ORIGINAL RESEARCH PAPER PATIENT DECISION MAKING PROCESS IN A DENTAL ENVIRONMENT Daya Srinivasan* Professor, Department of Pedodontia & Preventive Dentistry, Chettinad Dental College & Research Institute, Kelambakkam, Kancheepuram district, Tamil Nadu *Corresponding Author Shivi.B Intern, Chettinad Dental College & Research Institute. Kelambakkam, Kancheepuram district, Tamil Nadu Sara Mahfooza Intern, Chettinad Dental College & Research Institute. Kelambakkam, Kancheepuram district , Tamil Nadu ABSTRACT An understanding of patient's decision making process helps a Dentist to present various treatment options in an appropriate and a legitimate way. The dynamics of today's practice is changing, where information search is made through various media. Patients pass through sequential steps comprising of, problem recognition, pre-purchase information search, evaluation of alternatives, purchase decision and post-purchase outcome and reaction before a choice is made. This paper provides an overview of how choices are made scientifically which helps the dentist to sustain an established practice and to successfully deliver the Dental treatment. KEYWORDS Dental, evoked set, compensatory, non -compensatory rules, performance, expectation, clinic loyalty An understanding of the patient decision making process, helps a Dentist to present various treatment options in an appropriate and truthful way. The same template could be used to market one's own practice accordingly. Understanding the dynamics of changing perception [1, 2] of young patients is paramount essential in delivering the Dental needs of the patient. The changing trend of today's practice is, patient checks all the information through electronic media even before making an enquiry. This compels the health care provider to be a step ahead in knowing the thought process of the patient. An individual may or may not even realize that his decision making process runs in a definitive structured pattern John Dewey's (1910) original model of Decision making was modified by Engel-Kollat-Blackwell (EKB) into five -stage problem solving process and applied here to the patient behaviour. Five stages in decision making process [3, 4] are as follows. I. Problem recognition II. Pre-Purchase information search III. Evaluation of alternatives IV. Purchase decision V. Post-purchase outcome and reactions I. Problem recognition [3 ,4] A patient perceives that he has got forwardly placed teeth. This stimulus could be internally motivated, wherein he himself feels the need for the treatment or could be externally driven, someone suggesting treatment for better aesthetics. Problem recognition could result when (i) Actual state changes- The patient's present denture has broken and is in need of new one. These are reactive patients, they react only when a problem arise. (ii) Desired state changes-His present removable denture is functioning well, but wants a fixed prosthesis as suggested by his friends. These are proactive patients who are willing to experiment with newer and advanced products. Based on Hierarchy of needs by Maslow, lower level of needs (biological and Physiological needs) must be fulfilled before higher needs (esteem, self-actualisation) are met. [5, 6] Patients presenting complaint has to be addressed first before embarking on other treatment modalities. II. Pre -Purchase information search: The next stage of decision making is information search, wherein need related data are assimilated. A list of pros and cons are made even- though it might be time consuming. Considering a patient wants to buy a mouth wash as a over the counter product. The choice could be depended on - (i) Product category -herbal or alcohol based (ii) Pricing (iii) Brands and avail offers (iv) acceptability of taste. III. Evaluation of alternatives: This involves: i) Generation of choice alternatives [7] ii) Identification of evaluative criteria iii) Application of Decision Rules. i) Generation of Choices: [8, 9] considering a patient want to choose a dental clinic for treatment. He makes a list available from the internet. a) Evoked set/Consideration set: It is the list of dental clinics that patient perceives to be acceptable. [10] b) Inept set: This is the set which he excludes from the list as he finds them to be inferior or unacceptable. c) Inert set: It is narrowed down from evoked set. Patient on further consideration excludes [11]clinics ,as he perceives them to be less benefit. This could be based on proximity of his stay to the Dental clinic, appointment time preference based upon his work shift, insurance /claim acceptance. d) Choice set: The final set contains one or two clinics from which he ultimately decides.[12] ii) Identification of evaluative criteria: The choice made by the patient depends on benefits, attributes and features a product could offer. This is depended on three factors. a) Economic: The patient wants value for money to get the best dental service. Brand image [13] of the clinic, quality evaluation certificate from external agencies, infra-structure facilities are some of the factors that could determine in choosing the clinic. b) Behavioural: Largely depends on physical, psychological and personality of the individual. c) Social influences: The choice is depended on family, friends and peers.Many tend to follow the advice of opinion leaders .They could be experts/leaders/person with high social status. iii) Application of decision rules: 11, 12 These decision rules help in simplifying the decision process. These can be of two types. a) Compensatory rules: Various evaluative criteria are listed as attributes. Based on the attributes the products are ranked. Consider the patient has many brands of tooth paste to select. The patient could select depending on attributes like flavour, cost, brand offer, brand INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH Dental Science 36 International Journal of Scientific Research Volume-7 | Issue-5 | May-2018 | PRINT ISSN No 2277 - 8179