Going From Yes to No

Bill Claytor, DDS, MAGD
Executive Director, NCCDP

One issue that has always plagued the human race has been the lack of individuals setting boundaries. This appears to be an ubiquitous condition common to all cultures and societies. Subsequent consequences may include people being subjected to different types of abuse, whether mental, physical, verbal, or sexual.

Oftentimes in relationships there is a hierarchy of assumed power and dominance of one person over another. We see this in several aspects of life, from parent-child, teacher-student, manager-employee, politician-staff, to even dentist-employee. In and of themselves, these relationships are not necessarily bad. Understanding these relationships with mutual respect is crucial. However, if not kept in check, they can explode into atypical actions from one person with unintentional consequences for both people.

The foundations of all relationships are respect, care for the individual, and boundary setting with each other. The concept of boundary setting is not really implemented in most relationships because we want that person to like us. People say things like “Yes” to anything being asked of them without realizing how accepting these responsibilities may impact them or their families. I like the statement I once heard about co-dependency as it was defined as, “a chronic denial of self.” This can also be so true of dentists because we are such “people-pleasers”. Saying “No” is difficult for most of us. Setting boundaries can be a life saver for us. Most people think boundary setting is telling someone what is the maximum you will take from them, or “drawing a line in the sand” moment. While this is true, there is more to boundary setting that is often not addressed. A person needs to also tell the other person that if they cross the defined boundary in the relationship what the consequences of their actions will involve. Another words, if they cross a boundary, the following actions will occur (“If you do……,this will happen”). Most people don’t say this because they think the other person receiving this message will take it as threatening. In fact, nothing should be further from the truth. Instead, boundary setting clarifies your relationship with the other individual because now both parties know your expectations and are aware of the consequences if they do “cross that line”.

I remember being in Israel once when there was a red line in the road that said, “Do not cross because (the following consequences will occur)”.I thought, “Really?” Of course I crossed the red line and immediately the response was the quoted consequence of crossing the redline. Not good as I almost got into deep trouble! I remember my dad used to say to me, “I guess you don’t think a snake will bite?” Instead, consequences of someone violating your boundary should help define and form your relationship with them. Now everyone knows the expectations of what will happen if the boundary is broken.

We want our patients to “like” us and will do whatever it takes to make the patient (customer) happy. In today’s consumerism world, patient and Social Media reviews have dictated a lot of how we practice. Everyone wants a 5 star rating. Setting boundaries, by telling a patient “No” to a certain treatment they want that you know is not appropriate, telling a patient you will not prescribe them an opioid, or even confronting conflict with staff members were not taught in dental school as I remember. These are very difficult for most of us to confront and resolve.

Boundary setting is difficult for most of us. It is an acquired taste! One way to get started is when someone asks you a question, respond by just saying the word, “NO”. For me it was a hard thing to do because I always want to say “YES”. How about you?