It’s Impossible To Win A Tug-Of-War When Both Sides Are Pulling In The Same Direction.

Received an email from a Dentist client last week about a misunderstanding between a paying patient and his front office person.

The misunderstanding was concerning the out of pocket cost to the patient for a crown the patient had just received.

And the answer is simply that the problem arose because the patient did not have total clarity as to what they were expected to pay.

Now this may have been a misunderstanding between the patient and the practice.

It may have been that the patient chose not to hear what they were being told.

It may have been that the patient chose to “try one on”.

Or it may have been that the patient was not informed at all.

Sadly, deciding who is at fault after the fact is like debating who let the chickens out.

The answer is not who is at fault.

The answer is to save as many chickens as we can gather…

The correct answer is damage control.

Minimalise damage and then review later once the dust has settled.

When I was in practice I was once called to my front office by my receptionist when a new patient, who I had just finished treating, was questioning the fee for my treatment.

And so he said to me, when I arrived at the reception office, that he had not been told about how much his treatment was going to be.

As the treating dentist, I had assumed that he had been given costing options and fee estimates when he had made his appointment over the phone.

And when I had asked him whether he wanted to save his tooth rather than lose it, he had answered that he wanted to save it.

And so as his dentist I extirpated the pulp, dressed the tooth and temporized the cavity.

And the patient left the treatment room with the understanding that the next step was a visit to the endodontist.

Anyway, when I arrived at the front desk, the patient said he had not been pre-informed of the cost for treatment.

And so here is what I said to him:

“I apologise. Normally every patient that I treat has an idea about what our fees will be, and it appears that in your case our process has let you down.

“So here’s what I’d like to do for you.

“I’d like you to pay me whatever you believe my treatment for today is worth….


The patient was surprised.

This is because the patient was looking for an argument…

And so I repeated to him exactly what I had just said:

“I apologise. It appears that our process has let you down.

“Pay me whatever you believe my treatment is worth.


And I left it with my receptionist.

By doing this, I dropped the rope.


I was not going to compete in a tug-of-war over fees that I could not win.

Because even if I had succeeded in having him pay me my fee that I billed, I would have lost.

I would have had one very unhappy customer.

Or ex-customer.

Because the way I figured it, I was on a hiding to nothing to win this.

Reason being?

Patient was not given, or did not acknowledge receiving these three magical words:


And when that happens, you’re pushing the proverbial up hill…

It’s a battle you cannot win.

And so it’s all about damage control.

Thirty years ago, as an assistant dentist, I became involved in a rather “heated” and awkward discussion with a patient, [who I had gotten on well with prior to this], about the fee for a unilateral chrome partial lower denture.

And although I stood my ground for the practice, and the fee, and received full payment, my boss came to me later and said:

“If I was you, in that situation, then I’d have just given him what he wanted”

And although there were times following this, and in my own practice, where I completely forgot about my employer’s advice and wisdom that day, as I think about it today, he was telling me, or teaching me, the exact same lesson.

And that was, that it’s better to let go of the rope.

In this day and age, with social media and review sites, unhappy patients are in positions of even more power than ever before to leave indelible imprints in unfair circumstances.

And so, as you embark on a journey of who is wrong and who is right, sometimes it pays better, to be wrong, and be a loser, for some of the time.

Because in the end, you’ll end up the winner…


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