More than ever, I believe that doctors have a functional blindness to their own defects (kind of like the commercials on TV about people going “Nose Blind”). These doctors are not struggling because they cannot resolve these shortcomings. They struggle because they don’t see them. Perception is everything. One thing we all need to accept is that when it comes to clinical dentistry patients perceive “good” work by what they feel. Patients want their dentistry to look good, FEEL GOOD, and last a long time. In the last article, I detailed six easy steps to do away with hurting your patients. Let’s add another layer to this line of thought to help all of us deliver more than our patients expect.
Commitment to clinical excellence should permeate all you do. There is no excuse for taking shortcuts when you should know that a lack of integrity (or the excuse of not knowing how to do it right) is no excuse for marginal results. Accountability is like rain. We all need it but none of us really wants to get wet. I was in an office the other day when they were doing three single crowns. I looked at the preps and they had sharp line angles, minimal reduction, over tapered (greater than 4 degrees off of parallel), with less than a 2-millimeter prep height. Not a stellar prep. They had taken an impression that looked passable and were now making temporaries. They reinserted the pre-op impression with temporary material and when set, removed the temporaries. They checked the occlusion, and then immediately temporarily cemented the temps on the prepped teeth. These temporaries had over extended margins, no embrasures for the gingiva, and they had ground through the posterior temporary occlusion creating a 2-mm hole, and they didn’t even bother to polish them. For me the standard of care for a temporary would be good color match, precisely contoured shape that has perfect occlusion and polished to the point that it would feel to the patients tongue as smooth, if not more so, as the adjacent teeth. That patient was subjected to two weeks of temporaries where the one with the hole in the temp and not enough prep height coming off, the others feeling like sandpaper with sharp, jagged, incisal edges. The temporaries looked and felt nothing like a tooth. For me, this is a lack of knowledge or a lack of integrity. What do you think?
The problem isn’t what you and I think but what the patient thinks. This patient will evaluate the entire experience based on how they felt during the procedure (profound anesthesia, speed of delivery, comfort during the procedure) and how they felt after the appointment (sensitivity, rough temporaries, sharp surfaces, hot/cold sensitivity, etc.). If everything is great, they might tell a couple of people. Anything short of greatness and they will tell everyone they know to NOT go there.
The other person who evaluates what you do or don’t do is your staff. They are the ones that see and hear about a less than acceptable appointment. If they continue to hear negative feedback they begin to distance themselves from you and the practice. I have seen staff that would never have dentistry done in the office where they worked. I have had hygienists who will never sell dentistry because they don’t trust the results the doctor will deliver. Imagine the culture and esprit-de-corps your office would have when average or just marginal is how you operate?
There should be a third party that evaluates the work in your office: You. Most dentists never come close to their potential (financially, clinically, leadership, etc.). I will follow up this article with specifics about how to do away with the “prep and pray” treatment plans, along with tips that will insure a better result in all you do, while impressing the patient with the service you deliver. A life lived without reflection and adjustments is misspent. Your past performance and success does not define you. It is never too late to commit to change. An adjustment in trajectory should not take more than a minute. This is how you Summit.
Michael Abernathy, DDS