In preparation for my upcoming workshop on Success With New Patients sponsored by ACT Dental Practice Coaching, I thought it would be appropriate to share an example of relationship failure and success from the patient’s perspective.
As a result of the several experiences I’ve had with a personal friend, I have now discovered, or maybe created, an entirely new line of work: Dental Escort Services. I’m convinced that many people would respond well to the support a Dental Escort could provide. I envision taking out a full page ad in the Sunday supplement to the newspaper and a Yellow Pages ad smack in the middle of the Dentist listings. I’m thinking that many dentists and team members would be particularly aware of what they said and did were an informed advocate accompanying patients. Of course, one wants to think that each patient would always be treated with the utmost of care and concern, but we know that is sadly not the case. If it were, very few patients would recycle to new dentists. Remember, almost every “new” patient you receive is actually a recycled patient – moving on because the last practice failed to meet his or her expectations.
Mel is a personal friend and I do not know any of the dentists involved. Of course, all of the names have been changed to preserve confidentiality. Here is his story:
Mel Degrand, a 32 year old single male, had traumatizing dental experiences as a child and adolescent. Although he is very uncomfortable with injections, his greatest anxiety is aroused by “things” in his mouth: rubber dam, cotton rolls, dental film, etc. He is fearful of choking on saliva and he is easily overwhelmed by abrupt movements and less than gentle treatment. As a result of his fears, he neglected his dental care for fifteen years. Subsequently, he has experienced posterior tooth loss and massive decay. In some cases, the teeth have decayed to the gumline. Although he has experienced discomfort throughout this period of deterioration, he has been more fearful of pursuing treatment than he has been compelled by pain.
As a result of re-evaluating his life, Mel recently made some major decisions, one of which was to get his teeth fixed. A friend referred him to Dr. Jane Jones, a relatively young female practitioner, who had provided him with good, basic care. At the first appointment, Mel was precise and clear about his fears and concerns. Dr. Jones seemed to understand and responded appropriately. Mel was encouraged.
Upon examination, it became clear that none of the posterior teeth were salvageable. Because Mel wanted his mouth to be fully restored, they discussed extracting the stubs and roots, doing root canals on appropriate teeth, fabricating a temporary partial, placing implants and finally restoring everything with veneers and crowns. Mel agreed with the approach and was not discouraged by the $40-50,000 fee estimate, owing to a sizeable personal fortune. Although he remained cautious about the extensive treatment, he believed Dr. Jones could ensure his comfort.
The first sign of trouble came following the extractions by Dr. Smith, an oral surgeon to whom Dr. Jones had referred Mel. Thanks to sedation, the surgery went well. Three days later, however, Mel experienced discomfort which was not relieved by the prescribed medication and neither Dr. Smith nor Dr. Jones returned his first several calls. When he finally reached Dr. Jones, she expressed little concern about his discomfort and even less about their lack of responsiveness. Moreover, she told Mel of her concerns about Dr. Smith’s staff and his poor follow-through.
Cautious yet not completely dissuaded, Mel returned to Dr. Jones, who took impressions for his temporary partial. They made plans for two root canals, which would be done the day the partials were delivered. In the interim, Mel wanted a more specific idea about the cost of the implants so he could begin to make his financial plans. Dr. Jones referred him to Dr. Martin, the periodontist with whom she works, and a consultation appointment was made.
Mel appeared for the appointment and was taken to an operatory by an assistant, who never introduced herself and appeared unclear about what the appointment was designed to accomplish. As she began “poking, prodding and putting stuff” into his mouth, he asked her to wait and clearly conveyed his fears and anxieties. In response, she said, “Oh, don’t worry about it. We work with a lot of scaredy cats. You’ll be just fine.” as she proceeded to return to her charting. As she began to place x-ray film into his mouth, he stopped her and said, “I think there is some misunderstanding about this appointment. We planned a general discussion to see if Dr. Martin agreed with Dr. Jones’ general strategy and get some sense of the fees. I brought my x-rays with me.” The assistant responded with terseness. “He never uses anyone else’s x-rays. So you’ll have to have them redone.” When Mel protested, she left the room without comment.
Moments later, Dr. Martin entered the room and, without introducing himself, blurted, “What seems to be the problem here?” Mel, calming himself as best he could, replied, “Hello, I’m Mel Degrand. The appointment today was for us to talk about the general plan Dr. Jones has suggested and for me to get a sense of the costs I’m looking at.” Before Mel could repeat that he had brought the x-rays Dr. Jones had taken, Dr. Martin responded harshly, “Well, I need x-rays or I can’t do any of that, now can I? You’ll have to decide whether you can control yourself enough to get through this.”
Without hesitation, Mel stood up, removed his bib and replied, “Well, I guess I’m leaving now.” He turned to the assistant and said, “Will you please give me my x rays and help me get out of here?” As he turned to leave, he heard Dr. Martin throw the chart to the floor and as he walked down the hall, Dr. Martin “pursued” him. The last words Mel heard as he walked out the door were, “What a jerk!”
Shaken, Mel phoned Dr. Jones to relay his experience and express his frustration. Again, several calls went unanswered. When she did respond, she expressed little concern about Mel’s feelings. “He probably had a big case that morning,” was all she could say. Her next question floored Mel, “So, does that mean you don’t want to go back to him?” Realizing that she didn’t get it either, Mel felt alone with no where to turn. He subsequently canceled his root canal and delivery appointment.
Let’s assume that Mel’s description of the events is an accurate representation of his perception of the events. Your challenge is to dissect this case study and provide Dr. Jones, Dr. Smith and Dr. Martin with a critique. Clearly this is a relationship failure rather than a clinical one. What might each of them have done differently to avert the disaster which ensued? In an upcoming issue, I’ll give you my read on it and outline how each of the players created the result they achieved. I’ll also reveal how Mel’s
situation was resolved with the support of some very behaviorally gifted clinicians. Have fun with this.
