Dear Readers:

One of the more common complaints I hear from dentists is what their patients won’t do. Won’t do comprehensive treatment. Won’t do any more than the insurance will pay. Won’t complete exams. Won’t keep their recall appointments. Won’t do orthodontics. And of course, some of those statements are true for some patients. It is also true that in every practice, in every town, there are patients who want and will do all of those things. This creates a dilemma for practitioners. How do you know who is interested and who is not? An even bigger problem exists if you believe all of your patients don’t want the things listed above, because now you will examine and plan and present treatments with the belief that your patients probably don’t want to hear it. In doing so, you take away the opportunity for those who do desire the best care to hear about it and say yes to it. In addition, if you don’t present what you believe is best for the patient, you don’t get to perform dentistry in a way that you may find highly rewarding.

The question is: what to do? Unfortunately there are no easy answers. It may be helpful to ask yourself why you don’t present everything you find to every patient. Your answer may sound like this: “I don’t want to scare them away. I don’t want to be rejected. I don’t have time in my schedule to do complete exams and presentations on every patient.” I know in my town and my practice patients don’t want to hear about everything. I find it fascinating that these beliefs are so prevalent in dentistry. If you take your car to a mechanic for an oil change, do you want to hear that your fan belt is worn, your tires are bald, and your transmission is leaking? If you are like me, you want to be told, but you just may not enjoy what you hear. What you really don’t want is to be told what to do about the mechanic’s findings. Again, if you are like me, what you want is to know what will happen if you do nothing, what different options exist to solve the problems, and how much it will cost. And guess what? A certain percentage of people who hear about the fan belt, bald tires, and transmission leak will do nothing. Another group will fix whatever is perceived as the most critical problems, and some will take care of everything. What is certain is that if the mechanic doesn’t inform the customers about the problems, nobody will do anything.

My point is that whatever we don’t tell patients will impact their ability to choose their own care, and our ability to deliver it. We can take a lesson from excellent mechanics when doing our presentations. The first step is always to simply report findings. The second step is to inform the patient what will happen in each area if no treatment is done. The third step is to tell them what the benefits of treatment will be. And the last step is to outline the treatment plan, priorities, and costs.

Traditionally, most dentists start at the last step, presenting the plan first. This comes across the same way as the mechanic handing you a piece of paper describing how they will fix the fan belt, tires, and the transmission leak, and how much it costs before you even know the problems exist.

Another way of describing the process is to acknowledge that the goal of case presentation is patient education, not patient acceptance. Believe that when patients are educated, they will make the right choice regarding treatment. And, finally, remember that in every town, in every practice, some patients will say no, some will say yes to part of the plan, and some will say yes to everything… as long as you give them that option.

Sincerely,

Frank M. Spear, DDS, MSD