” I Fired My Worst Patient”

I recently saw a blog post from a colleague about an experience we all encounter. How would YOU handle this one?

I just fired my worst patient. She came to me from another dentist, bad mouthing him. First red flag. Long story short, she questioned everything. Wanting me to explain in great detail. No problem… I’m patient, I love educating my patients. She has since taken 5 hours of my life explaining dentistry… she then applies her “logic” and comes up with her own answers. All incorrect. 

 Last visit I tell her, if she cannot trust me, I cannot treat her. Today she starts in… she has a 2.5 hour cerec appt.. I just go, “nope, you’re the most difficult thing my life and you’re not worth it” she tells me how she needs this done. I say” I am escorting you out, now. I’ll send you a check for all you’ve spent here, you are not welcome”
Pearl, if someone makes you hate the work you love, GET RID OF THEM. 

No matter what business model you’re in, whether it’s a DSO, Charity Care, or High Touch, Low volume, it is risky business to do any dental treatment without first establishing a positive, nurturing mutually respectful and supportive rapport. It’s risky for your peace of mind, it’s risky for your health; it’s risky for your outcomes; it’s risky for your cash flow; and it’s risky for the people you serve. If we are constantly at odds with those whose trust we must have, there is neither joy nor success in anything we do with them.  

And I’ll go a step further. At our 2019 Speaking Consulting Network conference,  we heard from Todd Williams, an executive who helped develop the culture of the Four Seasons Hotel Chain and who currently serves Centura Health as Vice President of Culture Development. Mr Williams  talked extensively about the importance of love in any relationship, and that includes business- yes, I said business!!!!

Who hasn’t experienced the tear-your-hair -out aggravation of calling a business to whom you pay lots of money  , encountering what seems like 10 minutes of prompts, only to encounter a voicemail box or a call center operated by someone reading from a script with no clue of who you are, what you need, or how urgent your problem may be (think cable provider , insurance company )? Who hasn’t agreed with a friend who’s posted “I hate xyz cable company or abc insurance” ? And who has been fortunate enough to stay at a four or five star hotel or dine at a nice restaurant, where our feelings are every bit as important as the quality of the room or the food?

In a digital, transactional economy, just about every issue  we face  is almost expected to be  reduced to a one-size-fits-all solution solved with  a keystroke by a remotely located clerk reading a scripted set of questions. And when this happens, struggle, conflict, and disappointment are almost inevitable. 

Love. Empathy. Shared values. Outward mindset. Quid Pro Quo. Where have they gone? And what opportunities do they offer those of us who understand their real value today and always.  

Most dentistry is elective. It involves an exquisitely sensitive part of the body. Its success depends on so many factors, not the least of which is the informed approval and active maintenance by the receiver of the care. At bare minimum, it requires the physical, mental, and financial cooperation of the person receiving services. Ideally, we want to have that person in a relationship of active collaboration, where everyone is in agreement on what is in the best interest of the person receiving care. Once  that agreement is established, those receiving our care are more relaxed. They feel good about being in our company and receiving our best care. They are more likely to follow up on maintenance.  And  life becomes easier, outcomes are better, and any issues which could arise during or after treatment are easily resolvable. 

I love (and need to) get paid a fair fee for my services. What I love even more are the hugs I get from grateful people and the referrals to people who call my office saying that their friend said our office is just wonderful. Our office. Not our work, which is very good, of course, but our office. That means the experience they get every moment they interact with us and the feelings they have long after they leave.

Which brings us back to our colleague who fired her  confrontational patient.

Some seemingly tough people are merely expressing fear and can be won over with a little love and generous listening. I’ll take those people into my life with enthusiasm. But there are people who do not want love and empathy, and that’s fine. There are people who, for reasons beyond our control, have to fight over everything. That’s OK, too, but not in my personal or professional life. That’s my choice. And it’s yours, too!

Establish a culture of heartfelt care and concern by your entire team for all who enter your office. It doesn’t take long, and it’s so much fun. Ask probing questions. Express empathy. See how your dentistry can improve their lives. Connect as a competent person who likes people, nurture and maintain that connection,  and watch the material and intangible rewards follow. . 

The lesson learned by our esteemed colleague at the beginning of this piece is that we cannot be all things to all people. Whether you view dentistry as a business or a professional practice, your team, the people you serve, and you are so much better off when love is what differentiates yourself from everyone else. I’m not sure that The Beatles were right when they said “Love is All You Need”. We need clinical and business skills for sure, but love is a critical component if we are to thrive in any aspect of life, and yes,  that includes business! 

Guest blog from a financial professional



Three  Reasons Why You Should Have Already talked to your Accountant this Year


As the days grow shorter, temperature cools and leaves start to change – it’s easy to forget about the importance of talking with your accountant about 2018’s potential tax bill.  Let’s be honest, talking with your accountant does not usually rise to the top of your list.  However, as I have found through personal experience, you need to chat with your accountant regularly and early in the year.  If you haven’t spoken yet with them yet, please read my three reasons why you need to setup a meeting now!


My Experience

In early 2015 as I entered into the first full year of helping my wife manage her dental practice –  I asked my accoutnant when we would be meeting to talk about tax strategies   Their response was “we don’t usually discuss those things until late November or most likely in December?”

When I discussed this with our financial adviser,  he immediately referred me to a new accountant!

The Result

I met with the new accountant and was so impressed I decided to move my business to them right away.   Soon after, we reviewed numbers, the accountant created projections of our tax liability and helped us create strategies to minimize our burden. Luckily, we were at a point in the year where we could still make relatively easy changes to payroll deductions, 401(k) and HSA contributions, capital purchases, etc.


Here are three keys to managing your accountant and approach to taxes:


#1 – Your Advisors Work for You

If your advisor is not giving you what you need, then why keep them?  Breaking off relationships, even business ones, can be very uneasy.  Since many dentists are juggling so many aspects of owning a practice,  – it’s important  to get the answers you need when you need them.  Thankfully, I had a financial advisor who encouraged me to make a change to our support team!


#2 Build a Team that Works Together

Whether this means taking your advisors up on their referrals or interviewing them beforehand and asking of their willingness and ability to work with others that you may hire – having a team is key.  Team members should obviously be an accountant and a financial advisor, but may also include a lawyer, and insurance agent, and maybe even a banker.  My financial advisor is known to have follow-up conversations with my accountant on my behalf, and then report back on the high points of their discussion.  Think of it as interdisciplinary care for your finances.


#3 – Good Decisions are Never Made in a Time Crunch

There is a great video I saw on LinkedIn post showing someone drawing over the course of 10 seconds, 1 minute, and 10 minutes.  The point of the post was to show how different a result you will get when you spend more time on a task.  Making decisions and moving money at the last minute is never ideal.  Just like  patients make far better decisions on their dentistry when they’re not burdened with a toothache, you will be way better off if you plan and revisit your financial goals throughout the year!


Next Steps

Now that you know the importance of planning for taxes, you need to act!


  • Assemble recent paychecks from you/your spouse
  • Collect statements on retirement, health savings accounts, mortgage
  • Collect statements from any investment accounts you may have
  • Estimate your year-end charity, mileage, or other deductions you may have
  • Produce a full P&L (Income Statement, Balance Sheet, Statement of Cash Flows) if you manage your own books.
  • Deliver everything to your accountant and request a meeting (ASAP)
  • Contact your financial advisor and see if they can attend as well


A little bit of planning will go a long way to minimizing your tax burden and maximizing your wealth


Happy planning!



Adam Heim is a life-long learner, enthusiastic supporter of small business and hopeful entrepreneur.  He has spent nearly a decade in banking and has a background in product pricing, commercial real estate, demographics and financial modeling.  Adam created FirstTimeDentist.com in response to his perceived ‘gap’ in quality information, when he assisted his wife buy her dental practice in 2014. 


How do you handle the complaining patient?

Curiosity and the Complaint

Sally has been a patient for over 15 years. Her visits to us have been successful, productive, and delightful. We are very fond of each other.

At her last visit, with no warning, Sally laced into me, saying that I had deliberately placed a defective piece of dentistry that’s been trapping food for the last 6 months. She went on to say that I must have thought that she wasn’t going to live much longer and it didn’t matter to me that she had a problem.

Now if that doesn’t get your heart racing and activate your fight- or- flight reaction, nothing will!

I took a deep breath and coolly asked Sally to allow me to see the problem determine its cause. I discovered that Sally had fractured some porcelain off a screw retained crown over an implant which we had done for her a few years ago. Very calmly (and, of course, without reminding her that I had expressed concern about her bruxism several times in the past), I assured Sally that I can easily correct the problem. “I don’t want to go through any more drilling!”, Sally said belligerently, “and all this will be at YOUR expense!” Nonchalantly (while my insides quietly boiled) I assured her that there will neither be any drilling nor cost to her.

I realized that Sally’s confrontation was a professional make-or-break moment for us and had to be resolved. Here’s what I did:

I removed Sally’s crown, sent it to my lab for repair, and re-inserted it. Over the two appointments, I focused on the task at hand and maintained our usual connectedness. Once the crown was re-inserted, I asked Sally to come into my office for a few minutes. With body language, facial expression and vocal tone that expressed concern and curiosity, I asked Sally whether I was correct in my having heard her assertion that I intentionally placed a bad piece of dentistry in her mouth. Sally quickly responded “yes, that’s what I thought, but then I realized that, although you are a professional, you are also human. “I thanked Sally, but I went a bit further and asked, “You know, we’ve been through so much and accomplished a lot together. I’m wondering if anything else was troubling you a few weeks ago, because the comment didn’t seem to be consistent with what we really think about each other”.  Sally quickly warmed up, we had a lovely talk, and we ended with a hug.

In Conversational Intelligence, author Judith Glazer discusses neurochemical changes that occur during confrontation, which lead our minds to a defensive, fearful mode. In a dental situation, this is a recipe for disaster. The patient accuses, the dentist either gets overly defensive or needlessly appeasing, and the result is a winner and a loser, with one or both parties feeling badly about themselves and the practice.

The best antidote to this state of fear is trust. When someone shows us empathy, our brain chemistry changes, bringing connectedness, composure and constructive thought. My intentional actions and verbiage changing the nature of our discussion from You vs me into we transformed potential disaster into a strengthened relationship.


Closing thoughts:

1- If Sally had maintained an air of distrust and hostility, I was prepared to very compassionately tell her that perhaps I am no longer the right dentist for her.

2- Shortly after this episode, Sally lost a very close relative, devastating her and her family. Events leading up to this tragedy could very well have been what was causing Sally to have acted so strangely


3- Although no technique of communication will work 100% of the time, always act with kindness, empathy, and curiosity. Bond with people in your life in good and challenging times. Everyone is going through something. You have the power to heal. Use it well and use it often.

An Inconvenient Truth

An Inconvenient Truth We All Know :

Wellness is not an entitlement. It is both a behavioral choice and a responsibility, subject, of course, to some genetic and congenital limitations. The repair of the damages made by bad will cause us to suffer significant consequences and also bankrupt ourselves and our country.

The Challenge We Face:
To meaningfully connect with every human being we encounter to show them a better, healthier way to live


How can YOU combine your care, skill, judgment with an outward mindset to help someone get healthier today AND to differentiate yourself and your practice?

Here’s a Real Life Example

My wife and I went out to dinner with our friends, one of whom is a brilliant, highly accomplished nephrologist who is about to phase out of medicine and into retirement over the next few years. Alan and I were both residents at the same hospital and have remained friends for thirty- plus years. He’s an outstanding physician who has worked extremely hard, going from hospital to office to dialysis centers, often working well over 10 hours a day, not to mention the nights he is on call for life and death emergencies. Naturally, our conversation turned to our work. Alan deals with very, very sick people, whose kidneys are malfunctioning and/ or whose blood pressure is dangerously high. “we spend more money on dialysis patients who don’t show up”, Alan told me, to my astonishment, “ Non-compliant people cost us a fortune”

What Alan told me is that the dialysis world is filled with the same “no-show” issue that plagues many of our dental practices. Even as I’m writing this, I’m thinking, “are you kidding me? People put their lives at risk and won’t go out of their way for life sustaining treatment?!!”

If I can take a moment to state a fact in a politically incorrect manner, health is not an entitlement. It is both a behavioral choice and a responsibility, subject, of course, to some genetic and congenital limitations. If we make choices that are deleterious to our health and if we expect the repair of the damages made by those choices to be an entitlement, we will suffer significant consequences and also bankrupt ourselves and our country.

In our world, periodontal and dental health are attainable. It’s easy. Practice good hygiene habits, eat properly, correct issues before they take a toll, get checked periodically, and keep it all simple. Our challenge, my friends, is to get the message to people. We need to come together and battle the “gee Doc, it doesn’t hurt, so I really don’t want to fix the tooth, floss my teeth, correct my bite, etc.” We need to create new practice models to enhance wellness and discourage disease.

We have a huge opportunity to use our relationship based practices to influence people and show them that behavior is the key to health and wellness. My friend Alan’s frustration is the result of a population that is conditioned to think that they can do anything they want and the doctor will be there to fix it.

The same inconvenient truth holds together for ourselves- we, too, need to keep our own bodies in shape. Let’s cut down on the bad eating, let’s exercise to keep our muscle mass up and our body fat down. Let’s stay intellectually engaged to fend off the risk of soul-robbing dementia. And let’s stay socially engaged because that, too, is the key to quality longevity.

Forty- plus years after his tragic passing, Dr Bob Barkley’s words are resonating loud and clear. We have work to do, folks, for ourselves, for those we serve, and for our country. The political implications of this are way beyond our capacity to deal with; however, we can begin to fix the world, one dentist and one person at a time.

Let’s go!!


“How Soon should I do this, Doc?”

That was the question I heard last week from Sam, a very successful entrepreneur and business consultant  whose open proximal contact between a large, wide and  fractured composite restoration and a healthy tooth was causing chronic irritation to his periodontium. The tooth is clearly in need of a full coverage crown.

Now, we’ve all heard that line a million times in our practices. Back  in the 80s, gurus and consultants told us to give patients a sense of urgency to do their dentistry. “Get em to commit right then and there, while you have ‘em in the chair”, they’d say. “That way they can’t back out. And you know they need the treatment” When I heard this in the beginning of my career, I became agitated. And I still get agitated when a speaker, writer , or  one of my colleagues talks about getting a commitment from a hesitant or nervous person on extensive treatment during a brief chairside conversation.

I’ve always been uncomfortable with this blanket, one-size-fits-all  strategy for profitability. You see, wellness is elective. And, whether we like it or not, sometimes life throws other urgencies at people. Having teeth is elective. And maybe, just maybe, that seemingly successful person who lives in the great neighborhood may have more serious priorities in their lives, whether we think so or not!

If we are to have a meaningful, healing , nurturing relationship with people, we have to keep it real. Dr Pankey’s first rule was know your patient. In an era when people formerly known as patients have become consumers and we dentists are motivated to make their lives better,  it is absolutely critical that we behave in an open honest, nurturing manner and make them feel safe in expressing their concerns in the same way (yes, those we serve can nurture us every bit as well as we can nurture them).

Instead of establishing urgency to dental treatment, why not take a moment with that person and explore how it fits into their lives. Lead them to make THEIR best decision on that crown, that implant, that full mouth rehab that we are chomping at the bit to do. Because when the receiver of the service is in control of how and when they receive the treatment, we all benefit.

And if and when that person comes into your office with a condition that absolutely cannot wait, like early endodontic pain that’s about to become a full blown abscess, your sense of urgency will be quite real and credible.

It turns out that the company Sam is consulting is in a bit of trouble, but will be paying him a huge sum of money next month. So he asked if he could call us in a few weeks to schedule his work without any financial anxiety. We listened, we understood, Sam appreciated it, and the work will get done at a time that makes sense for him. After all, it’s HIS life we’re looking to make better.

Mission accomplished


Serving with Heart

There are times when the power of science is so seductive that we may come to feel that all that is required to serve others is to get our science right, our diagnosis, our treatment. But science can never serve unless it is first translated by people into a work of the heart”

 Rachel Remen from My Grandfather’s Blessings


No one can disagree that the technological and scientific advances of the last 50 – 60 years have improved the lives of countless people. And no one can argue that the pace of our advancement is accelerating faster than ever. Let us not forget, however, that compassion and care of another human being can easily get lost in the maze of technological advancements, both inside and outside of our dental world.

A few months ago, I found out that my social security account had been breached. With a sense of urgency, I moved a few patients in my schedule and went to my local Social Security office. What I encountered was nothing less than dehumanizing and nauseating. After a nearly two- hour wait, I encountered a clerk who took my complaint, looked at the co worker sitting next to her and said “we got another one” and proceeded to process my information at a snail’s pace. Not once did she express concern for my well being. Not once did she address me by name, or even “sir”.  She even scolded me for politely asking how long the process would take, only responding when I firmly told her that I am a practicing dentist , had been waiting for two hours and that a patient in pain was in my office waiting for emergency help. Civil service is a good thing. Heartless, unaccountable arrogance in any service is not. The clerk failed to realize – or had been conditioned not to even bother thinking of- each human being is a story of hope, fear, happiness, and sorrow. Empathy is clearly not in her job description. But shouldn’t empathy be in ALL of our interactions?

I am reminded of the debut of over-the- counter home tooth whitening products back in the 1990s. A salesman came to my office and touted the wonders of his product , telling me, among other things, that patients will not get the level of whitening from his product that they can get from a dentist and that they will seek additional whitening services once they try the OTC products that we should recommend. He also told me that patients would want to replace their anterior crowns and composites once their teeth become whiter. This phenomenon is an example of Dr Remen’s point. How heartless is it to manipulate a person to do something that could begin a cascade of overtreatment? How can we justify applying the latest and greatest technique or technology without understanding the needs, the wants, the lives of the people who are trusting us AND helping them understand how these technologies can impact their lives both positively and potentially negatively?

As we enter the very exciting digital era of dentistry, huge opportunities are unfolding before us. Scanning, digital smile design, digital recording of Centric Relation, and 3-D printing are here. But how will we use it all? Will we apply the latest technology each time a human being walks into our offices before a thorough evaluation? Will Third Party Payers, Electronic Health Records and algorithms supersede the care, skill, and judgment that only a human being can give?

My team and I are reviewing our core values in the process of  updating our Mission Statement to reflect our uniqueness,  what we value, and what we have to offer to people with our skills and with our hearts Practicing from the heart brings joy, fulfillment and prosperity to us and gives the people we serve a unique and valuable service unavailable in many other aspects of their lives. Let us never forget to keep this important element in our practices and, I dare say, in as many of our human interactions as possible.




Six Things to do Every Day



Let’s start with the understatement of the year- Dentistry is demanding. Focusing on small objects and doing our best work for six to eight hours a day can be physically draining. Dealing with the people attached to those teeth can and should be a joy. But staying focused on people as well as small objects just doubles the amount of energy we need during the day. Add to the mix the occasional difficult patient, a case that doesn’t seat, and perhaps a bit of business management, and your day could either be incredibly energy draining or equally rewarding.

We cannot avoid the imperfections of dentistry and life and we cannot dodge the many responsibilities that come with the privilege of owning a practice. But we can hedge our bets and be prepared for the things that get thrown at us every day. Here are a few things that have helped me over the years. I hope you find them useful.


Eat a good breakfast

You’ve heard it a million times but many people (perceive that they) don’t have time for breakfast. A high protein, moderate carbohydrate start to a day is an instant energy boost. My wife and I love our vegan protein shakes, but there are many other ways to get a great, tasty, essential energy surge for your mornings. Consult a nutritionist or a health coach or do some reading to find what works best for you. But please do not skip that morning fueling of your body’s engine!

Look in the mirror

Take a good look at yourself. What do you see? Do you see a living, vibrant, productive human being endowed with skills that few others have? I don’t care how successful or unsuccessful you (think you) are; you are, at a minimum, those wonderful things! Pause for a moment and see something great in the mirror.

Do you see something about yourself that you’d like to improve? Embrace it. Use it as a vehicle to be just a little bit better today. If you’re not what you want to be physically, think of ways to make yourself better. If you’re not what you want to be clinically, think of things you can study or learn. And if you’re not what you want to be personally, think of little things you can do to improve your relationships. We ALL have flaws. We are ALL imperfect. We do not have to accept those flaws as unchangeable. And we most certainly need not beat ourselves over the head over our imperfections. It feels great to have made improvements in all aspects of our lives, but remember that it takes a long time to become an overnight sensation and that change comes about as a result of a sustained effort, beginning with baby steps. Whatever it is you want to improve, take that baby step today!



We are hunters and gatherers by nature. By moving, we tell ourselves down to the cellular level that we are fulfilling a purpose. By moving, we are strengthening our hearts and developing collateral circulation. A general guideline is to do 150 minutes a week of cardiovascular exercise; that is, brisk walking, light running, cycling, elliptical machine use, etc. You can do five 30- minute sessions, ten 15- minute sessions, or any formula that works for you. The more days you do some cardio, the better.

By using some form of resistance training, we are toning our muscles to avoid the ill effects of aging. I like to get at least two resistance training sessions a week to stay toned. Try some push-ups, wall-sits, or planks at home.  Better yet, engage a personal trainer to show you things you can do for yourself. It’s a great investment!


Years ago, someone told me that gratitude is currency. That is SO true! Just about everyone walking this earth can think of something to be grateful for. You are blessed with, in the very least, a skill set that few others have. You have the ability to help people and earn an above-average living. Are your parents living? Are you healthy? Do you have a spouse? Children? Friends?  A roof over your head? Did at least one good thing happen to you today? I challenge you to think of at least three things to be grateful for every time your head hits the pillow each night. Do that and you will wake up prosperous each morning.

Change a life

Sometime during my morning routine, I put the following thought into my head: “Whose life will be better because of me today?” When you think about it, isn’t that what we are here for? I submit that even the simplest task we do for patients is really a powerful change to a sensitive part of a person’s moment-to-moment existence. And how do you think you can impact the life of the letter carrier or the UPS or FedEx guy when you greet them by name or offer them a cup of coffee or bottle of water when they come in? How about that team member you thank in a special way? Every interaction we have offers us the opportunity to enhance the life of another human being. For me, that’s more than enough to get me out of bed, happy to be alive, no matter what else is going on in my life.

Arrive early

Get to your office early. Ask the same of your team Walk into your office see what your patients will see when they come in. Look over your charts and have an idea of what you’ll be doing. Try to remember something about everyone you’re seeing today. And have a morning huddle to discuss it all. It only takes 10-15 minutes. Being prepared and punctual prevents that awful feeling of falling behind and gives you a greater sense of control of your day.

You can attain fulfillment in an imperfect, demanding, rapidly changing world. Take care of your health. Eat well and exercise regularly. Stay positive- remember that there are many good reasons to do so. And approach your work and everyone around you with enthusiasm. Prosperity happens when you make the world better for yourself, your families, and for those you serve. Take a few simple steps to assure that it happens in your world!


Seeing with Different Eyes

My Grandfather’s Blessings is a wonderful book of stories by psychotherapist Dr Rachel Remen. Her anecdotes of things that she learned from her very wise grandfather, along with the application of those lessons in real life offer us ways of changing our lives and the lives of those around us for the much better. As I read this wonderful book, I am inspired to relate her wisdom.

Dr Remen tells the transformative story of an oncologist who was on the verge of burnout in his career. She counseled this brilliant, accomplished life saver to begin to look for and document great things at work on a daily basis and to see his patients as though he were a novelist. The doctor began to see his people as brave, loving human beings and developed a new devotion to his very important work.

Let’s ponder.  If we take a moment to think about them, some of the things we see in our practices as mundane are anything but that. We render treatment to preserve and protect the critical components of a very sensitive part of a person’s health, comfort, function, dignity and esthetics. We spend so much energy “educating” people how important our work is; yet, we glance over what we see as simple fillings, routine prophies, and even denture adjustments. Of course we take pride in our restorative and other “major “services, but do we really understand the impact of our work on a human being? If we understand that impact, perhaps we could see our work in its proper perspective. We change people’s lives for the better every day. See it all and prosper.

Now, let’s get a new set of eyes towards those we serve. Who is that person at the other end of your and your hygienist’s instruments? Have you thought about how you can make or are making their lives better when they are in your office? Do you discuss the people you’ll be seeing in your morning huddle? Many times our team reminds one another that Mrs X ‘s son just got engaged or Mr Y’s wife is seriously ill. Have you thought about how that knowledge could affect what you say or do for them? Did you know that, more often than not, things you say or do will affect their lives in ways you couldn’t possibly anticipate?

We’ve lost ten people from our office since the beginning of the year. We’ve gone to ten wakes / funerals in the last 2 months. At each one, the families were astonished that the dentist would show up at their most heartbreaking moments. To us , it’s just natural to use our standing with another human being support our people in good times and bad. To their families, it’s profoundly meaningful. We’ve also gone to wedding ceremonies (we seldom have time to stay for the receptions) and are greeted with the same level of meaningfulness.

Another example for you- how do you treat the letter carrier, UPS, FedEx, and other delivery people who visit you? Do you take the time to learn their names? Do you express any interest in them? Try it – you won’t believe the rewards you get for this. You may even get one of them to engage your services, by the way!

When we understand that our profession can be a huge source of healing in ways we cannot imagine, we begin to get curious. We discover that we are connected to almost everyone. We learn that we can make at least one person’s life significantly better by simply listening to them. And we can innovate and create new ways to build and redefine our offices as so much more than spinning tooth dust.

As so- called health care devolves into algorithm driven patchwork of the human body, we have huge opportunity to be people caring for people in unimaginable ways. Yes, they’re coming to us for dentistry. But when they receive so much more than a fixed tooth, crowns, bridges, periodontal work, etc., life become very, very rich for you and for those you serve.

So sharpen up those eye and ears and discover those people you serve. They’ll love you and you’ll love your work even more!




Last year, my prosthodontist friend called to tell me he was referring someone to me to evaluate for an all on four full arch rehabilitation. I thought to myself, “Wow, out of all the dentists in this area, my prosthodontist- the guy I refer to for all my impossible cases- is too busy so he’s sending me his overflow. How cool is that! But my friend  told me not to get too excited yet; the lady was price shopping and asked him for another good dentist in the area and he hoped that perhaps my fees were a bit lower than his specialist fees and that I wouldn’t mind seeing her. Of course, I agreed to see her. And, of course, my friend the prosthodontist was right

When I asked Mrs. Problem to tell me how I could help her, she went on a rant that began with  “ I need implants but I don’t want to have to pay for the prosthodontist’s fancy office”. As you could expect, our initial interview didn’t get too far. I don’t know what happened to Mrs. Problem, but she did give me some good talk points for which I am very grateful. With Mrs Problem in mind, I submit the following:


The emphasis of most of our education, from elementary school through Continuing Education is – perhaps rightfully- how to do things better. After all, reading, writing, math, science, etc are important if we are to advance in life.

In dentistry, our academic and technique classes and our Continuing Education are needed for establishing and advancing our careers. And, of course, it is so cool to get the latest and greatest gizmos, gadgets, and digital stuff so that we can do things more efficiently and be very impressive.

Indeed, people look at our offices with an expectation of our being on the cutting edge of our profession. But there’s a missing piece here, and that is the impact of who we are and what we do. This is precisely why we attract people with values similar to ours and why people like Mrs Problem leave our practices thinking that they are paying for our undeserved luxurious lifestyle

I think that the biggest aspect of learning something new, decorating our offices, or (intelligently) acquiring a new piece of equipment is to calculate, evaluate, project, celebrate and, perhaps, measure the impact that all of this has on the lives of the people we serve.

Think of the self esteem that beautiful set of veneers does for the person who seeks them. Think of the dignity that an all on four restoration restores to a person with malformed, debilitated teeth. Think of the life enhancement and disease prevention that great preventive services give to our fellow human being. And think of how wonderful it is for us and our teams, as well, to give those precious gifts to others in a warm and comfortable environment.

When we think outwardly; that is, when we see how our work can address the challenges faced by those who grace our offices, and project those feelings every working moment, we become a magnet for those who want and appreciate true care. And if we periodically check in with those we serve to see how they’re doing with our work, we reinforce to them and to ourselves that we are here to serve.


Mrs. Problem’s resentment of the prosthodontist’s and my (in her perception) bloated fees and extravagant lifestyles were her attempt to tell me that her values and ours are not in line. The impact of our mindsets was clearly not for her. I am totally fine with that and I know that this is the farthest thing from a judgment on what my or my prosthodontist’s practice are or should be. Our practices simply did not impact her the way she would have liked and that is OK.

The Mrs. Problems of the world will always be among us. With respect and without sarcasm, they will get the care they seek and deserve.

When we clarify our core values, project them in everything we do, and never forget that when our work is outwardly directed, our impact on those who seek, need, and want us becomes profound and life gets a whole lot better.

The Sky is Falling…or is it?

A young dentist (let’s appropriately call him Dr Young ) recently asked to speak to me. He was clearly anxious as he opened an envelope to show me that he had been served with a lawsuit relating to a procedure he had performed a year ago. The details are unimportant here; suffice it to say that from my cursory review of the papers, I am 100% confident that the attorneys for his malpractice carrier will manage the case well with minimal, if any, tangible impact on him.

My concern is for the very promising career of an outstanding young dentist who is also a dedicated public servant. You see, Dr Young is seeing his career coming to a rapid end, envisioning a modern-day tar-and-feathering by his state’s Board of Dentistry. He is also questioning his ability to do anything and is reluctant to do procedures like the one he did in the case we are discussing. Our President would call Dr Young’s mindset fake news. I call it a false narrative.

The recipient of a legal summons is rightfully not happy and Dr Young’s short-term anxiety is not unreasonable. But disgruntled patients and bad outcomes from procedures done well, from the goodness of our hearts, happen every day. We need to not only put it all into perspective, but we also need to grow from them. Here are a few things Dr Young and I discussed.

  1. Never work on a stranger was one of Dr Pankey’s famous sound bites. When we establish a connection as one caring human being with another, outcomes seem to always be better. And even when things go awry, as they occasionally do, fixing the problems is much easier when doctor and patient have a rock solid trust in one another
  2. You will be imperfect 100% of the time despite your best efforts. That is not to say that open margins, periodontal neglect, or gross occlusal discrepancies are to be passively neglected. The point is that we can always find something to improve in our work. That is not a failure; it is a learning experience. We cannot beat ourselves over the head if a procedure of ours isn’t beyond critique, a disgruntled patient leaves our practice or files a complaint, or even if our cash flow is not what the so-called experts tell us it should be. We can only use these experiences as vehicles for self-improvement.
  3. Show me a person without stress and I’ll show you a cadaver is one of my signature lines. Dentistry is stressful. So is anything else we do! We cannot let our problems define us. We need to know that we are capable to rising to the challenges we face Dr Brenee Brown talks about this in her wonderful book, Rising Strong.
  4. Work is important, but there is far more to life. A bad day at work does not mean that you are any less worthy a human being or any less loved and respected by those who know you.
  5. Most importantly- 98% of things we fear never materialize. The great motivational speaker, Earl Nightingale, told us this in his classic book, Lead the Field. A complaint, a disgruntled patient, or even a lawsuit will make you feel awful but will very likely not destroy your career or life.

Remember that the Constitution of the United States guarantees us the right to life, liberty and the pursuit of happiness. That means that no one- not even you- is allowed to make you miserable. Don’t allow it.

I would love to see some feedback on this from the group. Any thoughts? How do YOU handle adversity?