2. Co-discovery or Shared discovery
What if your patients shared your passion for treating the problems that you have found in their mouth as a result of a comprehensive examination?
It is hard for patients to feel enthusiastic about the 'solution' you want/hope to provide for a problem that the patient wasn't aware of prior to the checkup.
Co-discovery is when you allow the patient to become aware of issues as you find them. This is a form of "priming" - we expose the patient to information during the checkup that will influence the receptiveness to later conversations about the problems and the solutions we offer.

Read more at: https://www.scienceofpeople.com/priming-psychology/

The purpose of co-discovery is to help ensure the patient feels they have a problem.

You have the solution to their problem. However unless the patient feels they have a problem AND the solution you suggest satisfys how the patient wants to be in the future (their value proposition), they will not want your solution.
The patient needs to be able to feel and know the consequence of their problem - what they will avoid by fixing it; what they will gain by not having it.

Show the patient "normal" ; then relate that to the patients present condition; and lastly look at the "future" (e.g. where they could be and where it looks like they are going!).
You and the patient are discovering the problem they have. You are not telling them what is wrong.

• The problem isn't that the patient doesn't know the knowledge that is in your head (not a dental education issue);
• The problem isn't that the patient needs to understand how you are going to treat this problem.
• The problem isn't that the patient needs to know why the problem occured. (until you get the problem as a serious issue that needs to be prevented next time...but for today you need the patient to want a solution).

The focus is on consequences (what it means to the patients) and not why it has happened.

If the patient comes to you because of they know they have a problem then you are well on the way of the journey.
But if this is a problem that you have found then you have a great task of:

• Changing what is in the patients head e.g. they have no problem (you have the problem)
• Making the problem unstable/ tension causing/ challenging - a problem the patient needs to deal with or the patient will not care about your solution.
  

You need to show that the instablity/tension/challenge =problem =poses a cost on them; or if solved, it will benefit them. "But, although, inconsistent, however, anomaly" - tension or challenge words used in writing. The problem needs to be one of instablity/tension/challenge for it to be something the patients care about.

Do not use language of continuity or you give the patient mixed messages. Is it important now or not! Is that why they came to you or is it something you have found.
If the patients do not perceive the problem then they DO NOT care about the solution.
Note: The problem needs to be unstable- you are aiming for tension.

The benefit of this technique is that it transfers the "power" to the patient. It acknowledges the patient's ability to understand and it "anchors the future".
Anchoring the future
This is a term for making the future feel like now. This is important because we are all terrible at taking notice of future consequences but by helping patients visualise the future we bring it closer to the patients decision making center. (Behaviour economics factor)

3. Patient decision tools
Helpful learning resources on ACSQHC site https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making
Patient decision tools are applicable when:

1. there is more than one reasonable option
2. no option has a clear advantage in terms of health outcomes
3. each option has benefits and harms that patients may value differently
   

International patient decision aid standards collaboration
Ottawa patient decision aids site

4. Shared decision making
This process isn't giving patients the options. It is exploring options and the patients values and attitudes. It is for when patients have a choice. It has to include informed consent. When there is only one choice then shared decision making is unnecessary but informed consent is necessary.
SDM =Patients preferences + Evidence -based info + practitioners experience
From tha ACSQHC course (Risk communication modules), which is excellent:

• Option talk’ aims to provide information about the options that are considered reasonable (can include taking ‘no action’) and discuss the pros and cons of each.[1,2,4,5]
• Risk talk: A vital component of option talk is ‘risk talk’. This aims to communicate information on the benefits, harms and uncertainties of available options [2] Rather than just a broad discussion about pros and cons, risk talk aims to convey statistical information.
• ‘Decision talk’ involves supporting the patient to explore their personal preferences and what matters most to them in response to the options that have been described. The clinician then attempts to integrate these preferences as a decision is arrived at through collaboration and discussion.
• Motivational interviewing: People can be initially confused by an apparent disparity between SDM and motivational interviewing. SDM involves promoting patients making an informed choice, while motivational interviewing typically has clear behavioural goals. But in reality, they are compatible and have some similarities, both:
  • are patient-centred methods that promote the ethical imperative of respecting autonomy
  • focus on engaging patients to explore their views and opinions, including options for treatment or management approaches from the patients’ perspective
  • require excellent communication skills
  • Although motivational interviewing and SDM have been considered applicable in distinct and nonoverlapping situations, in real-life clinical situations, there may be benefit from drawing on both methods
    SDM is not the same as informed consent. Informed consent is obtained before a (usually) single event, often focusses on only one option, and typically only on the risks (potential harms) of that option. In contrast, SDM is not a single event, it is a two way, multistep process that should occur well before the patient gives informed consent for an intervention.[1]
    While SDM should be part of the routine exchange between clinicians and patient, clinicians should document the process in the patient’s medical record, with notes about the advice and information provided to a patient, including the specific options that have been discussed, their benefits and harms, and educational resources that were provided (if any)

1. Codified communication (jargon)
Do we understand the codified language that we use? Check out this youtube on writting because it is an excellent expression of issues that we can relate to talking.
We need our foreign dental speak to communicate with collegues e.g. jargon is good and essential. But not for normal people (doesnt matter how academic they are).
The important part of communication is not what we know, but have we made a value proposition for the person listening to us. When someone says they don't understand it is not an opportunity to explain more. It means that you have NOT delivered valuable information. You need to address your value proposition.
If someone says "but what would you do?" it means you have not explained well enough for them to make a decision.
If you can't explain it simply, you don't understand it well enough - Albert Einstein
Doctor Speak up http://www.doctorsspeakup.com. Worth looking at especially if English is not your first language

Read about how websites should be written: User-centric vs. Maker-centric Language: 3 Essential Guidelines Summary:
Aim: To engage users, website copy must speak to readers and not at them. Include words people can relate to, and avoid jargon, business speak, and feature-driven language.