The “Dentist’s Prerogative” in Patient Relationships

Everyone loves to be in love. That’s why new romances are so exciting and energizing, because falling in love is about sensing the possibilities of what you can do together.

The same holds true for your professional relationships with your patients. There are few things that get a dentist more excited than a new patient in the schedule. New patients are filled with possibilities - possibilities for ideal care, for practice growth, for doing the kind of cases you love to do, for new invitations. In that sense, a new patient is really about a love story and that’s why you put so much effort into a new patient experience. You want this relationship to start off strong and last a long time.

But at some point, every relationship leads to a decision and that decision is about making a commitment to each other. Many of us have experienced the ultimate relationship of getting married. But many have also experienced the frustration of a relationship that feels fine but seems to be going nowhere.

This is representative of what goes on in the relationships in your practice too. You have the patients who have made the commitment to you and to their oral health. They are all-in.

Then there are the others. The ones that are great people, whom you might really like, but for a long time their level of commitment has not changed. The relationship is not going anywhere.

The symptoms of that are everywhere. Most practices have a goldmine of unaccepted treatment in the patient charts. Treatment that, by any clinical standard, needs to be done for the patient’s health. And yet, it’s sitting there unaccepted. It’s easy to say that’s because the patient didn’t accept it, but it’s also equally fair to note that many dentists don’t tell the patient everything they see. So the doctor doesn’t move the relationship forward and the patient doesn’t move the relationship forward.

And with a patient relationship, as with many personal relationships, you often develop a history of shared understanding—areas of disagreement where it is just understood that “we don’t talk about that anymore.” So you develop a psychological barrier that prevents you from fully communicating their needs all the time. What happens then is that you play the “watch and wait” game—even though you know that waiting is not going to help their condition.

This is where you need to break free and establish a new model for the dentist-patient relationship. As much as it may be your instinct to develop peaceful coexistence in these relationships because we’re socially programmed to find common ground with the people around us, in patient relationships you need to assert your professional prerogative.

Look at the charts of the patients you are going to see tomorrow. How many have untreated conditions in their mouths? How long has it been since you have spoken to them about it? Why? Is it because you don’t want to come across as “pushy?” If so, it’s time to re-define the relationship in a way that puts your professional responsibilities, and their oral health, first. Select a longtime patient with untreated issues and talk to them about the benefits of having a comprehensive “new patient” exam to evaluate the state of their oral health and talk about their priorities going forward. In any patient relationship, we can assume both of you are friendly, both respectful—but only one of you is the dentist. It is your purpose—your obligation, even— to always try to move the relationship forward to greater levels of commitment.