Difficult Conversations in the Dental Office Difficult conversations are inevitable in the dental office. Whether it’s addressing performance issues, negotiating salaries or managing patient dissatisfaction, these interactions often evoke discomfort and anxiety. In this article, Dr. Jessica Metcalfe explains how avoiding such conversations can lead to much larger issues over time. “The problem with avoiding difficult conversations is that when you let something fester for a period of time, it accumulates and eventually, everything comes out like water from a fire hose,” she says. By embracing a structured and empathetic approach, dentists can transform these challenging moments into opportunities for growth, stronger relationships and a healthier workplace culture. Dr. Jessica Metcalfe is a general dentist and leadership and workplace culture consultant. She is an award-winning international speaker and best-selling author of Speak Kindly, You’re Listening. Understanding Difficult Conversations Difficult conversations in the dental office can arise in many forms: salary discussions, performance evaluations, setting job expectations, or addressing gaps caused from terminations and resignations. For some, these can feel deeply personal, often triggering stress and self-doubt. Dr. Metcalfe explains that the definition of a “difficult” conversation is subjective, influenced by individual emotions and expectations. “A difficult conversation for you isn’t necessarily the same difficult conversation for me,” she notes. “We attach different emotions to these interactions.” Despite their emotional weight, these conversations are essential. Without them, issues can compound and create unnecessary tension within the dental office. “Being proactive doesn’t change the fact that these are going to be difficult, but it changes how you build your culture and take on leadership opportunities,” Dr. Metcalfe says. Tackling issues early can prevent them from escalating and ensures that both parties feel heard and valued. Avoidance may feel like the easier path, but it comes with significant risks. Dr. Metcalfe points out that unresolved issues grow over time, turning minor concerns into larger conflicts. “If you wait too long, everything gets bottled up. Then when you finally address the issue, it’s not just about one specific thing, it can be about everything and the kitchen sink!” she says. Addressing issues proactively reduces emotional intensity, improving discussions. This builds workplace trust and respect. Preparation and emotional regulation are critical components of any successful conversation. Dentists should plan and prepare for discussions. Dr. Metcalfe stresses that going into a conversation with a plan can make a big difference: “You don’t want to feel blindsided or unintentionally blindside the other person.” Despite their emotional weight, these conversations are essential. Without them, issues can compound and create unnecessary tension within the dental office. 30 | 2025 | Issue 3
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