I Just Fired My Worst Patient

Unfortunately, some patients simply want to fight you at every turn. Is it okay to politely show them the door? Alan Stern DDS, founder of Better, Richer, Stronger, shares his thoughts on the matter.

‍I recently saw a post from a colleague about an experience we all encounter. How would you handle this one?

‍I just fired my worst patient. She came to me from another dentist, bad mouthing him. First red flag. Long story short, she questioned everything. Wanting me to explain in great detail. No problem ... I'm patient, I love educating my patients. She has since taken 5 hours of my life explaining dentistry ... she then applies her "logic" and comes up with her own answers. All incorrect. Last visit I tell her, if she cannot trust me, I cannot treat her. Today she starts in ... she has a 2.5 hour cerec appt. [sic] I just go, "nope, you're the most difficult thing my life and you're not worth it." She tells me how she needs this done. I say" I am escorting you out, now. I'll send you a check for all you've spent here, you are not welcome" Pearl, if someone makes you hate the work you love, GET RID OF THEM.

‍No matter what business model you’re in — whether a DSO, charity care, or high touch, low volume — it's risky business to do any dental treatment without first establishing a positive, nurturing, mutually respectful and supportive rapport. It’s risky for your peace of mind; it’s risky for your health; it’s risky for your outcomes; it’s risky for your cash flow; and it’s risky for the people you serve. If we are constantly at odds with those whose trust we must have, there is neither joy nor success in anything we do with them.

Establish a culture of heartfelt care and concern by your entire team for all who enter your office

And I’ll go a step further. At our 2019 Speaking Consulting Network conference, we heard from Todd Williams, an executive who helped develop the culture of the Four Seasons Hotel Chain and who currently serves Centura Health as Vice President of Culture Development. Mr. Williams talked extensively about the importance of love in any relationship, and that includes business — yes, I said business!

Who hasn’t experienced the tear-your-hair-out aggravation of calling a business to whom you pay lots of money, encountering what seems like 10 minutes of prompts, only to encounter a voicemail box or a call center operated by someone reading from a script with no clue of who you are, what you need, or how urgent your problem may be?

Who hasn’t agreed with a friend that posted, “I hate xyz cable company or abc insurance”?

And who has been fortunate enough to stay at a four or five star hotel, or dine at a nice restaurant, where our feelings are every bit as important as the quality of the room and the food?

In a digital, transactional economy, nearly every issue we face is expected to be reduced to a one-size-fits-all solution. Something solved with a keystroke by a remotely located clerk reading a scripted set of questions. When this happens, struggle, conflict, and disappointment are almost inevitable. Love. Empathy. Shared values. Outward mindset. Quid pro quo. Where have they gone? And what opportunities do they offer those of us who understand their real value today and always?

Most dentistry is elective. It involves an exquisitely sensitive part of the body. Its success depends on so many factors, not the least of which is the informed approval and active maintenance by the care's recipient. At bare minimum, it requires the physical, mental, and financial cooperation of the person receiving services.

Ideally, we want to have that person in a relationship of active collaboration, where everyone is in agreement on what is in the best interest of the person receiving care. Once  that agreement is established, those receiving our care are more relaxed. They feel good about being in our company and receiving our best care. They are more likely to follow up on maintenance. Life becomes easier, outcomes are better, and any issues which could arise during or after treatment are easily resolvable.

Love is a critical component if we are to thrive in any aspect of life

I love (and need to) get paid a fair fee for my services. But what I love even more are the hugs I get from grateful people and the referrals to people who call my office saying that their friend said our office is just wonderful. Our office. Not our work, which is very good, of course, but our office.

That means the experience they get every moment they interact with us and the feelings they have long after they leave. Which brings us back to our colleague who fired her confrontational patient. Some seemingly tough people are merely expressing fear. They can be won over with a little love and generous listening. I’ll take these people into my life with enthusiasm.

But there are people who do not want love and empathy, and that’s fine. There are people who, for reasons beyond our control, have to fight over everything. That’s okay, too, but not in my personal or professional life. That’s my choice. And it’s yours, too!

Establish a culture of heartfelt care and concern by your entire team for all who enter your office. It doesn’t take long, and it’s so much fun. Ask probing questions. Express empathy. See how your dentistry can improve their lives. Connect as a competent person who likes people, nurture and maintain that connection, and watch the material and intangible rewards follow.

The lesson learned by our esteemed colleague at the beginning of this piece is that we cannot be all things to all people. Whether you view dentistry as a business or a professional practice, your team, the people you serve, and you are so much better off when love is what differentiates yourself from everyone else. I’m not sure that The Beatles were right when they said “Love is all you need.”

We need clinical and business skills for sure, but love is a critical component if we are to thrive in any aspect of life. And, yes, that includes business!

‍Learn more about how RevenueWell improves case acceptance and creates more close-knit relationships between dentists and their patients.