What do you do when a patient comes in and wants the wrong treatment? Yesterday, I had a patient who came into my office. She's from Romania. She came in with her husband and was very nervous.

She was talking and talking and talking. She had a very complicated medical history. Her teeth were falling out, and she couldn't bite down. She said, 'I want this tooth out because I'm going to Romania in a few weeks, and I need to have a flipper before I go.' This was my first visit with the patient.

She told me what to do. I looked at it and said, 'Okay, we can do that.' I never say I can't do anything. I always say, 'Yes, of course, we can do that.' I may not do it, but I always tell patients I can do it.

Why? Because I don't want to have any resistance when I meet a patient. Plus, I don't even know her, and she may change what she wants to do once she's educated. So I said to her, 'Listen, what do you want?' She replied, 'I'm in pain.'

She said, 'Don't come near me. I have bad breath.' She had severe periodontal disease. She had about twelve teeth left, and they all had about class two and three mobility. They were depressible.

She couldn't eat or bite into a sandwich. They were not very aesthetic. So she had a functional problem. She had pain in her mouth, she had an infection, and she had bleeding. She didn't feel good aesthetically.

She didn't like the way she looked. Her history was somewhat complicated. She had had a couple of strokes. She had an ankle that had just fractured. She had idiopathic thrombocytopenia.

She had a number of medical problems as well. I said, 'Don't worry, we can talk to your physician about that. We'll make sure it's okay.' I spent about 45 minutes with her and her husband. She started yelling at her husband in the middle of treatment, which was something that I see a lot.

I turned to her and said, 'Don't yell at him. He's here holding your pocketbook. He's being nice to you.' She said, 'No, I'm just nervous. I'm just nervous.'

Then he looked at me, and I said, 'That's just Geico. I'm just trying to make you comfortable.' I realized that when you have both patients in a room, you've got the husband and the wife. You've got to make sure that everyone's comfortable in that room. So I included them both in the conversation. I said, 'Do you mind if I take a few minutes to explain what some options are?' I didn't bring out any slides or X-rays. I just started to talk to her about different things that could be done.

I said, 'We can do implants. We can do a partial. We can do an extraction. I can make a flipper before you go. I can make a little temporary bridge,' and I started explaining all the different options available to her without giving her a treatment plan.

The husband turned to me and asked, 'How much?' I said, 'I don't know how much. First of all, we don't have a treatment plan. I'm not sure what the best thing is to do for you, but I will get you comfortable before you go on your vacation to Romania.' He asked, 'Well, what should we do?'

I said, 'I'm not sure. Let me do this. Let me go through all the different options for you. I'll send you a letter, which I always do for my patients. I'll give you a three-page letter, in her case, to go through different options, and I'll refer you to a restorative dentist with whom I work.'

I said, 'The two of us will then talk with you and come up with an option.' He said, 'Well, we're leaving in six weeks.' I said, 'It's not a problem.' I had my staff, my teammate, go to the front desk. They called the other office and made an appointment.

She's seeing him today. So within the first 24 hours of meeting this patient, I gave them a whole series of options, and I made sure they were into the restorative dentist's office. So we could go for a plan. When I finished going over all this with the patient, she started to cry. I looked at her and said, 'Are you okay?'

I knew she was okay. I knew what the tears were. In every room in our office, we have tissue boxes, as many of you may know, so when patients cry, we can immediately hand them a tissue. She started to cry, and she looked at me and said, 'Thank you so much.'

I asked, 'For what?' What I didn't know was I was the fifth dentist she had seen, the fifth surgeon she had seen in the last two months. She was looking for someone to talk to her. She found me on the web. Finding me on the web doesn't mean anything.

Maybe you do a little research. You see, I teach and publish some articles. But you don't know what kind of doctor I am. You'll never know what kind of person I am until you meet me one on one.

It's a one-on-one experience. I have to connect with my patients to make them feel comfortable about who they are. I look into the eyes of my patients, and I see a human being there. I don't see a full mouth reconstruction. I see a human being who has not had someone to explain the options to them.

As a patient myself, I know what that's like. As a person myself, I know what it's like when I'm in a situation where I need a lawyer, a financial analyst, or a chef—someone who has expertise in a field that I don't have and can do the right thing for me. So she cried. She stood up and asked, 'Can I give you a hug?' Earlier, she didn't want to get near me because of her bad periodontal disease breath.

I said, 'Sure, you can.' She gave me a hug and said, 'Thank you so much. I've seen five doctors, and you're the first one who spent any time with me.' Then I asked, because I was curious, 'Tell me about your experience in the other offices. How much time did they spend with you, and did they give you a treatment plan?'

Now, I hadn't given her a treatment plan, but I had spent 45 minutes with her. We took an X-ray, so I had a cone beam CT scan, and I had 45 minutes with her, her husband, and my assistant.

They told me quickly that I needed to lose all my teeth. They gave me a computer printout and handed it to me, saying this is what I need to have done. I asked, 'How long was the visit?' They said, 'Maybe ten minutes.'

I asked, 'Did they explain what they were going to do?' She said, 'No.' So she didn't feel the connection. A lot of people say to me, 'You know, Mike, you spend way too much time talking to your patients.' Well, maybe I do, but half my day is spent talking, and half my day is spent treating.

So I look at myself as being two types of people. One, I'm an educator—not educating a dentist, but educating my patients. And two, I'm a carpenter or surgeon. I do the treatment. Once they're educated, patients don't know what they need.

We have to educate them, and we have to spend the time connecting with them with education, compassion, love, and respect. We have to be there. If you slow down and take the time to be there with your patients, I guarantee you your case acceptance will soar, and the joy of practice will come back if you don't have it. Because most dentists, most physicians, would have done something else. They look back on their career. Me, I wouldn't trade this career for the world.

I have loved treating patients for these last 40 years. I still love it. It still gives me so much joy because I'm able to be there for patients. And, you know, the old prayer, 'You get more by giving than receiving,' by St. Francis of Assisi. Why? I believe that's true. It's almost selfish to give, which is ironic. And a lot of the concepts of life are ironic. So by being there and giving to my patients, I get so much more.

This patient will be back, and we'll be doing a full mouth rehabilitation either before she goes to Romania or when she comes back. But I'll make sure that when she goes to Romania, she's comfortable and has a nice smile. So spend the time with your patients. It's the greatest gift you can give them. I hope you have a great day.