Hinman Connects Blog

Compassion, or Just Foolishness?
Posted: 7/5/2018

One of the workshop scenarios I present is one most of us have experienced: the emergency patient that refuses a diagnostic radiograph.  The answer to my question, “How do you handle this objection?” is amazingly predictable.  Workshop attendees immediately suggest that, by educating the patient on how safe the radiation is, the patient will agree to having the x-ray! Yeah, right!  But we’re such compassionate care-givers, eventually someone offers the suggestion that we proceed with treatment without the radiograph because the patient is in pain and it’s our responsibility to help them.  Really?


According to CNA’s Dental Professional Liability Guide, “A reasonable and prudent

dentist should decline to treat any patient who refuses necessary diagnostic radiographs.”  And the ADA’s publication, Frequently Asked Legal Questions, states that “Obtaining informed refusal does not release the dentist from the responsibility of providing standard of care.”  In other words, this management issue is clearly “My Way or the Highway” as far as I’m concerned, and I’ve certainly dismissed more than one “new patient” without treatment over this very scenario.


Which brings me to my next point: why do we feel an obligation to treat everyone who walks through our door?  I’ll never forget the morning I entered an operatory to greet a new patient.  As I introduced myself, he angrily said, “You’re one minute late!”  I responded by apologizing to him, and then advised him that I couldn’t be his dentist because I was never on time.  I thanked him for coming and walked out of the operatory.  I don’t know about you, but I don’t care to spend time with folks like that.


After graduating Emory’s School of Dentistry in 1978, I was invited by Dr. Schaffer to work with the seniors in the removable prosthetics department each Friday.  It was a great privilege, a lot of fun, and I learned a great deal.  Soon, I received the referrals of denture patients from others in my community.  One day a gentleman appointed for a consultation presented with a paper bag full of dentures.  One by one, he proceeded to tell me precisely what was wrong with each set: this lateral incisor was poorly aligned, this cuspid was rotated, or these centrals were too small.  After listening to him talk non-stop for half an hour, I interrupted to say, “Wow!  You know a lot more about dentures than I do!  Sorry I can’t help!  ‘Bye!”


And why do we continue to tolerate abusive patients when we clearly have the legal option of terminating the doctor-patient relationship?  We’ve all sat through a morning huddle and acknowledged the sinking feeling in the pit of our stomach when we see that “Mrs. McGillicutty” is on the day’s schedule.  Why do we serve her, and then reappoint her for preventive care?  Why don’t we take the appropriate steps to dismiss her from our practice?  Just asking…


Then there’s the issue of dealing with a “less than optimal” employee.  We can counsel, advise, educate, correct, chide, cajole and support to the nth degree, but ultimately must recognize and accept that some people simply suck the energy out of everyone and everything, and are destructive to our practice, our person, and our culture.  I’m reminded of the time I advised my (remaining) teammates early one morning that I had fired a co-worker the night before.  I anticipated rebellion and unhappiness as they would now be responsible for the additional workload.  Imagine my surprise when everyone smiled and then screamed with delight.  We had a group hug, a group cry, and a group “happy dance!”  Clearly, I had no idea how toxic this person had become! 


Compassionate care givers we are, but we don’t need to be foolish in the process.  Dentistry may be our calling and commitment, but not all who seek our care or employment are worthy of our time and expertise.  We as a team work far too hard every day to meet the needs of others.  Serving our patients or working with negative people should not unnecessarily expose us to litigation, nor should it leave us physically and emotionally spent at the end of each day.  In the end, it’s our practice, and we deserve the opportunity to embrace each day with joy and the anticipation of satisfaction in serving others.  Be compassionate, of course, but don’t be foolish.  Life is too short.


Sharing forty years of clinical and business experience with the dental profession, Dr. Wayne Kerr earned Mastership in the AGD, and was honored in 2011 with its presentation of the Life Long Learning and Service Recognition Award.  He is a Fellow of both the ACD and ICD, and has been recognized by state and local organizations as Dentist of the Year, Small Business Person of the Year, and Citizen and Professional of the Year.  See more at

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