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How to Eliminate Patient Excuses from your Practice


secret to eliminating patient excusesBy Daniel Midson-Short

Can you tell the difference between a genuine patient and one who is making excuses?

No matter how skilled or experienced you are as a dentist, it's likely that you cannot.

A dentist can bond well with a patient, develop a rapport, and they can spend a lot of time in the exam explaining the treatment that they recommend. They can even bring the patient back for an extra consultation and have a beautiful treatment plan prepared.

Despite all this, the patient may not really be interested in the treatment. But, because of everything the dentist has said and done, the patient is now too embarrassed to give an honest ‘no.'

Instead of honesty from the patient, we get polite evasion. They use a range of tactics to defer treatment indefinitely:

  • "I need to think about it"
  • "I need to talk with my wife"
  • "I need to check finances"

Since the obstacles and excuses sound real, the biggest problem for the dentist is that there is no way to distinguish between real obstacles and polite evasion.

This puts the dentist into chase mode, trying to convince or cajole patients into treatment. The more we try to get a patient to have treatment, the better they become at avoiding us; it ends up feeling like a game of cat and mouse. The good news is the whole situation can be avoided if we start with a different approach.

Essential Versus Elective Treatment

In the patient's mind, the only essential treatment is the treatment that gets rid of the pain. In the dentist's mind, most treatment is essential. While this might seem like semantics, it is a different point of view that forms the root of many problems.

The most common complaints that patients make about dentists are that dentists prescribe treatment that isn't necessary. To try and convince someone that something 'is necessary' is philosophically difficult.

However, when we tell patients that most treatment is elective—not essential—something interesting happens. The ownership of the dental condition falls to the patient and we totally avoid a cascade of problems.

We can say to our patients that there are so many choices of treatment that it can be difficult for the dentist to simply prescribe a solution. The same condition can have a range of solutions that can spread from spending nothing to spending tens of thousands. For some people, the best option is the lowest cost. For others, the best option is what will last the longest. And for some, it's what looks the best. The dentist has to help the patient understand the choices and support their decision.

What does this achieve? The patient will never say that I tried to talk them into unnecessary treatment. I will never be slandered at dinner parties and lumped in with dentists who tried to sell unnecessary treatment. I won’t appear on a social network as a rip-off dentist to avoid.

The best way to avoid polite evasion: don’t create it

We create polite evasion by inadvertently making it too difficult for the patient to give us an honest 'no'.

Dentists must make recommendations for essential treatment (for pain relief and life-threatening conditions). Outside of these, it is important to define solutions as elective. When we try to recommend treatment for conditions that the patient view as elective, we run the risk of appearing to be selling something.

Patients will always be hypersensitive to dentists trying to sell unnecessary treatment. We defuse the whole problem when we make it clear that most treatment is elective.

Dental Patient Communication Quiz

Photo Credit: vandys via Flickr