Argue your way to understanding: Dental team dynamics benefit from seeing things from the opposite vantage point
BY Heidi Emmerling Muñoz, PhD
I am a chronic people pleaser. When I was in private practice, I wanted-more than anything-to have harmony in the office, which I thought meant avoiding arguments at all costs. I had the wrong definition of an argument: verbal judo where one wins and the other loses, involving anger and hostility, followed by slamming doors. I thought an argument was a pro/con debate, in which the goal would be to shoot down the opponent at all costs ... I have since learned otherwise.
When I teach advanced argumentation, we reframe the definition. Instead, an argument involves reasonable people seeking the best solution to a problem. It is my hope that this definition can be applicable to dental teams, assuming the team members are all reasonable and are all seeking the best solution.
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Other articles by Munoz
- Help! Let me out! What are the career options for dental hygienists who want to leave clinical?
- The mid-level: Alternative workforce models continue to develop in dentistry
- Holistic approaches to chronic disease: Author describes how the holistic philosophy allowed her to continue healing beyond traditional medicine
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To begin wrapping our heads around this concept, let's look at a relatively humble conflict between two team members-say, an assistant and a hygienist. Consider the following dialogue:
RDH: (rushing in to the sterilization area with a tray full of dirty instruments) Here you go. Make sure to bag the ultrasonic inserts separately from the other instruments.
DA: Whoa! My job is not to clean your instruments.
RDH: I am sure we discussed this at the last staff meeting.
DA: We did not discuss this, and I am not cleaning your instruments.
At this point, we have a quarrel, not an argument. Quarrelers are antagonistic and throw out statements with no rational justification. If the conversation does not go beyond "Yes, you will!" statements and "No, I won't!" statements, it either remains a quarrel or escalates into a fight. But notice what happens when the dialogue takes the following turn:
RDH: But the patient in Room 1 is overdue for her maintenance appointment and has been waiting for me for 15 minutes already.
Here, we are moving toward an argument (albeit not a well-developed or cogent one) because someone is beginning to justify a claim, which is a hallmark of an argument. The RDH asking the DA to clean the instruments is satisfactory, she says, because there is another patient waiting. The DA can now respond in one of several ways that will either advance the argument or turn it back into a quarrel. The DA can simply refuse, in which case the argument ceases. Or, the DA can provide reasons for her perspective (e.g., "I am not your employee, and I do not take orders from you"), in which case the argument takes a new turn.
Clarifying the assumptions
An exchange must involve two necessary elements in order to be called an argument: (1) a set of two or more conflicting assertions or claims, and (2) an attempt to resolve the conflict through an appeal to reason. But a good argument depends on much more than meeting these two requirements. For an effective argument, one is obliged to clarify and support the reasons. For example, "But the patient in Room 1 needs me now," is not clear support for the assertion, "You need to clean my instruments." On the surface, the RDH's argument might seem flimsy. The DA probably knows what is going on with the schedule. What makes it an argument is that, behind the RDH's claim, lies an unstated assumption that the patient should not be kept waiting.
What the RDH needs to do is support that assumption. In doing so, the RDH must anticipate the kinds of questions the assumption will raise in the mind of the DA. What will happen if the patient waits just a few more minutes? What if the DA is busy, too? Can the RDH be more effective with time management? Will the DA always be expected to clean the instruments, even if a patient is not waiting? Will the RDH be willing to help with the DA's instruments? And so forth.
Each of these questions above will cause the RDH to reexamine and clarify assumptions about the expectation of having the DA clean the instruments. And the RDH's answers to the questions should, in turn, force the DA to reexamine his or her stance about the role of an assistant in the office.
As the argument continues, the RDH and the DA may shift to a different line of reasoning. For example, the RDH might say, "You should clean my instruments because in the other offices I work at, the DAs always clean the hygiene instruments." Here, the unstated assumption is that the rules in this office ought to be based on the rules in other offices. The DA might respond, "But the last RDH never had me clean the instruments," in which case the unstated assumption is that current rules should be the same as they were with previous employees.
A surprising definition of argue?
As the RDH and the DA listen to each other's point of view (and begin realizing why the initial arguments were not persuasive for their intended audiences), both find themselves in the prickly position of having to examine their own beliefs and justify ideas they have taken for granted. It makes sense, then, that one of the earliest meanings of an argument was "to clarify." As an arguer begins to clarify his or her position on an issue, he or she must also clarify the audience's position. From there, he or she might need to accommodate the audience's views, perhaps by adjusting his or her own position or by developing reasons that appeal to the audience's values. The RDH might suggest an argument like this:
"You should clean my instruments when you are able to whenever we add extra patients to the schedule, which helps with overall office production, on which our bonuses are based. In turn, I will clean your instruments whenever you are busy and I have downtime."
Because this reason is likely to appeal to the DA's values (bonuses, reciprocity, respect) and because it has a qualifier "when you are able" (which reduces some of the threat of the RDH's demands), it could prompt a productive discussion.
Regardless of whether the RDH or the DA can work out the best solution, the preceding scenario illustrates how arguments lead people to clarify their reasons and provide justifications that can be examined rationally. The scenario also illustrates how an argument is both a process and a product and how arguments contain both truth seeking and persuasion.
In thinking about an argument as a product, the arguer will be moving back and forth between truth seeking and persuasion. The arguer will use questions about the subject matter, such as "What is the best solution?" and about the audience, such as "What does he or she value?"
Mingling the minds
Another strategy to successful argumentation is to think dialectically-sort of like a dialogue involving many different points of view. Experts actively seek out alternative views, not to shoot them down, but to listen to them to get closer to the truth and a satisfactory solution to the community as a whole. Several strategies to foster dialectic thinking include engaging in effective discussions to "mingle the minds," writing reading logs in which you summarize an author's position and then "dialogue" with the author, and writing exploratory essays in which you examine different points of view.
Another thing to keep in mind when arguing is whether you are trying to untangle an issue or look for an answer. A true issue has at least two alternative answers. An example would be, "Should RDHs be paid hourly or on commission?" Because it has at least two different responses, this could lead to a reasonable argument. This differs from an information question, in which you and/or your audience are seeking an "explication," which sets out to inform or explain, while the other party is sincerely looking for new knowledge on a topic. One example of an information question would be, "How do regional dental hygiene boards differ from state boards?"
Once you have determined that the question is a genuine issue, it is important to distinguish between a rational argument and a pseudo-argument. Rational arguments require reasonable participants who operate within the conventions of reasonable behavior, and they involve participants who have potentially sharable assumptions that can serve as a starting place or foundation for the argument. Lacking one or both of these elements can result in a pseudo-argument.
While a reasonable argument assumes the possibility of growth and change where disputants may modify their views as they acknowledge strengths in alternative views or weaknesses in their own, pseudo-arguments exist when disputants are either fanatically committed to their own point of view or fanatically opposed to an alternate point of view.
While there may be times when the axiom, "If you don't stand for something then you'll fall for anything," might hold true, such as not cutting corners with infection control, committed believers can seem rigidly fixed, incapable of growth or change. When committed believers with two clashing belief systems try to engage in dialogue with each other, a truth-seeking exchange becomes impossible as they talk past each other, replace dialogues with monologues, and push each other's buttons.
This is why some people have a policy of not discussing politics or religion at work. Disagreeing with a committed believer is like telling the sun not to rise. The only response you'll get is another sunrise.
In contrast to the committed believer, the fanatic skeptic dismisses the possibility of ever believing anything. They demand proof where no proof is possible. So what if the sun has risen for every day of recorded history? That's no proof it will rise tomorrow. Short of absolute proof, which never exists, fanatic skeptics accept nothing.
Thus, rational arguments degenerate into pseudo-arguments when there is no possibility for listening, learning, growth, or change. The biggest cause of pseudo-arguments is a lack of shared assumptions. The lack of shared ideologies (belief systems, worldviews) leads to pseudo-arguments, as do differing personal opinions. For example, some might claim that opera is boring or that pizza is better than nachos. You could have a rational argument about pizza versus nachos if you were discussing calories, nutrition, or cost, but if it is a matter of personal taste, then this is an opinion others might be unable to share.
Once you are ready to make a rational, issue-oriented argument, your task is to take a position on the issue and support it with reasons and evidence. Similar to a thesis statement in an essay, the claim is the position you want your colleague to accept, while the reason or premise is the evidence used to support the claim. Holding to the dialogic philosophy, you should identify the claims and reasons of any alternative points of view. Here's an example:
One view
Claim | Our office should quit using nitrous oxide.
Reason 1: There is evidence showing that health issues can result for women of childbearing age who are exposed to it, even in trace amounts.
Reason 2: The nosepiece and hoses are problematic for infection control and because they limit access to the oral cavity.
Reason 3: Storing nitrous oxide in the office makes us a target for burglary.
Alternative view
Claim | Our office should continue to offer nitrous oxide to our patients.
Reason 1: It makes procedures more comfortable for our patients.
Reason 2: When our patients are happy, they refer more patients.
Reason 3: We have the highest quality scavenger system on the market, and so far, no one has experienced adverse health issues that can be linked to exposure to nitrous oxide.
If you formulate a list of reasons like this, you break the argumentative task into a series of subtasks, which allows you to build your argument in parts. By listing any alternative points of view, you will be better able to understand and address those concerns.
Just because
After identifying differing claims and reasons, express the claim and reasons in "because" clauses. For example, "Our office should quit using nitrous oxide/oxygen sedation because there is evidence showing that health issues can result for women of childbearing age who are exposed to it, even in trace amounts; because the nosepiece and hoses are problematic for infection control and for access to the oral cavity; and because storing nitrous oxide in the office makes us a target for burglary. Even though logical relationships can be stated in various ways, writing out "because" clauses seems to be the most succinct and manageable way to clarify an argument for oneself. While this may seem frustrating or difficult, trying to summarize your argument by developing a single claim with reasons should help you see more clearly what you have to do.
Prior to presenting your claim and reasons, consider the alternative point of view. If you have a resistant audience, it may be more effective to address the alternative claim first. For example, "Although nitrous oxide/oxygen sedation makes procedures more comfortable for our patients; although those happy patients refer others; and although we have an amazing scavenger system, our office should quit using nitrous oxide/oxygen sedation because..." Addressing the alternative point of view first will help to keep your audience's ears and mind open. Failure to do so could be like talking to a brick wall: Your audience might think that you have failed to do your research, that you are oversimplifying the issue, or that you just don't get it.
If you have a highly resistant audience, you will need an "although" for every point you make. Please do not be tempted to short-change your audience by cherry picking the weakest argument and reducing it to half of a sentence before moving on to your points, dismissing everything else. I guarantee this will not work.
Even if your audience is neutral about or sympathetic to your side, it is important to present the alternative views to show your audience that you are reasonable and not fanatically committed to your own position. In this case, however, you can put the alternative at the end.
A final strategy for appealing to a resistant audience is to use a delayed thesis argument, which is helpful if the audience is downright hostile, or a Rogerian argument, which is a way of communicating and thinking that can broaden your perspective about a complex issue as well as your audience's.
A delayed thesis assumes an exploratory approach. You will convey that you are still thinking out your position. A delayed thesis enables you to engage your audience in a dialogic exploration of the problem before you argue a thesis. In the nitrous oxide example, you would begin by discussing an article you read about the health risks, mention the news you heard about the doctor down the street whose office was broken into, and empathetically discuss how difficult it is to work around the nosepiece and hoses. You would also discuss how effectively the nitrous oxide worked on a difficult patient and brag about the state-of-the-art system you have. At this point, the thesis could be presented.
Aside from delaying the thesis, a Rogerian argument, named after psychotherapist Carl Rogers, works to change the arguer as well as the audience by emphasizing "empathetic listening." In a Rogerian argument, the arguer sees an issue from a place of empathy, withholds judgment of an alternative point of view while listening attentively to the other person's reasoning, appreciates the other person's values, and respects the other person's humanity. A lower threat than a classical argument, this approach is particularly effective when dealing with emotional issues because it reduces the difference between the speaker and the audience. In a Rogerian argument, the emphasis is on areas about which both parties agree (e.g., "We all want happy patients who refer as well as a healthy team"). The structure of a Rogerian argument begins with an introduction addressing the issue. Then, the arguer summarizes the alternative point of view and demonstrates understanding before identifying the common ground and respectfully contributing his or her way of looking at the issue. After that, he or she might propose a synthesis of the two positions and explain how both parties could benefit. He or she might also invite the audience into ongoing negotiation.
When intending to engage colleagues, people often present one-sided arguments. Neutral or undecided audiences generally respond most favorably to the direct, classic approach that uses strong reasons in support of a claim, while openly summarizing alternative views and responding to them in either rebuttal or concession. Strongly resistant audiences typically respond most favorably to dialogic strategies, such as the delayed thesis and Rogerian arguments, both of which seek common ground, aim to reduce hostility, and take a more inquiring or conciliatory stance.
So, the next time you engage in an argument with your colleague, put down the boxing gloves and open your mind to new ideas. You just might argue your way out of a quarrel and into harmonious understanding. RDH
Heidi Emmerling Muñoz, PhD, is a professor of English at Cosumnes River College, where she has designed a course in technical communication and teaches all levels of writing, including Advanced Argumentation. Dr. Muñoz is also a delegate to the American Federation of Teachers (AFT) union. Prior to her current position, Dr. Muñoz was a CODA site consultant with the ADA, an interim director and professor of dental hygiene at Sacramento City College, and a private-practice clinical dental hygienist for more than 20 years. She has written numerous articles and columns and is a frequent contributor to RDH. Dr. Muñoz can be reached at [email protected].
References
1. Ramage J, Bean J, Johnson J. Writing Arguments: A Rhetoric with Readings. Brief 9th Edition. San Francisco: Pearson, 2012.