Monday, September 16, 2013

The Other Dentist

I recently had an interesting encounter with a patient. She was in for her clear aligner checkup, and asked about a spot on one of her teeth. I asked if she had recently been in for a checkup with her dentist. She said that she had not, and then asked if it was possible to come to our office for that service. I double-checked with her that she did not already have a dentist she was seeing. She replied, “No, I’m monogamous.”

As excited as I was to hear that my patient wanted to go steady with me, I started thinking about all my other patients that continue to “see other people.” Sure, I was a little jealous. But I was more concerned that they are not getting the same level of care that I would provide (that’s what we all say, right?).

The practice I currently work in is heavily focused on clear aligner therapy. Many patients that come here for orthodontics may already have a dentist that they see for cleaning and restorative work, but that just does not offer orthodontic services. I know many of these patients choose to go to another dentist because they have an established relationship with them, but it’s usually because they want to see someone that is in network with their insurance.

Typically, my orthodontic consult involves asking when the patient’s last cleaning/checkup was. If it was within the last six months and their x-rays look good, I trust that they are in good hands and proceed with my treatment. However, if I get a blank stare when I ask this question and I see pathology on their x-rays, I ask that they schedule a cleaning and new patient exam, either in our office or wherever they would like. I would say half the time they come to us. But if we do not take their insurance, they see someone who does. I honestly do not have a problem with this. My main pet peeve is when they return from their dental provider after an SRP or even a “cleaning,” and there is still so much plaque and buildup on the teeth that I cannot even take a proper impression. I have patients that come back complaining of sensitivity after a mouth full of freshly-placed fillings. The best was when someone had brand new ceramic crowns placed on teeth that clearly had failing root canals and periapical pathology. This patient assured me that their dentist told them everything was fine.

I know it is a huge taboo to bad mouth a fellow dentist. It does not make our profession look good and it is highly discouraged in our community. In the case of the failing root canal, I attempted to personally contact this dentist, only to be ignored after leaving several messages. I try my best to inform the patient about the state of their dental work. I try to avoid saying anything bad about the other dentist, but it is difficult when I have to inform them of the reasons I cannot perform my treatment. When I have a patient that complains because they are unhappy with work that I have done, I make every effort to correct it or redo it because I want to make sure they have a good experience. If they ever ended up in the hands of another dentist who questioned my work (my worst nightmare), I would feel terrible!

I do my best not to judge. I know we have all had difficulties and you can never truly understand the situation unless you have experienced it firsthand. But I seem to find myself presented with these scenarios more often than I would like. Have any of you ever had these types of experiences? If so, how do you handle them? Do you demand monogamy from all your patients? When I develop a relationship with a patient because they see me so often, it’s hard not to feel jealous or protective if I learn they are getting other dental work taken care of somewhere else. I guess I just have to hope one day they will realize what they are missing out on!

Lilya Horowitz, DDS

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