Transcript
Speaker: Join Dr. Savannah Craig and Renetta Sartor as we navigate life beyond graduation. Real conversations about forging our own paths in our early years, in our careers. There's a reason it's called practicing dentistry. Hello and welcome back to Beyond Graduation with Dr. Craig and Dr. Sartor. This week we are talking about patient expectations.
Speaker: Yeah, this is a great, great topic and it's very important for managing patient expectations. So many things come to mind. What about you? The hardest part of my day is this piece.
Speaker: So true. I can do the teeth. It's the patient. That's the challenge. Very true. So how, all right, I'm a new patient in your practice. Does managing the expectations, when does managing my expectations start in your opinions?
Speaker: I think it starts, you know, as soon as the patient's in the chair, we discuss what their goals are. I think we live in a society now where, you know, you can have Instacart dropped off at your home and you can have something ordered and dropped off within a day of ordering it. And especially for more extensive and complex cases in dentistry, you don't and you shouldn't just write off
Speaker: from that first appointment create a treatment plan unless it's something very straightforward. For more complex cases, it's okay to tell the patient, hey, would you mind coming back for workers so that we can get additional photography, get additional molds so that I can actually sit down and study your case and be able to provide you with
Speaker: the best care that I think we together deem necessary. Sometimes you just cannot do that in a 30 -minute interaction with a patient, especially on more complex cases. I think for a lot of complex cases and even
Speaker: not super complex but you know even if it's an aesthetic case but you know they're healthy otherwise it's more so setting the expectation that okay we're not going to rush and do this we're gonna take the time to study and make sure it's done right so that whatever we do lasts as long as it can potentially last. What about you know patients in pain and
Speaker: You know, there's just so many fires to put out. What sort of your thought that way? Or how do you approach that patient? I think a lot of it depends on, you know, the patient.
Speaker: And so if they come in and they have one chief area of concern, we can address that chief area of concern in terms of it being, you know, pain or an emergent type situation. And then if they have other fires to put out, like you said, we do a plan of attack to address those so that we can move on to, you know, comprehensive type dentistry once all of the emergent care is out.
Speaker: What about you? Yeah, I think it's been, you know, obviously this has changed since dental school and even since residency, like trying to, you know, be efficient for everybody. And, you know, OK, number 19 is in pain, but also there are a couple of fillings in that same area. You'll be numb. You know, let's try to take care of that and focusing on
Speaker: I don't know, active disease, whether that be pain and infection or caries or perio. And then I've had a couple of patients and immediately they're like, well, how are you going to replace that tooth? And listen, we got to get everything else under control.
Speaker: You know, and it might take a while and then we can talk about replacing teeth. And I mean, patients don't always like that approach, but those are like the conversations that I struggle with a lot to just be like.
Speaker: Listen, if I put anything else in here, it's not going to last because we've got other other things we need to deal with. Yeah, at our office, we've started taking a more holistic approach. So we have like a floor that we have the patient fill out and it has on one side of it, all the things from a dental perspective that
Speaker: they self report. So for example, like broken teeth or sleep apnea or clenching and grinding their teeth or acid reflux. And then on the other side of the form, it has how those oral problems have, you know, implications in the rest of the body as well.
Speaker: And for us on our team, it's been very helpful to have more meaningful discussions with patients to have them value.
Speaker: and take as much responsibility for their oral health as we are. And so I think it's set in different expectations that, okay, the mouth is a part of the body, but it's also, you know, it's a gateway that tells you about other health issues that you can rehab. And so we're having, you know, multiple conversations about, okay, well,
Speaker: you have sleep apnea or you have signs that would let us think or put you at high risk for potentially having it.
Speaker: I think you should have a sleep study done or you have acid reflux and it's been untreated for so long and this is how it's impacting your dentition, but that's impacting your everyday life as well. So all things are connected. What a shocking discovery that your mouth is a part of your body.
Speaker: It's really, it's really unfortunate that we as a society have separated them. Like it blows my mind every day, but that's a topic for another term. Um, I think the, the most interesting, and I haven't figured out a good way to figure this out yet. You know, obviously I'm very early into this whole thing, but.
Speaker: Patience come in, you know, just tons and tons of problems. You know, my so and so is getting married next week. Can you fix everything? And I, or, you know, crazy, crazy things of like, they come in December 1st and they need everything done by the end of the year because their insurance is going to run out. And I just don't know the tactful way to be like,
Speaker: Why today, like this has been a process for at least a few months, if not years, why, what, what made you call the office today and show up for an emergent new patient exam and decide that everything, you know, that you think I have this magic wand that I can fix years of problems by the end of the week.
Speaker: I'm sure you have these patients as well. Have you figured out a way to get that out of them? Am I approaching it the wrong way? No, I think for a lot of patients, especially patients that know that they need a lot of dental work done, a lot of guilt and shame can come up at those initial appointments.
Speaker: Before I even get into, hey, we can't fix all of this right now, I let them know how happy I am that they made the first step and scheduled the appointment and they're in the right place and they're doing right by themselves by taking the first initial steps.
Speaker: And then from there, we just have a discussion in terms of what's important to them in terms of their goals and how we can get there. And a lot of times, you know,
Speaker: It's almost like if you, it's kind of off topic a little bit, but if you think about like weight loss journeys and that sort of thing, well, if you gained a bunch of weight, you didn't do it overnight. So you're not going to lose it overnight. And that's kind of the same thing with dental health too. Like the cavities didn't form overnight. And so it's unrealistic to think that just overnight we can have everything fixed.
Speaker: But we can definitely work on it and address the things that are major concerns. So I guess to answer your question, it's not like I don't have a magic, you know, expression or line that I say to patients. A lot of it just happens organically once I hear what their, you know, chief complaints are.
Speaker: Yeah. And I think that's good that you're, you know, approaching that from such a place of compassion. And like, I think, I think, you know, people have internalized, like you said, that shame and, um, reminding them that, you know, Hey, at least you're here now. You know, we've got some problems to tackle, but, but you're here now. So that's really good, good advice. I think the other piece.
Speaker: and human psychology is bananas, but figuring out how do you get the patient to take responsibility because I think there's
Speaker: There's a fine line between figuring out how we ended up in this situation so that the work that I do is going to last, you know, but also not putting more shame on the patient. Cause I do think, at least in my practice, a lot of it is just like ignorance, unfortunately. You know what I mean? Everyone in their life has lost their teeth at this age or whatever, you know? Well, I try to spend,
Speaker: a good amount of time educating the patient and so on. Okay.
Speaker: you know, here's what I'm proposing that we do. But like, for example, that patient that has acid reflux, or, you know, that patient that potentially has, or, you know, we we think they have obstructive sleep apnea, but they haven't had a sleep study study done. Those are patients that are urged down before we do any major type work that they go and have those things assessed before we get started.
Speaker: And then I explained to them if we don't address it how that will impact them from a dental standpoint and that Regardless of what I put in their mouth They likely would destroy it Hey, you know and then
Speaker: Yeah, that's why it goes back to education, but also setting the expectation that, okay, we have a bigger issue that's gone on that has potential to ruin your dentition, even if you spend thousands of dollars trying to fix it. If you don't fix the bigger problem or address the bigger problem,
Speaker: then there's pretty much nothing that I can do. And, you know, they have to own that, that pretty much we, we, we had the discussion, you know, if you, if you decide to not have those things addressed, then to some extent, you know, especially if it's something that they want as aesthetic, that's not a necessity, you know, not in pain,
Speaker: That's when it's on us because it's our license on the line to, you know, tell that patient, okay, well, I don't feel comfortable providing this treatment in this scenario. And in some cases, you know, sometimes if a patient's expectation is way on the other end of the spectrum,
Speaker: And, you know, you've tried to make those explanations. Sometimes they might be better served in another practice. Yeah. Sometimes no treatment is the best treatment. For sure. Yeah. That's a really good point there.
Speaker: Um, and you know, I, I am famous for, you know, the teeth, you know, the good Lord gave you didn't last. Why, why do you think I can do better? You know, that sinks in for people. I think sometimes I was going to ask, um, how do you address those situations?
Speaker: Yeah, I think just trying to explain the limitations of the situation that we're in. And like I said, anything I'm putting in there is manmade. Unfortunately, nothing lasts forever, especially in your mouth and especially under
Speaker: unfavorable conditions and I think a lot of days in dentistry were making compromises and I'm just very very clear with the patient of like you know what what compromises what risks are you willing to take on and not
Speaker: you know, not letting them pressure me into things that I'm not comfortable with, you know, I had, I can think of a patient that, you know, really wanted an immediate implant. And I, I knew there wasn't, you know, enough buckle plate for this. And I was like, you know, it's gonna be
Speaker: several months of healing with the graft and then the implant is placed and that heals for several months and they, you know, were like, well, I heard somewhere else they can do it, blah, blah, blah. And I was like, that's fine. There might be, but this is my training and these are my, you know, this is what I'm willing to do. And if, you know, you're unhappy with that timeline,
Speaker: your mouth, your choice, all good. No harm, no foul here. It's just my job to let you know what I am comfortable doing, what is possible in my hands. And as long as you're okay with just not letting them force you into things to
Speaker: to be the savior because the moment you push yourself outside of your bounds, those are the sticky situations. Conveniently, people forget that you're like, I told you I didn't want to do this and that definitely doesn't stand up in the cordial form. I think documentation is key, especially when we're having these tough educational and expectation discussions with patients.
Speaker: Yeah, and I think it's become so, I don't know, it's super rewarding when you explain things to patients and I really take a long time to educate them because it's amazing how little the general public knows about what we do. You know what I mean? It's kind of, it's kind of humbling in some ways, but yeah, you just gotta, at the end of the day, if I've said my piece and you know, you take a little,
Speaker: A little bit of information home, even if you decide that I'm not the dentist for you, I can sleep at night, you know? And then they'll remember the discussion that you had, if and when it doesn't work. Yeah, those are, you know, when they come back and they're like, well, I went for a second opinion and I liked what you said better. And you're like, well.
Speaker: Glad you cried, I guess. Yeah, look at the sedation course that I went to. They were reminding us, like, dentistry is so unique in that, especially in, like, sedation, for example. Like, you're sort of on an island, for better or for worse. Like, in a hospital setting, you've got, you know, a code team. You've got backup where, like, you know, I've trained my staff, but if something really goes sideways, it's on me.
Speaker: And so they were they were like you're the you're the pilot of the plane and you only fly in clear blue skies, you know, like Don't don't take on more than you know You're comfortable with and I feel like that, you know is definitely true in sedation but in so many other aspects of what we do is just Remembering like, you know for better for worse. It is sort of all on your shoulders in a way not to make that a scary thing but
Speaker: I think that's an excellent way to wrap this episode up. Alrighty. Catch us back next week for more Beyond Graduation. Thank you for joining us for this episode of Beyond Graduation. If you enjoyed this week's episode, be sure to share it with a friend. Connect with us on social media at Savannah Craig DDS and at Dr. Underscore Sartor. And remember, you are not alone on this journey.
