Inside Dentistry
August 2015
Volume 11, Issue 8

Dealing with Patient Issues

Converting an Unhappy Patient

The best way to get rid of an enemy is to turn them into a friend. Ask a patient, how is everything? If they respond fine, but if you see from their face or tone of their voice that it isn’t, you should ask what the problem is. If the patient has a complaint, don’t get defensive; allow patients to express themselves. Ask them how you can make them satisfied. Then if it is possible, accommodate them. Happy patients make referrals to the office; unhappy individuals do not return.

Managing a Patient’s Fear of Dentistry

Respect the concerns of patients who express fear of dental procedures. Tell them they are courageous, because they presented for help even though they have anxiety. If someone is not scared, it doesn’t take courage to come to the dental office. To assuage patient fears, a soft tone and assurance help. A gentle step-by-step approach also may be warranted. Patient should be given the option of taking a tranquilizer to help them cope with procedures that cause them anxiety. You can make patients laugh by saying, “It’s okay if you are nervous. The only time you should worry is when the doctor is nervous.”

What Is Important to a Patient?

Patients want to achieve health, which is why they seek professional care. They anticipate everything will be done correctly. However, patients do not assess the office solely on treatment. They often judge the surroundings as well. Seemingly small things are important, such as having high-quality paper products. Patients expect the office and the bathroom to be clean. They expect courtesy at the front desk. In that regard, if the doctor is running late, the patient should be informed and told why. This simple courtesy avoids patients’ annoyance. Similarly, written payment plans and explanation of insurance benefits prior to initiating therapy circumvent misunderstandings.

Enhancing Relations with Colleagues

Demonstrating Respect

If you are a dental specialist and receive referrals from a general practitioner, there are several steps that should be taken to ensure a good relationship, in addition to doing good work. The sine qua non is that you must always show respect for a referring doctor in front of their patients. Remember, patients usually go to their dentist because they like him/her.

It is important to always have a good word to say about the referring doctor, even those for whom your regard is not the highest. Watch your facial gestures and body posture when presenting results of an examination. Patients are watching and interpreting your movements positively or negatively concerning your assessment of their dentist’s ideas. It is appropriate to send a written report to the referring doctor and he/she should be called and provided a verbal evaluation with respect to their patient. The referring dentist is important and should be included in the final decision-making process. Ultimately, it must be emphasized that the referring doctor’s success is part of your success. From another perspective, if a referred patient asks to be sent to another general practitioner, politely decline to do this. Because, if you do, and this gets back to the referring dentist, you can lose his/her confidence and that of their dental friends in the area. This statement is not contradictory to liking your patients and doing the right thing for them. Do the best you can for the patient and counsel the referring dentist when you disagree with his/her assessments. Otherwise, you can lose a referring dentist, and it will be costly. Yes, there are exceptions to this concept, but be prepared for the consequences of your actions.

Problematic Issues

Problems can arise with respect to prescription referrals to any specialty office, for example, a periodontist. Sometimes when patients are referred for a specific procedure, such as crown lengthening, the examination reveals other concerns (eg, periodontitis). Upon referral, it becomes the periodontist’s responsibility to examine the patient’s periodontal status. Now comes the difficult part. The referring doctor must be informed of all clinical findings. In addition, the periodontist needs to indicate to the patient that although a specific procedure was requested by their dentist, other issues were detected and consultation with their dentist is needed before any additional procedures are contemplated. However, an inquisitive patient may pursue the subject, asking questions, such as about how long the problem has been present or whether the referral for evaluation should have been made sooner. It can get more complicated, if the patient asks about the extent of the problem. A prescription referral in a situation described above is problematic. The periodontist can’t ignore detected problems, and at the same time, does not want to undermine the referring doctor. It is a dilemma for which there is no easy answer. The best way to avoid this type of situation is to ask referring doctors when they make a prescription referral to mention that the periodontist will conduct a more thorough overall periodontal evaluation.

Professional Involvement

Become professionally active at the local, state, or national level. Join committees where you will meet the nicest people and engage in professional camaraderie. Surprisingly, you will find that a prepared person on a committee who has passion and knowledge can make a difference. Dentistry is a great and noble career. Enjoy it.


This essay is based on personal experiences, lectures heard over many years, and opinions of colleagues.

About the Author

Gary Greenstein is a clinical professor in the department of periodontology at the College of Dental Medicine at Columbia University in New York, New York. He also maintains a private practice specializing in surgical implantology and periodontics in Freehold, New Jersey.

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