October 30, 2025 • 28 mins
It’s the classic lose-lose situation: a patient walks in with no pain, goes home, and calls you back and says, “I’m having pain and it didn’t hurt until you touched it.” Even when you do everything right, you still get the blame.
In this episode, you’ll learn exactly what you can say in appointments to avoid conflict, the treatment planning mistakes that can come back to bite you, and how to handle to patients who demand you pay to fix what’s “wrong.”
Topics discussed:
- Why new dentists struggle with patient complaints
- How to communicate risks with empathy
- The importance of decisiveness in treatment planning
- Using AI to address post-op pain
- How to explain post-op sensitivity and possible complications
- How the DPH coaches handle retreatment and refund demands
- Learning from mistakes and addressing issues with your team
This episode was produced by Podcast Boutique https://www.podcastboutique.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Paul (00:56):
It didn't hurt until you touched it, Doc.
If that sentence makes yourstomach drop, you're not alone.
From post-op sensitivity tobite issues to the dreaded, you
may need a root canal, thesemoments test every single one of
us dentists.
And in this episode, we'regonna break down how to set the
expectations before problemsstart, how to respond with
(01:17):
empathy instead ofdefensiveness, and how to
protect both your reputation andyour peace of mind when dealing
with the unexpected outcomesthat sometimes come from
treating patients as a dentist.
If you've ever been blamed byan upset patient, this episode
is for you.
You are listening to the DentalPractice Heroes podcast, where
we teach dentists how to stepback from the chair, empower
(01:39):
their team, and build a practicethat gives them their life
back.
I'm your host, Dr.
Paul Etchison, dental coach,author of two books on dental
practice management, and ownerof a large four-doctor practice
that runs with ease while I workjust one clinical day a week.
If you're ready for a practicethat supports your life instead
of consuming it, you're in theright place.
My team of legendary dentalcoaches and I are here to guide
(02:02):
you on your path fromoverwhelmed owner to dental
practice hero.
Let's get started.
Hello and welcome back to theDental Practice Heroes Podcast.
I'm your host, Dr.
Paul Edgison, and I'm joinedwith my two DPH coaches, the
magnificent Dr.
Steve Markowitz, a uh sixthpractice, multi-practice owner
(02:25):
on the East Coast of the UnitedStates of America.
And also Dr.
Henry Ernst, who is also fromthe United States.
We're all from the UnitedStates, and Henry's got an
18-out practice.
And we just so we don'tpractice a lot anymore.
Henry (02:40):
I started doing the Pledge of Allegiance during
that, uh, Paul.
Paul (02:43):
I was about to stand out myself.
This is the worst intro ever,but we're gonna leave it.
Let's go.
Cool.
So just recently we had ourfirst two meetings of the new
mastermind this year, and man,the group is awesome.
But it's been interesting tohear some issues that a lot of
docs are having.
And one thing that has come uprecently with a few of our
coaching clients is we'venoticed that sometimes doctors,
(03:04):
we just don't know what to dowith, I don't want to say like
upset patients, but how are wemanaging patients?
Like you get a patient thatcomes back for a bite adjustment
and then they're upset, or youyou get a tooth you work on, and
now it didn't hurt until youtouched it, Doc.
And now they need an endo, andthen they want you to pay for
the endo.
So I think these are toughsituations to navigate, but
nonetheless, I think very, verysimple if you follow a few
(03:26):
principles.
And we thought it'd be great togo through down this rabbit
hole today and talk about, giveyou guys some tips so that you
can figure out like how tohandle these better because
they're stressful.
I mean, let's face it, we don'twant to go through these
things.
So I'm gonna pass it to you,Steve, first.
What are your thoughts on this?
What do you see?
What do you think?
What advice would you have?
Henry (03:43):
Yeah, I feel like this is probably the most stressful
thing for new dentists whenthey're feeling like they're
trying to help this patient byjumping in and seeing decay or
under a crown or doing awhatever it is, and then the
patient comes back and what theythought was gonna happen, there
was some kind of complication.
And just happened a couple oftimes this week in our in our
(04:04):
group where there was a decayunder a crown, doctor came in,
the patient came in, doctorcleaned it up, made a new crown,
made a new temporary, and nowthe patient's in pain coming
back and says, What the heck didyou do?
And I totally understand that.
I think there's a couple thingsthat are really important to
help navigate these.
Number one, set expectations.
(04:25):
Patients don't know enough.
All they know is they weren'tin pain, now they are in pain,
and the only thing to them thatchanged was they saw the
dentist.
So of course it must have beenyou, dentist.
That's the only thing I knowthat's different.
The other thing is we have tolead with empathy.
This patient comes in, they'rein pain.
(04:45):
That sucks.
We should acknowledge that.
The way that we try toaccomplish that, which is more
challenging, especially whenwe're navigating this for the
first couple of times, is nomatter how big or small that
decay is, it was bigger than Ithought it was going to be.
And I tell the patient, I'mglad we were able to take care
of this.
This is what I expect tohappen.
(05:06):
I expect to have you to havesome temperature sensitivity, I
expect you to have somediscomfort.
I don't expect this, this, andthis because the decay wasn't
encroaching the nerve.
However, every single time youtouch a tooth, there is a risk
that there can be an adversereaction.
So if you're experiencing painon biting, prolonged temperature
(05:28):
sensitivity, I need to be thesecond person to know you're
gonna be the first.
I make that joke.
And then and the reason why Iwant you to do the sound call.
Paul (05:37):
That was a great one.
Thank you.
Your assistant has to roll hereyes right there.
Henry (05:42):
Well, it's I have the same script of five things I say
all day.
So and the reason why it's soimportant that you let me know
is because this tooth has beenthrough a lot, and because it's
been through so much, I don'tknow exactly when it's gonna be
the point when the tooth says nomore.
And if it's you're experiencingthose symptoms, you more likely
than not may need the nerve tobe addressed.
(06:02):
I don't use the word rootcanal, I say nerve for being
addressed, and then I leave itat that.
That's my spiel every singletime I leave a crown
appointment.
And then it gets even furtherback to I don't treatment plan
things that I know are not gonnawork out, and that comes with
experience.
So treatment plan, worst casescenario.
And then when those times thathappen where the patient comes
in pain, I am sorry.
(06:24):
This sucks.
I'm sorry you're in pain.
I wish I could have foreseenthat with all this tooth has
been through, that this wouldhave been the outcome.
We were trying to beconservative in our approach,
but I want to make sure you'recomfortable.
I want to make sure we takecare of you, and I'm so sorry
you're feeling this way.
Paul (06:40):
I remember being early in my career, and you get this
feeling like you go in there andlike maybe like you thought the
decay was really deep, but thenit like it wrapped maybe a
little facial or lingual, and itwasn't as close to the nerve as
you thought.
And you're really happy aboutthis.
So, like you look the patientin the eye, you say, Hey, you
know what?
I think everything's great.
It's not as bad as I thought.
It's everything's gonna feelgreat.
And I remember doing this witha patient and coming back and
(07:01):
going through this like loss ofsleep, and like, my God, did I
do something wrong?
And why is this person soupset?
It's their tooth.
I mean, we see this on theFacebook forums.
This is not your problem, thisis their tooth, blah, blah,
blah.
But I think you're right,you've got to come from a
position of empathy that, hey,their tooth really didn't hurt
until you touched it.
(07:21):
So, what are you gonna do?
I love that you bring that up,Steve.
One thing that you said that Ithink is huge for anyone
listening is I cannot stand thiswhen I my associates do this.
It might be a root canal.
We'll figure it out day of.
Is it a root canal or it's nota root canal?
Because if you say it might bea root canal and you decide the
day of it's a root canal, you'rean asshole.
(07:43):
Okay.
And if you say it might be aroot canal and you don't do the
root canal and it needs a netroot canal, you're an asshole.
So you always lose.
You need to pick is it a rootcanal or is it not?
Is it a crown or is it not?
And I think that comes withtime and treatment planning.
Like you just learn it's justnot worth it.
If it's close to the nerve withexperience, you realize that's
gonna go endo.
What are we waiting for?
(08:04):
My thing for endo is does itpercuss?
If it percusses, it's endo.
I mean, that's just me.
What are your thoughts on this,Henry?
You remember a time like whereyou got kicked in the butt by
one of these?
Oh, we've all been there.
Steve (08:15):
I don't want to kind of Steve made some great points.
A lot of those I say the sameexact thing.
And I think it's most importantto understand that you're
always gonna, as the dentist,we'll always be the one.
It's always our fault.
The second we touch it, it'sour fault.
So always remember that.
And I come from a point ofworking with multiple associates
in the practice where we haveto calibrate and we have to
(08:36):
understand that when we tell thepatient something ahead of
time, we're giving them areason.
There was a lot of decay.
There was this, there was that.
If we tell them afterwards,then it's just an excuse.
And the patient thinks thatwe're backpedaling and it's it's
our fault and this and that.
So from the beginning, makesure echoing some of the
statements, treatment plan itcorrectly.
(08:56):
Younger dentists tend to bewhat I call a hero dontist.
They look at a tooth thatreally needs a crown, and for
some reason, they for somereason they want to put a
filling on that darn tooth.
Why?
I don't know.
And I always tell them you'regonna put this big filling on
this tooth, and you think thatyou're doing the patient a huge
service and you're their hero.
But you know what happens?
They come back into thepractice about eight weeks later
(09:19):
with a broken tooth.
And what do they tell when theysee some other doctor?
Oh, yeah, the doctor touchedhis tooth, now it's broken.
Treatment plan it correctly thefirst time.
And always say any potentialcomplication that day or even
beforehand, right?
This way, it is not an excuse,it's a reason.
I probably, I'm just like you,Steve.
I probably have these spielsthat my assistants joke in their
(09:41):
head, they probably can likestop me mid-sentence and finish
it.
Anytime I cement a crown, Ialways say the same thing.
Hey, listen, you know, yourbite feels really great right
now.
I want you to test drive it.
Kind of like I give you thekeys to a brand new car.
I want you to test drive it.
You should be able to chewtotally, completely comfortably.
Maybe once in a while, maybe 2%of the time, patients come back
a few weeks later, a monthlater, and they'll say something
(10:02):
like, hey, Doc, you know thattooth you touched there that you
put a crown on?
It just feels weird when I'mbiting something crunchy.
If there's anything weird likethat, call me, come back in.
Sometimes the way that you'rebiting today on our paper may be
different than chewing a juicycheeseburger and maybe needs a
little adjustment.
So this way, I don't get peoplethinking that's abnormal, you
know, and it really is true.
It doesn't happen that often.
(11:45):
And I think we made somecomments, Paul, before we talked
on this podcast is justsometimes people being very
wishy-washy.
Like when you're gonna adjustthe bite, adjust the bite,
right?
Yeah, get aggressive, get itright, get it right, get it
right the first time.
Treatment plan thingscorrectly.
I think that's the number onething that's gonna save you.
And I think I will add thisalso is that I have been become
(12:07):
a fan of the AI technologies.
You know, we adapted Pearl inour practice a couple months
ago.
And I think it's really greatfor those scenarios where you
can show the patient, you know,the pictures of the tooth parts
and you can show them the wherethe decay is.
So always tell them ahead oftime, dentist too.
I'll tell them this path isgonna suck for the first few
(12:27):
weeks.
You may even lose weight,right?
And they always say, Oh, that'sgreat.
No, that's not great, but thismay happen.
So you're always just preparingthem for the absolute worst.
This way it sounds better.
Yeah.
When they actually undergothese things.
Paul (12:39):
Yeah, I think you're so right.
It's all about settingexpectations.
And I think we just come out ofschool and we don't think this
is an important part.
We think it's all about theclinical, but it's so much about
managing the emotions of thepatient.
And the thing with theocclusion, I'll see some of my
sometimes my associates will dothis.
Somebody comes back and they'vegot they're having
post-operative sensitivity on afilling or a crown or something.
And the associate will mark itand say, No, it's fine.
(13:01):
You just got to give up moretime.
Just buzz it.
You got to do something.
You know, they want you to dosomething.
And even like I'm thinkingsituations where crowns de-ment,
it's occlusion.
It is almost nine times out often there's something you have
to adjust in the occlusion, andthey don't touch it, and it
happens again and again.
We're shooting ourselves in thefoot.
And I think from a patientperspective, and I'd love to
(13:23):
hear what you guys think ofthis, but I think most patients
will tolerate, I don't know, twoto three occlusal adjustments,
like where you tap, tap, tap,and you adjust it some more.
After that, they start to go,like, what the hell's going on
here?
What are we doing?
Like, why do we keep checkingthis?
I mean, they don't realize howinexact that science is, but if
(13:43):
you adjust it twice and you gotto adjust it a third time, like
I'm always biting and seeing howdiscluded the anterior teeth
are.
And if they're reallydiscluded, I'm not doing that
with a fine burr.
I'm grabbing a coarse burr andI'm going to town, and that
thing is not gonna touch foryears, maybe not years, but you
get what I mean.
I'm gonna get aggressive withit.
So, I mean, there's so muchthat we can do.
(14:03):
I love it.
You know, what you said as faras verbiage, and I'll give mine
is I tell anyone we work on atooth, whether it's a filling or
it's a crown.
This, I guess I would say thismore for crowns, is I say, hey,
everything went really great.
We got all the decay cleanedup.
I'm really happy with it.
But anytime we mess with atooth, it always causes
sensitivity to the nerve.
That is totally normal.
But you should know that thereis always a chance that this
(14:26):
tooth may need a root canal.
And they go, and I go, there'sno way to know.
It could be two months fromnow, it could be 25 years from
now from the decay that was heretoday.
We just don't know.
I think it's gonna be good.
We cross our fingers, we hopefor the best.
If it needs a root canal, we'llcross that bridge when it
comes.
Don't worry about it.
And that is literally just myreal quick and easy.
I don't know.
(14:47):
That might be just like, hey,don't worry about it.
It's gonna be cool, man.
Just chillax.
And then I tell them when Iknow it's deep, I say, Hey, when
this starts to hurt, becauseit's going to, it's gonna get
sensitive.
You got two options.
One, wait it out.
Two, let's do a root canal.
You pick.
So that way they don't evencall me and say, like, hey, what
happened?
They know the rules, it's yourchoice.
You know, either we're gonna doa root canal or we're gonna
(15:08):
keep moving.
So those are like things thatpopped in my mind there.
You got anything else, uh,Steve, that popped in there?
Henry (15:14):
Yeah, I think when, especially with newer dentists,
they're afraid to be the bearerof bad news.
So they don't share thosepossible expectations for their
with the patient.
But in my experience,especially at the more the more
I've had these difficultconversations, when I tell
patients that something bad'sgonna happen and it happens, I'm
a genius.
When I tell patients somethingbad's gonna happen and it
(15:36):
doesn't happen, I'm anincredible dentist.
Yeah, both are awesome.
So I would not shy away frompossible adverse reactions that
may happen, but it needs to bepresented in a way not to scare
people, but just to have themunderstand.
And at the end of theappointment, if you sit them up
(15:57):
and you look at them and yousay, Everything went great.
I'm really happy we were ableto clean up the decay, we're
able to clean up this tooth.
I do want you to be aware ofthis as a possibility.
If it happens, I am here foryou.
Like Henry said, give me acall.
And then we covered ourselveson that side, but we didn't do
it in a way that's like pushingthem out the door and making
(16:18):
them scared about dentistry.
Paul (16:19):
You know, if this is your opportunity as a dentist to
really provide a really goodpatient experience, that whole
appointment could suck.
But if you can just slow downand give those post op
instructions to let the patientknow what to expect and that you
care.
Same thing.
I mean, I care.
Call me.
My phone number is on thevoicemail.
Um, my phone number is on allof the business cards, it's on
(16:41):
the website.
Call me at home if you needanything.
Nobody calls.
I mean, I wouldn't say nobody,but it's not a nuisance, I
guess.
I call, but you don't pick up.
Yes, that's do not disturb.
Steve (16:51):
That's just for you, especially before 9 a.m.
Do not call.
Steve is on my black list.
Henry (16:56):
All right, that makes me feel better.
I understand.
Steve (16:58):
So, one thing that came into my mind also is I've seen
some of these things, Paul, fromthe other side of it.
Our practice sees about 170,180 new patients a month.
And I see patients from otheroffices.
And here's a scenario Patientcomes in, they had a crown done
recently, and they're havingproblems with it.
And, you know, you look at itand everything looks fine on the
(17:20):
x-ray.
It's not really sensitive, butthey can't bite on it.
It's a simple bite adjustment,right?
I went there three or fourtimes and they can't figure it
out.
Like you mentioned, Paul, uh,they're just fed up with it.
Now they're going somewhereelse.
And you know what?
I do a bite adjustment.
I adjust the opposing cusp.
That's a big thing a lot oftimes.
People don't understand that.
And all of a sudden you relievethat now, like you said, Steve.
(17:41):
Now all of a sudden I'm thehero.
Oh my God, that other guycouldn't figure it out.
I'm nothing special.
I just what do you say when youdo that, Henry?
What do you say so they're notlike, why are you drilling down
there?
So the number one thing thatI'll like, let's say this same
scenario.
I'm just going step by step.
I looked at your x-rays,everything looks fine.
Another mistake people make isthey always people love to trash
the other dentist.
Paul (18:01):
Yeah, I hate that.
Steve (18:01):
And I know that that's like a red flag for me.
When somebody trashes anotherpractitioner, that's just, I
don't know.
I don't look good on that.
Everything looks fine with thex-ray.
You know what?
You're not really havingsensitivity when I blow on it.
You know what?
It looks like you're, it may bejust something as simple as
adjusting your bite.
Your upper tooth has a cusp onit, it's really sharp.
I think it's smashing in there.
Why don't we just adjust?
Let me adjust it a little bit.
(18:22):
We don't have much to lose.
And you know what?
What I'm doing basically costsnothing, right?
We charge a little bit for abite adjustment, but all of a
sudden, they maybe walked inwith the expectation of there
was something wrong with theircrown, they needed a root canal.
Now I'm like their hero.
And now I've probably got a newpatient that I stole from this
other dentist just because Italked them through it and I
just adjusted the, I wasn'twishy-washy with it.
Paul (18:44):
Yeah, that's great advice.
And I do the same thingwhenever I'm reducing the
opposing, it's my mystery.
You know, it's like, I know Idon't want to thin out this
porcelain anymore.
And I know I don't want to goback and reprep if I have
inadequate clearance.
That's one thing.
I just say, hey, you know what?
The computer's recommendingthat we we round off this little
cusp down here.
It's just a little sharp.
We're just gonna give it alittle manicure on the edges so
(19:05):
that way nobody questions it.
And a little manicure, it justsounds so minor.
Henry (19:09):
What do you do when someone gets to the point where
they're like demanding that youpay for their next treatment?
Paul (19:15):
Yeah.
Henry (19:16):
We see that a lot on the Facebook groups.
And I know I have thoughts, butI'd love to hear what you guys
do when it gets to the point,and maybe it's not a patient
that you saw or have ever seen,but in your office, they're
frustrated to the point wherethey're demanding that we pay
for them to go have dentistryelsewhere.
Paul (19:34):
I feel like I've covered those bases preemptively that I
don't think the expectation isever there.
I mean, I think if you do thepost op right, it's right.
Now, not to say that I haven'twell gone through that.
Now, I have paid for patientsto get their endo retreated, and
it's because I did an endo, itlasted maybe a year or so, and I
can visually see like a shortfill, something where I'm like,
(19:58):
okay, that could be improvedupon.
Maybe that's what's causing it.
But if it looks gorgeous, I'mnot paying for that endo.
And I would say the person werefer to 99% of the time does
it.
She's not charging us anyway.
But I'll tell her like she justdoes a solid because we refer
her to so many people.
But yeah, that's it's I don'tknow.
Steve (20:15):
I mean, Henry, what about you?
So I would say the scenariocomes about maybe with an
associate that maybe just wasn'ton their ball game that day.
And I I love to refer to thephotograph of the original tooth
before we touched it, right?
Which hopefully everybody has.
And you show them a photograph,and I look at that photograph,
oh yeah, I'm gonna put thisreally big picture and I show
them this picture of this hugeamalgam that was leaking,
(20:37):
broken.
I said, This is what your toothwas like beforehand, right?
We fixed it and stuff likethat.
And some of the points youmentioned before, Paul, is we
never know what happens.
We tried to be conservative, weput a crown on this tooth,
which is certainly standard ofcare.
And we didn't anticipate a rootcanal at the time, which again
is conservative, and now itlooks like it needs it.
So your choices at this pointare to do the root canal on the
(21:00):
tooth, or the only alternate isto remove the tooth.
And I mean, this is dentistry,right?
This is normal.
And maybe when you're younger,it's like so, oh my gosh, you
lose sleep or this or that.
But as you get involved withthis, I mean, I think I can't
press upon how important it isfrom the very beginning.
If it was done correctly, Imean, I'll knock on wood.
I can't remember the last timethis happened in our practice.
(21:21):
We're very good about tellingthe patients ahead of time.
The worst case scenario isthis.
Because keep in mind, there arethere is a segment of people
out there that think that rootcanals are like the devil.
Well, they say, oh no, no, noroot canals ever, ever, ever.
Then your alternate is justremove the tooth, right?
Tell them like it is.
Don't be afraid to give the badnews.
That's what we're here for.
We're not the sugarcoat stuff.
Henry (21:43):
I'm just thinking about I just had this patient that
called the office and isdemanding that we pay for the
root canal, that she had anotheroffice and that it was our
fault.
And I think for me, the painthat I felt and why I feel
comfortable in my treatmentplanning and how I set
expectations is because therewas a time where if someone were
to call me and demand that, Iwould give them the money.
(22:06):
I would just be like, it's notworth my time.
Get this the F off my plate.
And I actually had to feel thepain.
And that was my approach.
And what I learned from that isa different way to set
expectations with the patients.
I think it helped shape myverbiage and how how I'm able to
talk to patients because I feltthat pain financially.
I want all doctors to be ableto learn from that.
(22:28):
So I think that for me, thereis benefits of saying, hey guys,
we all need to learn from this.
And the only way we truly learnis if the pain isn't enough to
change or the reward is strongenough to pull us to change.
Which one do we want?
Here, let's say we're gonna paythis patient, we're gonna pay
for this patient's treatment.
And you as a doctor are gonnashare with me in that payment so
(22:50):
that we can learn and not dothat.
Because ultimately, what I wantthem to do, our entire team, is
set expectations clearly withthe patients, talk about
worst-case scenarios and whatcan happen in a kind and caring
way.
But I need I need behavioralchange because if only every
single time I take it off theirplate as the doctors and say,
(23:10):
I'm gonna take it, or I'll paythe patient back, but it won't
affect your collection.
We're not learning.
So I think it is helpful, atleast for me, and you guys can
tell me I'm stupid, you do allthe time.
Um, I think it is helpful forme.
You're doing great, Steven.
I really needed that today.
Thank you, Paul.
You're super, you're super.
But I think it's reallyimportant that that there's
(23:32):
opportunities to learn andthere's pain from the mistakes
that we made.
And in this case, the mistakeis we didn't set the
expectations properly.
Steve (23:39):
Well, let's explain, let's talk about a little bit
more specifics here.
Let's talk about this specificcase you have in your brain
right now.
So I'm like Paul.
If I look at my work and crownlooks good and this is good, uh
I'm not giving them refund,right?
I'm not doing any of that.
Henry (23:52):
Yeah, I get that.
Steve (23:53):
When you say we messed up, what do you mean like
clinically?
What do you mean by we messedup?
Henry (23:57):
So, like, yeah, so this specific patient, they have 14
and 15, were both blown up.
They needed a rookonel.
We did the rookonel on 14.
That was the one that wethought was causing the pain.
15 was also had a very deepdecay, but it we weren't able to
test it to make it symptomaticor whatever endodontists do.
(24:18):
I don't know.
And then we completed thetreatment on 14.
It was better for a week and ahalf.
Patient came back.
Now 15 is bothersome to you.
Obviously, we took that 14 outof occlusion, that makes sense.
And now the patient is like,you did the wrong tooth.
I'm going to another office,you guys messed up.
And the endodontist, the newendodontist, said, Yeah, this
tooth needs a root canal.
Steve (24:39):
How did they not know?
What did How did they not know?
But didn't 14 need a rootcanal, Steve?
14 did too.
So then why refund?
I'm being devil's advocatehere.
Why give them anything?
I totally get that.
I understand it.
Henry (24:51):
But the real answer is we're gonna schedule both of
these, we're gonna take care ofboth of these teeth.
And if you, patient, want tochoose only one or the other,
you need to know that you couldbe the one choosing wrong.
I'm saying both of this need tobe done now.
But we made the decision forthe patient, and we were right,
but we were also not complete.
(25:12):
So because we weren't complete,the patient doesn't understand
that.
So I'm like, all right, guys, Itotally get it.
I want this off our plate.
I don't want this patientrunning around town thinking
that we misdiagnose.
That sounds way worse.
Let's share in this.
I'm gonna call over to theendodontist office myself and
I'm gonna say, hey, this iswhat's going on.
Here's the story.
(25:33):
We don't refer out a ton, sothey don't need to give us
anything.
And we just wrote it, we wrotethe endodontist office a check,
and that's it, and it's done.
And then I don't ever want tosee the patient again.
They obviously lost trust inus, and I don't think about it
ever until you guys made methink about it.
And now I'm gonna have notsleep well tonight, so screw you
guys.
Paul (25:51):
But all that shame comes back.
That's what we're here for.
Henry (25:53):
I do think it's important.
I do think it's important forus as a team to understand why
someone may be thinking thatway, empathy, and then learn
from the mistakes so that we cantake better care of our
patients moving forward.
Paul (26:09):
Yeah, I think that's a great thing that you mentioned,
Steve.
It's like the important part iswe got to learn from it.
Learn from it and see whathappened.
What can we do differently?
And what I would like to leavethe listener with is that we're
asking you and suggesting thatyou should put a little bit more
time and energy into yourpost-operative instructions.
And I know we're busy, we'vegot to get to the next room.
(26:29):
But what I want you to see isthat how much time you save by
doing that, you don't have apatient coming back, you don't
have your front desk answering aphone call for the patient in
pain, you don't have somebodycomplaining, somebody coming and
questioning your abilities andquestioning your skill and your
competence and stuff.
So these things are worthdoing.
So you see how much knowledgeis in the room here with us
(26:52):
three.
I mean, these coaches aregreat.
These are the kind of thingsthat you get from working with
an experienced coach.
And so if you're looking for acoach for your practice, so you
can have a better run practicethat gives you more freedom and
more time to do the things thatyou love, please go to our
website,dentalpracticeheroes.com, and
set up a strategy call with us.
We would be happy to talk toyou about what options and what
we see in the future for yourpractice.
(27:13):
Thank you so much forlistening, and we'll talk to you
next time.
It didn't hurt until you touched it, Doc.
If that sentence makes yourstomach drop, you're not alone.
From post-op sensitivity tobite issues to the dreaded, you
may need a root canal, thesemoments test every single one of
us dentists.
And in this episode, we'regonna break down how to set the
expectations before problemsstart, how to respond with
(01:17):
empathy instead ofdefensiveness, and how to
protect both your reputation andyour peace of mind when dealing
with the unexpected outcomesthat sometimes come from
treating patients as a dentist.
If you've ever been blamed byan upset patient, this episode
is for you.
You are listening to the DentalPractice Heroes podcast, where
we teach dentists how to stepback from the chair, empower
(01:39):
their team, and build a practicethat gives them their life
back.
I'm your host, Dr.
Paul Etchison, dental coach,author of two books on dental
practice management, and ownerof a large four-doctor practice
that runs with ease while I workjust one clinical day a week.
If you're ready for a practicethat supports your life instead
of consuming it, you're in theright place.
My team of legendary dentalcoaches and I are here to guide
(02:02):
you on your path fromoverwhelmed owner to dental
practice hero.
Let's get started.
Hello and welcome back to theDental Practice Heroes Podcast.
I'm your host, Dr.
Paul Edgison, and I'm joinedwith my two DPH coaches, the
magnificent Dr.
Steve Markowitz, a uh sixthpractice, multi-practice owner
(02:25):
on the East Coast of the UnitedStates of America.
And also Dr.
Henry Ernst, who is also fromthe United States.
We're all from the UnitedStates, and Henry's got an
18-out practice.
And we just so we don'tpractice a lot anymore.
Henry (02:40):
I started doing the Pledge of Allegiance during
that, uh, Paul.
Paul (02:43):
I was about to stand out myself.
This is the worst intro ever,but we're gonna leave it.
Let's go.
Cool.
So just recently we had ourfirst two meetings of the new
mastermind this year, and man,the group is awesome.
But it's been interesting tohear some issues that a lot of
docs are having.
And one thing that has come uprecently with a few of our
coaching clients is we'venoticed that sometimes doctors,
(03:04):
we just don't know what to dowith, I don't want to say like
upset patients, but how are wemanaging patients?
Like you get a patient thatcomes back for a bite adjustment
and then they're upset, or youyou get a tooth you work on, and
now it didn't hurt until youtouched it, Doc.
And now they need an endo, andthen they want you to pay for
the endo.
So I think these are toughsituations to navigate, but
nonetheless, I think very, verysimple if you follow a few
(03:26):
principles.
And we thought it'd be great togo through down this rabbit
hole today and talk about, giveyou guys some tips so that you
can figure out like how tohandle these better because
they're stressful.
I mean, let's face it, we don'twant to go through these
things.
So I'm gonna pass it to you,Steve, first.
What are your thoughts on this?
What do you see?
What do you think?
What advice would you have?
Henry (03:43):
Yeah, I feel like this is probably the most stressful
thing for new dentists whenthey're feeling like they're
trying to help this patient byjumping in and seeing decay or
under a crown or doing awhatever it is, and then the
patient comes back and what theythought was gonna happen, there
was some kind of complication.
And just happened a couple oftimes this week in our in our
(04:04):
group where there was a decayunder a crown, doctor came in,
the patient came in, doctorcleaned it up, made a new crown,
made a new temporary, and nowthe patient's in pain coming
back and says, What the heck didyou do?
And I totally understand that.
I think there's a couple thingsthat are really important to
help navigate these.
Number one, set expectations.
(04:25):
Patients don't know enough.
All they know is they weren'tin pain, now they are in pain,
and the only thing to them thatchanged was they saw the
dentist.
So of course it must have beenyou, dentist.
That's the only thing I knowthat's different.
The other thing is we have tolead with empathy.
This patient comes in, they'rein pain.
(04:45):
That sucks.
We should acknowledge that.
The way that we try toaccomplish that, which is more
challenging, especially whenwe're navigating this for the
first couple of times, is nomatter how big or small that
decay is, it was bigger than Ithought it was going to be.
And I tell the patient, I'mglad we were able to take care
of this.
This is what I expect tohappen.
(05:06):
I expect to have you to havesome temperature sensitivity, I
expect you to have somediscomfort.
I don't expect this, this, andthis because the decay wasn't
encroaching the nerve.
However, every single time youtouch a tooth, there is a risk
that there can be an adversereaction.
So if you're experiencing painon biting, prolonged temperature
(05:28):
sensitivity, I need to be thesecond person to know you're
gonna be the first.
I make that joke.
And then and the reason why Iwant you to do the sound call.
Paul (05:37):
That was a great one.
Thank you.
Your assistant has to roll hereyes right there.
Henry (05:42):
Well, it's I have the same script of five things I say
all day.
So and the reason why it's soimportant that you let me know
is because this tooth has beenthrough a lot, and because it's
been through so much, I don'tknow exactly when it's gonna be
the point when the tooth says nomore.
And if it's you're experiencingthose symptoms, you more likely
than not may need the nerve tobe addressed.
(06:02):
I don't use the word rootcanal, I say nerve for being
addressed, and then I leave itat that.
That's my spiel every singletime I leave a crown
appointment.
And then it gets even furtherback to I don't treatment plan
things that I know are not gonnawork out, and that comes with
experience.
So treatment plan, worst casescenario.
And then when those times thathappen where the patient comes
in pain, I am sorry.
(06:24):
This sucks.
I'm sorry you're in pain.
I wish I could have foreseenthat with all this tooth has
been through, that this wouldhave been the outcome.
We were trying to beconservative in our approach,
but I want to make sure you'recomfortable.
I want to make sure we takecare of you, and I'm so sorry
you're feeling this way.
Paul (06:40):
I remember being early in my career, and you get this
feeling like you go in there andlike maybe like you thought the
decay was really deep, but thenit like it wrapped maybe a
little facial or lingual, and itwasn't as close to the nerve as
you thought.
And you're really happy aboutthis.
So, like you look the patientin the eye, you say, Hey, you
know what?
I think everything's great.
It's not as bad as I thought.
It's everything's gonna feelgreat.
And I remember doing this witha patient and coming back and
(07:01):
going through this like loss ofsleep, and like, my God, did I
do something wrong?
And why is this person soupset?
It's their tooth.
I mean, we see this on theFacebook forums.
This is not your problem, thisis their tooth, blah, blah,
blah.
But I think you're right,you've got to come from a
position of empathy that, hey,their tooth really didn't hurt
until you touched it.
(07:21):
So, what are you gonna do?
I love that you bring that up,Steve.
One thing that you said that Ithink is huge for anyone
listening is I cannot stand thiswhen I my associates do this.
It might be a root canal.
We'll figure it out day of.
Is it a root canal or it's nota root canal?
Because if you say it might bea root canal and you decide the
day of it's a root canal, you'rean asshole.
(07:43):
Okay.
And if you say it might be aroot canal and you don't do the
root canal and it needs a netroot canal, you're an asshole.
So you always lose.
You need to pick is it a rootcanal or is it not?
Is it a crown or is it not?
And I think that comes withtime and treatment planning.
Like you just learn it's justnot worth it.
If it's close to the nerve withexperience, you realize that's
gonna go endo.
What are we waiting for?
(08:04):
My thing for endo is does itpercuss?
If it percusses, it's endo.
I mean, that's just me.
What are your thoughts on this,Henry?
You remember a time like whereyou got kicked in the butt by
one of these?
Oh, we've all been there.
Steve (08:15):
I don't want to kind of Steve made some great points.
A lot of those I say the sameexact thing.
And I think it's most importantto understand that you're
always gonna, as the dentist,we'll always be the one.
It's always our fault.
The second we touch it, it'sour fault.
So always remember that.
And I come from a point ofworking with multiple associates
in the practice where we haveto calibrate and we have to
(08:36):
understand that when we tell thepatient something ahead of
time, we're giving them areason.
There was a lot of decay.
There was this, there was that.
If we tell them afterwards,then it's just an excuse.
And the patient thinks thatwe're backpedaling and it's it's
our fault and this and that.
So from the beginning, makesure echoing some of the
statements, treatment plan itcorrectly.
(08:56):
Younger dentists tend to bewhat I call a hero dontist.
They look at a tooth thatreally needs a crown, and for
some reason, they for somereason they want to put a
filling on that darn tooth.
Why?
I don't know.
And I always tell them you'regonna put this big filling on
this tooth, and you think thatyou're doing the patient a huge
service and you're their hero.
But you know what happens?
They come back into thepractice about eight weeks later
(09:19):
with a broken tooth.
And what do they tell when theysee some other doctor?
Oh, yeah, the doctor touchedhis tooth, now it's broken.
Treatment plan it correctly thefirst time.
And always say any potentialcomplication that day or even
beforehand, right?
This way, it is not an excuse,it's a reason.
I probably, I'm just like you,Steve.
I probably have these spielsthat my assistants joke in their
(09:41):
head, they probably can likestop me mid-sentence and finish
it.
Anytime I cement a crown, Ialways say the same thing.
Hey, listen, you know, yourbite feels really great right
now.
I want you to test drive it.
Kind of like I give you thekeys to a brand new car.
I want you to test drive it.
You should be able to chewtotally, completely comfortably.
Maybe once in a while, maybe 2%of the time, patients come back
a few weeks later, a monthlater, and they'll say something
(10:02):
like, hey, Doc, you know thattooth you touched there that you
put a crown on?
It just feels weird when I'mbiting something crunchy.
If there's anything weird likethat, call me, come back in.
Sometimes the way that you'rebiting today on our paper may be
different than chewing a juicycheeseburger and maybe needs a
little adjustment.
So this way, I don't get peoplethinking that's abnormal, you
know, and it really is true.
It doesn't happen that often.
(11:45):
And I think we made somecomments, Paul, before we talked
on this podcast is justsometimes people being very
wishy-washy.
Like when you're gonna adjustthe bite, adjust the bite,
right?
Yeah, get aggressive, get itright, get it right, get it
right the first time.
Treatment plan thingscorrectly.
I think that's the number onething that's gonna save you.
And I think I will add thisalso is that I have been become
(12:07):
a fan of the AI technologies.
You know, we adapted Pearl inour practice a couple months
ago.
And I think it's really greatfor those scenarios where you
can show the patient, you know,the pictures of the tooth parts
and you can show them the wherethe decay is.
So always tell them ahead oftime, dentist too.
I'll tell them this path isgonna suck for the first few
(12:27):
weeks.
You may even lose weight,right?
And they always say, Oh, that'sgreat.
No, that's not great, but thismay happen.
So you're always just preparingthem for the absolute worst.
This way it sounds better.
Yeah.
When they actually undergothese things.
Paul (12:39):
Yeah, I think you're so right.
It's all about settingexpectations.
And I think we just come out ofschool and we don't think this
is an important part.
We think it's all about theclinical, but it's so much about
managing the emotions of thepatient.
And the thing with theocclusion, I'll see some of my
sometimes my associates will dothis.
Somebody comes back and they'vegot they're having
post-operative sensitivity on afilling or a crown or something.
And the associate will mark itand say, No, it's fine.
(13:01):
You just got to give up moretime.
Just buzz it.
You got to do something.
You know, they want you to dosomething.
And even like I'm thinkingsituations where crowns de-ment,
it's occlusion.
It is almost nine times out often there's something you have
to adjust in the occlusion, andthey don't touch it, and it
happens again and again.
We're shooting ourselves in thefoot.
And I think from a patientperspective, and I'd love to
(13:23):
hear what you guys think ofthis, but I think most patients
will tolerate, I don't know, twoto three occlusal adjustments,
like where you tap, tap, tap,and you adjust it some more.
After that, they start to go,like, what the hell's going on
here?
What are we doing?
Like, why do we keep checkingthis?
I mean, they don't realize howinexact that science is, but if
(13:43):
you adjust it twice and you gotto adjust it a third time, like
I'm always biting and seeing howdiscluded the anterior teeth
are.
And if they're reallydiscluded, I'm not doing that
with a fine burr.
I'm grabbing a coarse burr andI'm going to town, and that
thing is not gonna touch foryears, maybe not years, but you
get what I mean.
I'm gonna get aggressive withit.
So, I mean, there's so muchthat we can do.
(14:03):
I love it.
You know, what you said as faras verbiage, and I'll give mine
is I tell anyone we work on atooth, whether it's a filling or
it's a crown.
This, I guess I would say thismore for crowns, is I say, hey,
everything went really great.
We got all the decay cleanedup.
I'm really happy with it.
But anytime we mess with atooth, it always causes
sensitivity to the nerve.
That is totally normal.
But you should know that thereis always a chance that this
(14:26):
tooth may need a root canal.
And they go, and I go, there'sno way to know.
It could be two months fromnow, it could be 25 years from
now from the decay that was heretoday.
We just don't know.
I think it's gonna be good.
We cross our fingers, we hopefor the best.
If it needs a root canal, we'llcross that bridge when it
comes.
Don't worry about it.
And that is literally just myreal quick and easy.
I don't know.
(14:47):
That might be just like, hey,don't worry about it.
It's gonna be cool, man.
Just chillax.
And then I tell them when Iknow it's deep, I say, Hey, when
this starts to hurt, becauseit's going to, it's gonna get
sensitive.
You got two options.
One, wait it out.
Two, let's do a root canal.
You pick.
So that way they don't evencall me and say, like, hey, what
happened?
They know the rules, it's yourchoice.
You know, either we're gonna doa root canal or we're gonna
(15:08):
keep moving.
So those are like things thatpopped in my mind there.
You got anything else, uh,Steve, that popped in there?
Henry (15:14):
Yeah, I think when, especially with newer dentists,
they're afraid to be the bearerof bad news.
So they don't share thosepossible expectations for their
with the patient.
But in my experience,especially at the more the more
I've had these difficultconversations, when I tell
patients that something bad'sgonna happen and it happens, I'm
a genius.
When I tell patients somethingbad's gonna happen and it
(15:36):
doesn't happen, I'm anincredible dentist.
Yeah, both are awesome.
So I would not shy away frompossible adverse reactions that
may happen, but it needs to bepresented in a way not to scare
people, but just to have themunderstand.
And at the end of theappointment, if you sit them up
(15:57):
and you look at them and yousay, Everything went great.
I'm really happy we were ableto clean up the decay, we're
able to clean up this tooth.
I do want you to be aware ofthis as a possibility.
If it happens, I am here foryou.
Like Henry said, give me acall.
And then we covered ourselveson that side, but we didn't do
it in a way that's like pushingthem out the door and making
(16:18):
them scared about dentistry.
Paul (16:19):
You know, if this is your opportunity as a dentist to
really provide a really goodpatient experience, that whole
appointment could suck.
But if you can just slow downand give those post op
instructions to let the patientknow what to expect and that you
care.
Same thing.
I mean, I care.
Call me.
My phone number is on thevoicemail.
Um, my phone number is on allof the business cards, it's on
(16:41):
the website.
Call me at home if you needanything.
Nobody calls.
I mean, I wouldn't say nobody,but it's not a nuisance, I
guess.
I call, but you don't pick up.
Yes, that's do not disturb.
Steve (16:51):
That's just for you, especially before 9 a.m.
Do not call.
Steve is on my black list.
Henry (16:56):
All right, that makes me feel better.
I understand.
Steve (16:58):
So, one thing that came into my mind also is I've seen
some of these things, Paul, fromthe other side of it.
Our practice sees about 170,180 new patients a month.
And I see patients from otheroffices.
And here's a scenario Patientcomes in, they had a crown done
recently, and they're havingproblems with it.
And, you know, you look at itand everything looks fine on the
(17:20):
x-ray.
It's not really sensitive, butthey can't bite on it.
It's a simple bite adjustment,right?
I went there three or fourtimes and they can't figure it
out.
Like you mentioned, Paul, uh,they're just fed up with it.
Now they're going somewhereelse.
And you know what?
I do a bite adjustment.
I adjust the opposing cusp.
That's a big thing a lot oftimes.
People don't understand that.
And all of a sudden you relievethat now, like you said, Steve.
(17:41):
Now all of a sudden I'm thehero.
Oh my God, that other guycouldn't figure it out.
I'm nothing special.
I just what do you say when youdo that, Henry?
What do you say so they're notlike, why are you drilling down
there?
So the number one thing thatI'll like, let's say this same
scenario.
I'm just going step by step.
I looked at your x-rays,everything looks fine.
Another mistake people make isthey always people love to trash
the other dentist.
Paul (18:01):
Yeah, I hate that.
Steve (18:01):
And I know that that's like a red flag for me.
When somebody trashes anotherpractitioner, that's just, I
don't know.
I don't look good on that.
Everything looks fine with thex-ray.
You know what?
You're not really havingsensitivity when I blow on it.
You know what?
It looks like you're, it may bejust something as simple as
adjusting your bite.
Your upper tooth has a cusp onit, it's really sharp.
I think it's smashing in there.
Why don't we just adjust?
Let me adjust it a little bit.
(18:22):
We don't have much to lose.
And you know what?
What I'm doing basically costsnothing, right?
We charge a little bit for abite adjustment, but all of a
sudden, they maybe walked inwith the expectation of there
was something wrong with theircrown, they needed a root canal.
Now I'm like their hero.
And now I've probably got a newpatient that I stole from this
other dentist just because Italked them through it and I
just adjusted the, I wasn'twishy-washy with it.
Paul (18:44):
Yeah, that's great advice.
And I do the same thingwhenever I'm reducing the
opposing, it's my mystery.
You know, it's like, I know Idon't want to thin out this
porcelain anymore.
And I know I don't want to goback and reprep if I have
inadequate clearance.
That's one thing.
I just say, hey, you know what?
The computer's recommendingthat we we round off this little
cusp down here.
It's just a little sharp.
We're just gonna give it alittle manicure on the edges so
(19:05):
that way nobody questions it.
And a little manicure, it justsounds so minor.
Henry (19:09):
What do you do when someone gets to the point where
they're like demanding that youpay for their next treatment?
Paul (19:15):
Yeah.
Henry (19:16):
We see that a lot on the Facebook groups.
And I know I have thoughts, butI'd love to hear what you guys
do when it gets to the point,and maybe it's not a patient
that you saw or have ever seen,but in your office, they're
frustrated to the point wherethey're demanding that we pay
for them to go have dentistryelsewhere.
Paul (19:34):
I feel like I've covered those bases preemptively that I
don't think the expectation isever there.
I mean, I think if you do thepost op right, it's right.
Now, not to say that I haven'twell gone through that.
Now, I have paid for patientsto get their endo retreated, and
it's because I did an endo, itlasted maybe a year or so, and I
can visually see like a shortfill, something where I'm like,
(19:58):
okay, that could be improvedupon.
Maybe that's what's causing it.
But if it looks gorgeous, I'mnot paying for that endo.
And I would say the person werefer to 99% of the time does
it.
She's not charging us anyway.
But I'll tell her like she justdoes a solid because we refer
her to so many people.
But yeah, that's it's I don'tknow.
Steve (20:15):
I mean, Henry, what about you?
So I would say the scenariocomes about maybe with an
associate that maybe just wasn'ton their ball game that day.
And I I love to refer to thephotograph of the original tooth
before we touched it, right?
Which hopefully everybody has.
And you show them a photograph,and I look at that photograph,
oh yeah, I'm gonna put thisreally big picture and I show
them this picture of this hugeamalgam that was leaking,
(20:37):
broken.
I said, This is what your toothwas like beforehand, right?
We fixed it and stuff likethat.
And some of the points youmentioned before, Paul, is we
never know what happens.
We tried to be conservative, weput a crown on this tooth,
which is certainly standard ofcare.
And we didn't anticipate a rootcanal at the time, which again
is conservative, and now itlooks like it needs it.
So your choices at this pointare to do the root canal on the
(21:00):
tooth, or the only alternate isto remove the tooth.
And I mean, this is dentistry,right?
This is normal.
And maybe when you're younger,it's like so, oh my gosh, you
lose sleep or this or that.
But as you get involved withthis, I mean, I think I can't
press upon how important it isfrom the very beginning.
If it was done correctly, Imean, I'll knock on wood.
I can't remember the last timethis happened in our practice.
(21:21):
We're very good about tellingthe patients ahead of time.
The worst case scenario isthis.
Because keep in mind, there arethere is a segment of people
out there that think that rootcanals are like the devil.
Well, they say, oh no, no, noroot canals ever, ever, ever.
Then your alternate is justremove the tooth, right?
Tell them like it is.
Don't be afraid to give the badnews.
That's what we're here for.
We're not the sugarcoat stuff.
Henry (21:43):
I'm just thinking about I just had this patient that
called the office and isdemanding that we pay for the
root canal, that she had anotheroffice and that it was our
fault.
And I think for me, the painthat I felt and why I feel
comfortable in my treatmentplanning and how I set
expectations is because therewas a time where if someone were
to call me and demand that, Iwould give them the money.
(22:06):
I would just be like, it's notworth my time.
Get this the F off my plate.
And I actually had to feel thepain.
And that was my approach.
And what I learned from that isa different way to set
expectations with the patients.
I think it helped shape myverbiage and how how I'm able to
talk to patients because I feltthat pain financially.
I want all doctors to be ableto learn from that.
(22:28):
So I think that for me, thereis benefits of saying, hey guys,
we all need to learn from this.
And the only way we truly learnis if the pain isn't enough to
change or the reward is strongenough to pull us to change.
Which one do we want?
Here, let's say we're gonna paythis patient, we're gonna pay
for this patient's treatment.
And you as a doctor are gonnashare with me in that payment so
(22:50):
that we can learn and not dothat.
Because ultimately, what I wantthem to do, our entire team, is
set expectations clearly withthe patients, talk about
worst-case scenarios and whatcan happen in a kind and caring
way.
But I need I need behavioralchange because if only every
single time I take it off theirplate as the doctors and say,
(23:10):
I'm gonna take it, or I'll paythe patient back, but it won't
affect your collection.
We're not learning.
So I think it is helpful, atleast for me, and you guys can
tell me I'm stupid, you do allthe time.
Um, I think it is helpful forme.
You're doing great, Steven.
I really needed that today.
Thank you, Paul.
You're super, you're super.
But I think it's reallyimportant that that there's
(23:32):
opportunities to learn andthere's pain from the mistakes
that we made.
And in this case, the mistakeis we didn't set the
expectations properly.
Steve (23:39):
Well, let's explain, let's talk about a little bit
more specifics here.
Let's talk about this specificcase you have in your brain
right now.
So I'm like Paul.
If I look at my work and crownlooks good and this is good, uh
I'm not giving them refund,right?
I'm not doing any of that.
Henry (23:52):
Yeah, I get that.
Steve (23:53):
When you say we messed up, what do you mean like
clinically?
What do you mean by we messedup?
Henry (23:57):
So, like, yeah, so this specific patient, they have 14
and 15, were both blown up.
They needed a rookonel.
We did the rookonel on 14.
That was the one that wethought was causing the pain.
15 was also had a very deepdecay, but it we weren't able to
test it to make it symptomaticor whatever endodontists do.
(24:18):
I don't know.
And then we completed thetreatment on 14.
It was better for a week and ahalf.
Patient came back.
Now 15 is bothersome to you.
Obviously, we took that 14 outof occlusion, that makes sense.
And now the patient is like,you did the wrong tooth.
I'm going to another office,you guys messed up.
And the endodontist, the newendodontist, said, Yeah, this
tooth needs a root canal.
Steve (24:39):
How did they not know?
What did How did they not know?
But didn't 14 need a rootcanal, Steve?
14 did too.
So then why refund?
I'm being devil's advocatehere.
Why give them anything?
I totally get that.
I understand it.
Henry (24:51):
But the real answer is we're gonna schedule both of
these, we're gonna take care ofboth of these teeth.
And if you, patient, want tochoose only one or the other,
you need to know that you couldbe the one choosing wrong.
I'm saying both of this need tobe done now.
But we made the decision forthe patient, and we were right,
but we were also not complete.
(25:12):
So because we weren't complete,the patient doesn't understand
that.
So I'm like, all right, guys, Itotally get it.
I want this off our plate.
I don't want this patientrunning around town thinking
that we misdiagnose.
That sounds way worse.
Let's share in this.
I'm gonna call over to theendodontist office myself and
I'm gonna say, hey, this iswhat's going on.
Here's the story.
(25:33):
We don't refer out a ton, sothey don't need to give us
anything.
And we just wrote it, we wrotethe endodontist office a check,
and that's it, and it's done.
And then I don't ever want tosee the patient again.
They obviously lost trust inus, and I don't think about it
ever until you guys made methink about it.
And now I'm gonna have notsleep well tonight, so screw you
guys.
Paul (25:51):
But all that shame comes back.
That's what we're here for.
Henry (25:53):
I do think it's important.
I do think it's important forus as a team to understand why
someone may be thinking thatway, empathy, and then learn
from the mistakes so that we cantake better care of our
patients moving forward.
Paul (26:09):
Yeah, I think that's a great thing that you mentioned,
Steve.
It's like the important part iswe got to learn from it.
Learn from it and see whathappened.
What can we do differently?
And what I would like to leavethe listener with is that we're
asking you and suggesting thatyou should put a little bit more
time and energy into yourpost-operative instructions.
And I know we're busy, we'vegot to get to the next room.
(26:29):
But what I want you to see isthat how much time you save by
doing that, you don't have apatient coming back, you don't
have your front desk answering aphone call for the patient in
pain, you don't have somebodycomplaining, somebody coming and
questioning your abilities andquestioning your skill and your
competence and stuff.
So these things are worthdoing.
So you see how much knowledgeis in the room here with us
(26:52):
three.
I mean, these coaches aregreat.
These are the kind of thingsthat you get from working with
an experienced coach.
And so if you're looking for acoach for your practice, so you
can have a better run practicethat gives you more freedom and
more time to do the things thatyou love, please go to our
website,dentalpracticeheroes.com, and
set up a strategy call with us.
We would be happy to talk toyou about what options and what
we see in the future for yourpractice.
(27:13):
Thank you so much forlistening, and we'll talk to you
next time.
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