The High Cost of Doing Nothing

I continue to be amazed by the number of dentists who say to their patients, Mrs Jones, you have a fracture in this molar.  Let’s keep a watch on that.  Watch what?  The tooth shatter?  Money walk out the door?  Your stress level go through the roof? Or worse yet, your patient takes off to the dentist down the street?

While some of us have a hard time recommending high-dollar treatment, we might want to consider the high cost of waiting. 

I had a client that his team lovingly referred to as “Patch Adams”,  He wouldn’t provide comprehensive dentistry and did so in the name of conservatism. His schedule was riddled with composite patches, class five crown margin repairs and the occasional extraction and partial adjustments.  He frantically moved through his day barely making ends meet.  

Down the hall was his hygienist.  Her patients often brought in photo albums from their latest vacation, family reunion or child’s graduation.  They would gather over the photos and chat about the event while sprinkling a little bit of the conversation with her kiddo’s soccer weekend.  The patients loved her!  Somewhere towards the end of the appointment I heard her say, “Sally, you have some deeper pockets around the back teeth and we are going to keep a watch on those.”  And she and Sally walked to the reception desk, where they parted ways with a hug and a, “Call us in six months and schedule your appointment Sally.”

Now I don’t mean to pick on these two, but when I asked the doctor if his mother were in the chair if the treatment recommendation would be the same, he said he would have crowned the tooth!  Why then did he not recommend it for the patient? Because I can assure you the cost of a crown costs less than three composite repairs and three appointments worth of time for our patients.  A crown costs less than a root canal due to a fracture, or an extraction and implant caused by broken tooth.  

Sometimes, we are so concerned with being a friend or not being the pushy dentist that we lose sight of the fact that our patients count on us to deliver comprehensive care.  They are buying an hour with our hygienist not to chat and polish, but to be advised of the how, what and why treatment is being recommended for their disease.  They are purchasing exam time to be advised on the best course of treatment to meet their needs.  It is our professional responsibility!

So Monday when your patients arrive in your dental chair consider this:  When evaluating treatment needs, do not evaluate what you think may or may not be in your patients wallet but rather what should be in your patients mouth.  If respect, trust and friendship are what you are looking for, tell it like it is!  Mrs. Jones, repairing this filling is not what is best for you long-term.  What you need is a crown, which will help protect it from much costlier treatment or tooth loss in the future. I will venture to say Mrs. Jones will schedule a crown.

My mentor had a great line, “People can afford what they value and for which they find a need…just look at how many 50” plasma televisions are attached to the inside walls in the trailer parks.” 

It is our job to create value for the services we provide and help our patients want the treatment we know they need.  This means recommending the best treatment.  The treatment you would want in your own mouth.  Stop scratching your head and wondering why the month-end reports are abysmal and stop practicing rat-wheel dentistry.  Insist that your hygienist stop chatting about soccer and start talking about dentistry!   Waiting and watching is costing you and your patients way too much.