lynn was still noticing that he had frustrations within his practice. Effective communication with his patients and his team members became his passion and sparked a new interest in learning. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_cloudinary_featured_overwrite":false,"footnotes":""},"categories":[303],"tags":[309,305,304,307],"yoast_head":"\nWhat You’ll Learn From This Episode:<\/h3>\n
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Listen To The Full Interview:<\/h3>\n\n
Featured On The Show:<\/h3>\n
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Full Episode Transcript:<\/h3>\n
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<\/a><\/p>\nMastering Motivational Interviewing with Lynn Carlisle<\/h3>\n
CLICK HERE TO READ THE TRANSCRIPT (9,220 WORDS )<\/span><\/a><\/div>\n
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