Dentaltown July 2019 - 36

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dalmacija
Member Since: 04/14/15
Posts: 5 and 6 of 38

OP, sounds like you did everything right. There's no need for you to tackle a difficult endo
case on an angry patient when you are a newb. Also, don't worry about this-let your office
manager deal with this. If your X-rays look good and the treatment was necessary, you are fine.
When you build a relationship with patients, this will happen much less often and they will
trust you more.
Sometimes being empathetic will help. Seems like she has been in pain for a while now.
Dear Patient So-and-So: I am sorry your condition has worsened. I want to get you out of pain and
I'm going to send you to the best endo to get you out of pain.
And, no, definitely don't refund. You went over RBA and she consented-not your problem
she needs endo now. ■
4/25/2019

aapl
Member Since: 07/11/17
Post: 7 of 38

Her tooth was in bad condition. Had she not taken care of it, she could've let it get to the
point of it needing extraction. The attempt was to prevent that from happening by doing a
crown, but the decay on her tooth or the abfraction was so big the tooth needed a RCT. Tooth
is still saved, it just needs some more treatment.
Every time a tooth is touched, there's a risk. Patient sounds unreasonable and will probably
try blaming you for any other problem she ends up having. ■
4/25/2019

DocHorton
Member Since: 08/19/11
Post: 8 of 38

Patients hate to be referred out ... all of them. I've never once had a patient be happy about
being referred out. It takes time, usually costs more, is inconvenient, makes them think they are
wasting their time with you. Even if you think you are explaining it well, they still don't like it.
Trust me: If OP would have done it in her office, the patient wouldn't have been nearly as
mad, because the dentist would have been taking care of the problem that, to the patient, the
dentist caused. To a patient, referring out looks like, "I can't handle what happened during this
routine procedure, so I am sending you to someone who can."
Feel free to refer out, but don't be surprised if patients get even more upset. ■
4/26/2019

jhobgoDDS
Member Since: 06/15/15
Post: 9 of 38

So, we should make clinical decisions based on how a patient might perceive it? How the
patient feels about being referred factors little into my decision-making as to what the best thing
for them would be. If they don't like what I suggest, then you're right-they can go elsewhere.
This is what a lot of the "super GPs" tell themselves to justify keeping it all in-house, regardless
of their skill set or competency: "I do it all because my patients hate being referred out."
You are right, though-most people hate being referred, but many are OK with it once it's
explained why we are referring. Our egos tell us referring makes us look like less of a dentist in
the patient's eyes but I don't think that's true in the majority of cases. Most are just concerned
with money and assume "specialist" = "more money" (which I agree is true a lot of the time), but
sometimes it is the best course of action for them, whether they like it or not.
OP, it sounds like she's already dismissing herself from the practice, so I wouldn't sweat it.
If your radiographs show good margins and your documentation is good, then no refund. ■
4/26/2019

dalmacija
Member Since: 04/14/15
Post: 10 of 38

It depends how you explain it to the patient. The endo is more challenging because it's
through a crown. With angry patients, the treatment needs to be nailed. And also not a bad idea
to spread the liability around.
I hear this all the time: "Patients don't like to be referred." I seldom get pushback from

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