The Arc of Dehumanization

I remember during my hospital residency being upset when a medical resident referred to a patient as “a DNR.”

Not a patient with a DNR order.

A DNR.

Three letters had replaced a human being.

At the time, I wondered whether it was my religious background making me overly sensitive. Maybe I was taking that whole “created in the image of God” thing too far.

I don’t think so anymore.  Today, I think what I recognized was a symptom of a more troubling affliction that’s having a negative impact on our society.

Recently, I saw a dentist on Facebook asking for treatment planning advice, and referring to his patient as a “case.” I felt compelled to comment that behind the photographs and X-rays was a human being. Someone with a soul. Feelings. A family. A story.

Can you really divorce a treatment plan from the individual? That’s a blog for another day.

The incident got me thinking about how much depersonalizing—and eventually dehumanizing—language and behavior we’ve allowed to creep into our personal and professional lives.

There is a difference between the two.

Depersonalization removes the identity. Dehumanization removes the humanity.

And one can quietly lead to the other.

Every mature practice has a Margaret.

Margaret had been coming to the dental practice for more than twelve years.

The receptionist knew her husband. The hygienist remembered when her daughter got married. The dentist knew she was terrified of injections because of a bad experience she’d had as a child.

Nobody needed to look at the chart to know who Margaret was.

She was Margaret.

Then the practice was sold.

At first, very little seemed different. Same building. Same chairs. Most of the same people.

But slowly, the culture changed.

There were new systems. New metrics. New protocols. More attention to efficiency and production. Insurance participation became more important. Technology increasingly mediated communication. And an increasing preoccupation with HIPAA compliance made everyone appropriately more cautious about how names and personal information were used.

None of those things, individually, were necessarily wrong.

But Margaret gradually became “the 10 o’clock.”

Then “the crown on 30.”

At the front desk, she became “the Delta patient.”

When the claim was denied, she became “that denied crown.”

Margaret hadn’t changed.

The way the practice saw Margaret had.

That’s depersonalization.

And it can begin quite innocently. Shorthand saves time. Codes make systems work. Insurance identification gets claims paid. Technology increases efficiency. Privacy protections are important.

But there can be an unintended consequence.

The name disappears.

Then the story.

Then the circumstances.

Eventually, the person begins to disappear.

Now, when Margaret questions a bill, she isn’t a recently widowed woman trying to understand an unexpected expense.

She’s “difficult.”

When the person who usually drives her cancels and she arrives fifteen minutes late, she’s “noncompliant.”

When she hesitates to proceed with treatment because she’s worried about money, she becomes “a low case-acceptance patient.”

Notice what just happened.

We’re no longer describing something Margaret did.

We’re describing what Margaret is.

That’s where depersonalization begins sliding toward dehumanization.

And I don’t believe this is merely a dental problem.

We increasingly reduce human beings to categories, acronyms, usernames, political affiliations, demographic groups and avatars. Much of our interaction now takes place through screens, where it’s remarkably easy to forget that the person on the other side has feelings every bit as real as our own.

Perhaps it’s a kind of communal narcissism: so much attention directed inward—toward our own objectives, frustrations, schedules and opinions—that we gradually lose curiosity about everyone else.

We may not be able to reverse that societal trajectory.

But as practice owners, we can refuse to let it become the culture inside our own four walls.

So here’s a simple self-assessment.

Has Depersonalization Crept Into Your Practice?

Efficiency isn’t the enemy.

Neither are systems, technology, insurance, privacy regulations or metrics.

The danger comes when the systems designed to help us care for people slowly become more important than the people they were designed to serve.

Dentistry remains one of the most personal professions imaginable.

We work inches from another human being’s face. Patients allow us into an intimate part of their body. They reveal fears, embarrassment, financial concerns and sometimes stories they haven’t told anyone else.

That person isn’t a case.

They aren’t a procedure code.

They aren’t a reimbursement problem.

They aren’t the 10 o’clock.

They have a name.

Perhaps preserving humanity begins with something as simple as remembering to use it.

And perhaps there’s a consequence that reaches beyond our practices.

If the people who entrust their care to us experience what it feels like to be seen, known and treated as human beings, perhaps they’ll be a little more likely to extend that same humanity to the next person they encounter.

We may not be able to change society all at once.
But humanity, like dehumanization, can spread one interaction at a time.

Let’s start playing it forward.