Try Ruffling Some Feathers

Fear of rejection is the big private-practice clinician killer. Dentists come by this very honestly. Too many dentists are concerned with being their patient’s best friend, not wanting to ruffle anyone’s feathers. This is where speaking taught me the importance of ruffling feathers, because ruffling feathers is how we gain case treatment acceptance. Telling the truth = ruffling feathers. You can’t succeed by telling people what they want to hear, but only by telling them the truth. If that makes them my best friend, then so be it.

Too many dentists avoid treatment-planning anything, just to avoid rejection. I told my staff for years that I do not want to know if the patient even has insurance, let alone what type they have. If I am advised of this ahead of time, it surely will bias any treatment that I propose. For example, if I know a patient’s insurance will not pay for crowns, that naturally pushes me away from those and into large restorations. This not only compromises that patient’s treatment but is unethical.

I propose the correct and highest-quality solutions for each patient. If the patient wants to talk down the degree of quality, then that’s on the patient, not on me. Rejection is your formula for success, because when you keep throwing quality treatment plans at the proverbial wall, sooner or later, some will stick.

The one single event that changed all my concerns over patient rejection was the diagnosis and treatment planning of periodontal disease. In the 1980s, I didn’t have the benefit of our current knowledge with regard to the oral-systemic connection: we did not yet know periodontal disease was linked to heart disease, stroke, diabetes, premature births, respiratory ailments, cancer, arthritis, and yes, even Alzheimer’s disease. Despite this, I was receiving about a 90 percent case treatment acceptance from my adult patients.

The simple reason my acceptance rate was so high was that my patient education always started with the premise that this is a disease. There is no way to try and convince a patient that they have crown-and bridge disease, implant disease, or orthodontic disease. But you can say they have periodontal disease. Disease is something no one wants to own. It is also a word that is seldom used in dental practices and needs to be, as it reflects the severity of a condition.

No patient wants to be referred to as a diseased human being. They will immediately say, “Can you cure this?” “Am I going to lose my teeth?” “Will I need dentures?” The instant that any one of these questions is asked, the patient has already accepted your treatment plan. And you haven’t even told them what the cost will be, because they don’t ask unless they want to fix the problem. And let me tell you, they all ask.

Periodontal disease is intimately tied to every procedure (except dentures) that you provide in the dental practice, and the ultimate success or failure of those procedures will completely depend upon the resolution and control of this disease.