Don’t Let the Inmates Run the Asylum

I’m not sure why dentists are told they need to get toe to toe knee-to-knee with their patients for an hour to build rapport.

Frankly, if you can’t win someone over in the first five minutes with your personality, then get out of private practice and go and work on non-paying patients. Because you’re doing a great disservice to people *paying* you for their dental *services*. And I am emphasizing the word services.

Being personable is easy. You just need to ask questions and start your patients talking about themselves.

Then listen. Listen with empathy.

Follow this with a provisional diagnosis. “Sounds like it could be this, this or this.”

Then look at the problem area….then “just let me confirm that with an x-ray…”

And of course, follow all that with…”if you were my mother/sister/daughter me this is what I would be doing.”

Or, “if this were my tooth this is the treatment that I’d be having done”.

Be definitive. Clear course of action.

I see so many doctors telling patients that they’re going to “watch” that tooth.

This is so wrong! Watch it? Watch it do what?

Watch it deteriorate? Watch it fall apart? Watch it decay? Watch it need root therapy?

Never watch! Watching is bad for the patient, both health wise and financially.

If something needs watching it needs fixing.

Nothing is more distressing to me than seeing a new patient walk in with sixteen posterior teeth restored with heavily overfilled and patched old amalgams that the previous dentist has been watching!

It’s just a minefield of wrong down there!!

You see I cut my teeth in dentistry at a time when dentists were placing a lot of the old “ledemix time-bombs”. I learned very quickly that this was wrong, and wrong for everyone.

For those who don’t know, ledemix time-bombs were dressings placed on exposed pulps under huge amalgams with the hope that things would settle down and go away….and they usually did. But what would go away was usually the patient, until the amalgam started to shift, or break [well it’s sitting on a ledemix sponge so why wouldn’t it, eventually!!] and the patient would turn up at the next dentist with a problem.

And guess what? The problem would be worse because it should have been addressed back then, not now, this time!

So there were three losers. The new dentist had a more difficult tooth to treat. The patient had a more advanced condition [i.e. more difficult] and more costly, just due to inflation and time, and the original dentist missed out on doing the treatment.

I quickly learned how wrong this was on all counts…you see ledemix time-bombs were the epitome of dental “watching” …

So back to diagnosis….

You see, many years ago a patient once said to me:

“What are you asking me for? You’re the one wearing the white coat. That’s why I’m here. For your expert opinion.”

Famous, great words of wisdom!! How right he was!

Because, as soon as you hand your skills and knowledge and your decision making as to what is best treatment, as soon as you hand *that* decision over to the patient, then that’s when the inmates start running the asylum.


Did your patient go to dental school?

I don’t profess to knowing how the fuel injectors of a car work, nor am I an expert on the stability of reactive clay and the depth of footings or slab required to support my house.

That’s why, when I require these services, I take expert advice.

So offer best treatment. Because in dentistry, what’s second best, is often a long, long way second.

And second best treatment, well patients still expect first best results…don’t they? At second best prices!!

Stand up for your sanity. Diagnose and treat correctly and appropriately. Every time. And don’t watch. Ever!

Your patients will thank you.

And you’ll sleep a whole lot better.



The Ultimate Patient Experience is a simple easy to implement system I developed that allowed me to build an extraordinary dental office in an ordinary Sydney suburb.  If you’d like to know more, ask me about my free special report.

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