I find myself on the airplane thinking about the event I have just attended, Woody Oaks' "Excellence in Dentistry" meeting in Las Vegas. My personal self debriefing is usually centered around what I learned at a meeting, rather than the information I presented to the doctors and staff who graciously listened to me lecture for four to eight hours. At this meeting, I met many great people, but one who stands out is a wonderful dentist who was wearing a "YES" pin. The concept of "YES" always has been a big part of my practice-management philosophy, so I knew, I needed to know more about the owner of that pin and how he got it. "So where did you get that YES pin?" I asked. "Oh, I saw a guy wearing it," he replied. "I asked him where he got it, and he just gave it to me. I wear it all the time!" My next question had to be, "Can I have your YES pin?" His response was quick and sure: "After hearing you lecture, I know why you want it and you cannot have mine." He then asked me for my popular "GIRAFFE" pin and I easily said no to him. 'We both had a good laugh! So, what about the concept of YES? It is so easy to say "NO" to everything. "Doctor Hoos, can you cut off my arm and sew it to the top of my head?" I use this crazy example as something far-fetched, but it's a close analogy to what dentists hear frequently in their careers: "Doctor, can you remove all my teeth and give me dentures?" So if the answer is "YES" in our practice, we always need to add an additional key phrase, such as: "Let's talk about the results of doing the treatment you are asking me to do for you." I want to immediately clarify that I am not talking about unethical treatment, overtreatment, acquiescing to crazy dental requests, or compromising your personal dental beliefs and treatments. So please do not flood me with flaming emails! What I want to achieve is a dialogue with my patients so I can truly understand what they desire for their dental future. I want to impart dental information to my patients, but I cannot have a conversation with someone if the first word out of my mouth is "NO." That is not an open-ended response and it prevents any chance of creating a lasting relationship with someone. Think about the YES concept in your personal life. Every action has a consequence, and some of the consequences can be very unpleasant. So, even though you may have said "YES" to help empower your patient, that person must understand the results of a chosen behavior. The YES concept empowers your client and reduces the negative barriers people naturally set up when they are confronted with the negativity of NO. It is amazing how many children grow up, thinking their middle name is "No," as in "Mary, no, do not do that," or "Jeffrey, no, you cannot have that." Negativity holds everyone back and keeps them from achieving their goals. The other important part of YES when it comes to providing health care is the concept of "informed consent." Informed consent is about giving the patient enough information so that he or she can make a reasonable decision within the limitation of a layperson's understanding. We use a formula that I call the "BRAN Theory," and when you eat BRAN, everything comes out OK. BRAN stands for "Benefits, Risks, Alternative Treatment, and No Treatment." Benefit statements are the reasons why people buy products or services or agree to anything. When a statement has the word "you" in it, that is a benefit statement. Risks of treatment should be discussed, but that does not mean you have to frighten the patient and certainly, the more complex the procedure, the more detailed you need to be. All alternative treatments must be discussed. Even if you cannot provide a certain treatment, all alternatives still should be offered. The most important part of the BRAN Theory is the "no treatment" option. Not everyone can afford, nor do they desire, the doctor's concept of how their dental problems should be solved. Where does this leave us? Try saying "YES" to your patients first so you can create a dialogue to help you understand their concerns and desires. You will be amazed at the information you will glean and how it will translate into more dentistry being performed in your office. But, remember, you must always gain informed consent by using the BRAN Theory before proceeding with treatment. Have a great productive month trying to find that balance and learning to say "YES." Jeffrey C. Hoos, DMD, FAGD, is president of the Giraffe Society: "Professionals willing to stick their necks out." His seminars focus on "Balancing: The Art, Science, & Business of Dentistry." Contact him by email at jchdmd@msn.com [1] or visit his Web site at www.dentalexplorations.com [2].