Dental Diaries: Fast, cheap, good

I have always wanted to write a book. If you ever call my cellphone and get my voicemail, you will hear that I am working on my "Great American Novel." This is not the title of my next book or even a movie script (though it would be a good one). This is the reality show in my office.

I attended a practice management seminar earlier this summer with Dr. Roger Levin. Always informative, sometimes humorous, the day seemed to fly by. I took one or two of his knowledge pearls and tried them out the next day. For example, he recommended you contact all of your patients who have disappeared over the past two years and let them know you are offering a free periodontal and oral cancer exam if they will schedule an appointment. His rationale: Give away $50 to reclaim a patient whose worth is in the range of $12,500 over their lifetime.

Good logic, I thought. So I proceeded to call a bunch of patients who I felt were more promising to return than others. Interestingly enough, it worked. I had three patients reactivate and another one ready to schedule.

Of these returning patients, one was a woman who left my practice for a "cheaper" (to her own admission) alternative. She had an awesome dental plan, which covered a great majority of the procedures and had a very high annual maximum. She felt that she wanted to go to a dentist in her plan and decided to move onward. When I called her to give her the new offer, she was thrilled. She said, "I have been thinking about you for the past few weeks and was planning on calling. Your ears must have been burning."

This was a very strange response, but I accepted it as a compliment. She proceeded to tell me that she went to another dentist several months before and that he did the same treatments we had previously discussed (a crown and a composite restoration), but ever since the crown was placed she had been in pain. She felt the tooth was too big, the temporary never fit correctly, and now, when she had a glass of wine, it felt as if tinfoil was in her teeth. She'd had radiating pain in the area ever since the treatment and wanted something to be done about it. As we had done a crown previously, she said the temporary and crown she now had never felt like the one she received from our office. She had gone back to the other dentist but he didn't do anything to correct the situation. She wanted the "bad" crown off, a new temporary placed, and, of course, to be rid of the pain.

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So I scheduled her for the following week. At her scheduled appointment, I evaluated the area and took a few radiographs. She commented again, "I know this is a huge mistake, and I just want it out of my mouth. I know it is going to cost me, but I will just chalk it up to trying to save money but that didn't work." During her visit, I contacted my endodontist to run down the symptoms. He recommended removing the crown and placing a temporary to see if the symptoms abated. He said he would take a look at her but wouldn't jump into endodontics quite yet.

I took off the old/new crown, placed a temporary, and voilà-- she hasn't had any discomfort since. She actually wrote me a note, thanking me for being her dentist again. A happy patient is a referring patient!

This was an interesting turn of events. How many of our patients leave us to go somewhere they feel is "better" only to find out that their original practice was where they should have stayed? Dental benefits sometimes cause a rift between the patient and the dentist, apparently dictating treatment with their coverage fees (even though the professional relationship is between the practitioner and the patient).

Speaking of seminars, I attended one years ago where the primary message was "fast, cheap, and good." There are three scenarios: Dentistry can be fast, but it may not be cheap or good. It can be cheap, but it may not be fast or good. Or it can be good, but it probably won't be fast or cheap. You get the picture.

The "free" periodontal and oral cancer exams I offered did work for some of my reticent patients, but not all. There are some who are still staying away because of the economy and a small number who have changed practices. We will make a few more calls and try to remind patients of the need to seek out oral care. After all, if we are not able to be cheerleaders for our own practice, who will?

Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at [email protected].

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