Dr Darryl Marsh writes… In this blog entry I talk about my approach to my patients and how this has evolved over the years.
Why do different dentists differ in their treatment approaches?
If you have been to more than one dentist in your life then you will know that their approach to the dental care of their patients and their treatments are not always the same.
Dentists are biased… to saving teeth
When you speak to dentists about these different approaches, the truth is that they are very biased. It’s not wrong, it’s just that we are dentists – our teeth (and by that I mean the teeth I look after) are important to us and quite frankly most dentists would do almost anything to save teeth.
It’s what we were taught in dental school and because we spend most of our days saving teeth, we ASSUME everyone feels and thinks exactly the same way we do. We think that people come to see us so we can save their teeth for them.
“Many well-intentioned dentists annoy and alienate their patients because their dental care approach just doesn’t match their patients.”
Assuming is very dangerous thinking. Don’t get me wrong. I used to think like this too. I ASSUMED that all of my patients came to my office for me to save their teeth.
I was wrong...More than that though, quite frankly it was insensitive and rude of me to make that assumption. Now don’t get me wrong, most people go to the dentists because they want help and advice on how to save their teeth.
A male and female go shopping: a dental analogy
It’s like when my wife goes clothes shopping compared to when I go clothes shopping.
Me: When I go shopping it is with one purpose in mind. To walk out with what I need, a new shirt or pants (usually to wear to work) and to do so in less than thirty minutes.
My wife: It’s a different story. A visit to the department store can mean many things. It could be to pick up a necessity like a replacement pair of stockings, it can be a fact-finding mission, or it can be a form of entertainment and exploration – just to see what’s new in store. It’s for fun.
Now I know people don’t visit the dentist just for fun, but I also know that it’s not because they have had an epiphany and now are on a mission to save their teeth whatever it takes or costs.
You see that’s where many well-intentioned dentists annoy and alienate so many of their patients. Their dental care approach just doesn’t match their patients.
Some dentists assume their patients think just like them
I actually think it’s OK for my patients to come to see me and after we have discussed their condition or whatever ails them, for them to decide that they are going to not take the steps required to save their teeth. You see it’s not my responsibility as a dentist to save my patient’s teeth. Or to make someone feel bad or guilty if they don’t save their teeth. Because they are their teeth, not mine.
The Dental Menu: your options presented like a menu
It’s like having a menu. It’s my role to explain what’s on the menu. Whatever you choose from the menu is up to you.
There are two reasons I follow this approach:
- Firstly as I mentioned I am legally obliged to go through all the options with my patients – and the last thing I want is to be sued for not doing what is legally required. Just as importantly though, it’s what I would like if I were the patient. It’s our Golden Rule – ‘Do unto others as you would have them do unto you.’
- Secondly, I’ve been a patient where the doctor didn’t spend the time to explain the nature of my problem and all the options available to me. He just said: “You need to have X “. He left me feeling like he thought I was a dummy because I didn’t understand all of the ‘ins and outs’ of his particular medical specialty and that he’d know for sure that I was a dummy if I ever asked him a question.
I wanted to know all the facts, more so than I wanted the doctor to think I was smart. So I asked all the ‘dumb’ questions I needed until I understood my situation and the options available to me. But it was clear this was an inconvenience to him.
Worse than this though is when someone pushes you toward, or tries to persuade you to do, one treatment or another. I have been guilty of this myself before I took my dental options menu approach. I wasn’t trying to ‘sell’ them anything, but I’m sure that subconsciously, by the tone of voice or body language, the patient would be in no doubt about which was the ‘smart’ option and which were the ‘bad ‘options.
Without realising it medical professionals can be insensitive
I now realise that no matter how well intentioned this advice is insensitive and downright rude.
Firstly it assumes the patient has the same priorities as the dentist with respect to saving their teeth. And if they don’t feel this way then they are in some way ‘wrong’.
Secondly, for many people I see in my practice It has been some time since they have been to the dentist – in many cases 5 years, 10 years or even longer. A lot of damage can happen to teeth in this time and fixing that damage and returning the teeth to optimal health can be complex and expensive. But for many people this type of complex treatment is completely out of the question due to the costs involved with the dental treatment.
The bottom line – my approach with my patients
I’m a dentist so I’ll do anything to keep my teeth. My teeth are really important to me. I don’t really expect all my patients to have the same level of concern and motivation about keeping their teeth that I do. Some do, some don’t. And that’s OK with me.
My role is to help my patients understand their exact situation and be aware of all their possible options so they can make an informed decision for themselves. As long as the patient understands all the consequences of their treatment choices, then I’ll support anything they want to do – including doing nothing.