Handling Difficult Patient Encounters (E.265)

“Get rid of the need to be right.” ~Dr. Paul Etchison

Ever had a patient interaction that left you feeling emotionally drained or second-guessing your approach? You’re not alone. In this episode of Everyday Practices Dental Podcast, we are joined by Dr. Paul Etchison to identify three methods you can use to handle challenging patient encounters. Together, we provide insights so you can turn aggravating situations into opportunities for growth and stronger relationships.

Dr. Etchison shared practical, real-world insights that will not only help your practice but also restore your peace of mind.

As you listen to this episode, we invite you to ask yourself the following questions:

• How can I stay calm and in control when a patient is upset?
• What tools can I give my team to handle difficult interactions gracefully?
• Is it possible to turn an unhappy patient into a raving fan?

P.S. Get your free guide: “How to Deal with Difficult Patients” here: https://www.dentalpracticeheroes.com/everyday

Here’s to navigating patient relationships with confidence.

EPISODE TRANSCRIPT 

[00:00:00] Announcer: The Productive Dentist Academy Podcast Network.

[00:00:04] Dr. Paul Etchison: When we’ve got conflict with people, it really comes down to what the other person’s perception is of motivations and that’s why it hurts us so bad is because somebody is questioning our intentions.

[00:00:13] Regan Robertson: Welcome to the Everyday Practices Dental Podcast. I’m Regan Robertson and my co-hosts, Dr. Chad Johnson, Dr. Maggie Augustyn, and I are on a mission to share the story. stories of everyday dentists who generate extraordinary results using practical proven methods you can take into your own dental practice. If you are ready to reclaim your time so you can focus on great patient care without sacrificing yourself along the way, buckle up and listen in. Doctor, what would an additional 219, 000 mean for your practice? I mean, really think about it. 219, 000. What would you do with it? That’s what PDA clients generated on average in just the last 10 months alone. 219, 000. You too can take control of your future today. Register for the 2025 PDA Conference to get the five key frameworks, so you can accelerate your productivity, align your team for accountability, and elevate patient care like never before. If you want case acceptance that skyrockets and stress that’s evaporated, this is the event for you. If it’s time to stop spinning your wheels and instead get the predictable growth you deserve. Go to productivedentist.com right now and register for PDA’s 2025 conference, March 13th to the 15th in Frisco, Texas. We look forward to seeing you. What do you do when you have a really, really aggravating patient, customer interaction with anybody in your life? What, what kind of tools do you go to? Do you stay in control of your emotional quotient and you’re just like an emotional ninja and you can just navigate the waters really, really gracefully? Well, I know I can’t always do that and sometimes bad interactions get the best of me and we have an exceptional guest today, Dr. Paul Etchison of Dental Practice Heroes Podcast, in addition to being Productive Dentist Academy alumni as well. So, uh, hello, Dr. Chad Johnson, Dr. Maggie Augustine and welcome Dr. Paul Etchison.

[00:02:07] Dr. Paul Etchison: Thank you so much. I’m so excited to talk about this today.

[00:02:10] Regan Robertson: Are you really? Really?

[00:02:12] Dr. Paul Etchison: I am so red hot on this right now. Like this is like my jam right now. This is where I’m at at my practice. I’m just gonna, I’m just gonna go right into it. We have been having, ever since COVID, people have been just so mean and I think the patients have just gotten meaner and the expectations have gotten out of control and we went through this at our practice. For a long time where we went through, we dropped Delta and I really pushed on my team. We are special. We don’t deserve to be treated badly. We deserve to get paid more for what we do. We’re special and it turned into this long thing of we started sticking up for ourselves when we had the bad patients and the aggravated patients and the people that were just downright mean to us and it backfired. Big and we had a, it just, it’s funny, man. No, I didn’t either. We started kicking patients out, dismissing people. You’re not going to talk to me like that. Hanging up the phone and I learned a lot through this process and what I learned. Recently in a, in a meeting that we had about two months ago is we were talking about this in the front desk said, you know, “It really hurts us when we have to stick up for this office and stick up for our policies and they yelled us and they treat us like crap and then we hand it over to you or a manager and you just bend over backwards and give them whatever the hell they want. We feel like you’re not sticking up for us,” and it got them to the point of tears that they’re just like, it is so hard all day long. People are yelling at us. And what it made me realize is that, oh my gosh, like, I think I started this by giving the impression that we don’t need to take nothing from nobody and it made me realize I have never trained my team on how to properly handle upset patients. So this led me go taking a deep dive down what are some skills and looking at like, “I feel like at my practice, I am the doctor that everyone, I get the difficult patients because for some reason I’m good at dealing with them,” and I really thought about what is it? Why am I so good at dealing with people? And wow, what a need instead of just. Having my team say, stick up for yourself and get all pissed off, like, what if they could just diffuse the situation and turn this pissed off patient into a raving fan? So that’s what led me to trying to figure this stuff out. So this is going on at my practice right now, and we just trained on it a few weeks ago and man, what a difference. And my team is just saying, “Wow, I wish I would have had these skills years ago. It makes my job so much easier because now the pissed off patient is a predictable problem.” It’s not an unpredictable thing that’s going to ruin your day. Cause I’m like, “Oh yes, dude, I get a patient man of me and I’m going to stew over it for like weeks.” Sure. And I’m going to, and it’s going to come up like two months later. I’m just, someone’s going to say their name or someone name that rides me. And I’m just like, Oh, screw that guy.

[00:04:38] Regan Robertson: Paul, I cannot wait to hear. What you’re going to tell us, because this is not just a dental problem. This, this is across healthcare and my point, my proof point for this is I was at one of my doctor’s offices and she consistently tells me every time I see her, how happy I make her, how she sees me on the docket for the day and she cannot wait to see me because I uplift her and blah, blah, blah. And I felt like she was just trying to make me feel great. And she leans in and she’s like, “No, patients are really difficult these days,” and she, and I loved that she shared it with me, but I, it gave me, since I’m not a dentist or a doctor, this inside scoop of everything, the weight that teams have to carry every day with patients and how you have to go from one situation to the next and I have had that Paul in my life multiple times where I’m the one that’s given difficult say clients or customers. So inside dentistry and outside of dentistry. So it doesn’t matter what they’d say, “Give it, give them to Regan,” and she’ll get to baseline and we’ll figure out a plan moving forward and it’ll be. Okay. So I want to definitely know what type of skills you figured out that you’re employing, that helps you get through these difficult conversations and I’m with you completely. If you can take that upset person and transform it into a positive interaction that works for both. That’s a huge win.

[00:05:51] Dr. Maggie Augustyn: Yeah. This is especially eye opening because as we’re facing the holidays, as we’re at the end of the year, as we have just gone through an election and people are upset for all kinds of reasons. You know, it’s one thing to be in alignment with your team where you’re standing up for your, for your team and you could inadvertently be losing a patient. Here you are and you have found a solution, which I’m, I also can’t wait to hear where you’re turning the dynamics around of potentially losing a patient and you are turning them into a raving fan. And it has been, you know, the last couple of months have been very, very difficult and since COVID people have become really unforgivingly unkind, and they just have this carte blanche of living within their own world. Um, everything is happening to them. We are, we are just a part of their world. Um, we are not human. Certainly as providers, we are not human and forget the fact that we have these incredible people that are working along our side. They are so much less important than we are and so it’s just become so unfair the way that we are treated, our teams are treated, the way that we are manipulated. Just the other day, I had a patient who complained. Our office was incredibly generous with him, and he had received several thousands of dollars worth of treatment from us and he called because his insurance did not cover, I think, a 77 exam and I don’t know, maybe 24 x rays and he called to say that, and first of all, he referred to me as her, which is just so disrespectful and he said, “I never gave her permission to do an exam. I never gave her permission to take X-rays,” and a funny thing is that, you know, he opened his mouth for both the x rays and the exam, and that ruined Not just my day, you know, but, uh, the next several days moving forward and that was just one of those, one of the things that happened in that day mm-hmm That made it so very difficult and so I can’t tell you how much I’m looking forward to everything that you’ve had to say, because I know that my encounter with this particular patient in terms of what’s happening these days, is not unique.

[00:08:10] Dr. Paul Etchison: Mm-hmm . Yeah and, and it’s ruining your time right now. I’m sure you’ve got some emotions that are coming out right now as you talk about it.

[00:08:16] Dr. Maggie Augustyn: Oh, you think, did, did I let, did did I let that out?

[00:08:19] Dr. Chad Johnson: The role over is what you’re talking about, Paul. It’s not like it just stops,

[00:08:22] Dr. Paul Etchison: Right? And it doesn’t and it’s, it’s one of those things that, so I had to talk with my team about this and it’s hard for them to understand because we want to stick up for ourselves. Whenever we have an upset patient, we’re essentially dealing with some expectations that weren’t met and sometimes those are expectations that we set. Sometimes they’re not ones that we set and the patient sets their own and sometimes they’re just like are they reasonable expectations for someone and they’re unspoken, such as, you know, as a patient goes into somewhere, they expect to be sat on time at a dental office, right? At a medical office. No, they’re totally fine. Do you wait? But at the dental office, they want to be set on time. So we have to accept that that’s going to be an expectation. Another expectation is going to be that we’re going to nail their insurance estimate. We know how it is. We work in dentistry. It’s hard to nail it a hundred percent of the time and we do our best and we tell them. This is just an estimate, but that doesn’t matter. Their expectation is always going to be that we, what we told them is what we’re supposed to charge them. So I think what we got to do, and we got to get our teams to understand is that really looking at this from a perspective of the patient, is that a reasonable expectation given knowing what the patient knows, the patient’s experience, not our experience, our experience, that’s very unreasonable. Come on, we can’t know this insurance stuff. We can’t always see you on time, but for the patients. Their perspective, yes, it is reasonable. So we have to say, we have to acknowledge and validate that that’s okay. So what I tell my team to do now is think about what is the result that I want from this interaction, because it can go one or two ways we can defend ourselves, we can say we’re right and no, you’re wrong patient. That’s not what happened. That’s not how it’s supposed to be. We did everything we’re supposed to, and you’re wrong. You’re your perspective is wrong and all this and then we can take a five minute interaction. We can turn it into 30 and then we can have another 30 minute interaction with them later and then they can call back. For the office manager. I had one like this just recently. I spoke to this person two separate days where I was just like, “What can we do for you? I understand what happened. What can we do? Why are you calling me over and over and over again?” I didn’t say that, but it never resolved because we blew it from the beginning. So what is the result? Do we want a five minute interaction where the patient’s going to be happy and we can take care of it? Or do we want someone to do that? Call us over and over again. Go and write us two one star Google reviews, one on Facebook, and then she called back and we said, “Yeah, we saw all your reviews.” What reviews? All three of them. I didn’t write three and then she wrote another review about how we accused her of writing reviews. They were identical. They were talking about Christmas things in like July. It was so funny so obvious, but what kind of

[00:10:50] Regan Robertson: They really stuck it to you? I mean, that’s cross platform annoyance right there. They’re really giving it to you

[00:10:55] Dr. Paul Etchison: And I’m just like, you know, Maggie, I’m pissed off. Yeah. I don’t, I don’t even want to do this podcast anymore. I’m so pissed off, but you know, literally like, is that the result we wanted or did we want to just say, you know what, I’m going to humble myself. I’m going to humble my pride. I am going to let this patient feel like they are right. They are not. The customer is not always right in my office, but it’s our job to make them feel like they are. So what we can do is we approach it from what is the result I want? Do I want somebody singing my praises all over town? I forget about this interaction tonight. I never think about it ever again, or do I want to be right now and do I want to stick up for myself and stick up with my pride? And at the same time, they’re going to drive me nuts emotionally. I have to carry the emotional baggage of this interaction all day, every day for a few days, and it’s going to keep popping up. So I think that’s the first thing, because when we start looking at a perspective, what is the goal we want? We want a, we want to resolve situation. We want a happy patient. So when we look at what’s the result, then we start thinking differently and we might approach that a little bit differently. Another thing we’ve got to get over with is that I think there’s this natural human bias for us versus them. We have teams. I mean, Maggie, you just, you just mentioned the election. It’s, it’s. It’s very divided. You know, we’ve got us and them and when we have the patient and we have our front desk team or anyone on our team, the patient sees that as an us versus them. If they’re getting mistreated, they’re getting screwed over. It’s by our team. It’s a versus. It’s you guys screwed up and you guys are not taking care of me and I am being mistreated and that’s another thing that we’ve got to realize. It’s there. It’s part of our human bias and we’ve got to work around that as well. So we’re working against that as well. So we’ve got to think about those two things. I have a two step process. This is what I tell my team. I want them to understand those principles and the first thing they got to do is just immediately acknowledge and validate that the patient, their perspective is good, that we understand and validate their perspective, no matter how ridiculous it is. This comes back to you. What’s the result we want? Do we want to tell them how ridiculous it is? I mean, I had, I had a patient that was upset with a hygienist named Gina and if any of our listeners want to go look at my one star reviews, you can read it. Upset with a hygienist named Gina.

[00:12:57] Regan Robertson: I like the invitation. That’s bold.

[00:13:00] Dr. Paul Etchison: But you’ll see something, you’ll see something in two one star reviews that happened in a very short period of time and it was that my office manager had sent said to this patient, “That’s crazy. I, I just, I’m so surprised nobody ever complains about Gina. No one’s ever complained about Gina before,” and what my office manager is saying is saying, “Hey, like, I’m really surprised. Gina’s awesome. No one complains about her. She’s like one of our best hygienists,” but what the patient is hearing is you must be crazy. You must be wrong because nobody. complains about Gina. So that complaint was not validated and that was one of those ones that also turned into eventually I want to talk to the doctor. I want to talk to the owner and then I have a post it on my desk sitting there and I wait like four days to call him back cause I don’t want to have a conversation and I have it and it’s, it’s, it’s just, it’s lost. We can’t save it. So the first thing is validating is. Hey, Mr. Patient, I, I am so sorry that that happened. I totally get why you’re frustrated. I would be too. That’s all we don’t have to say that we screwed anything up. We’re sorry that it happened. We’re sorry. They had that experience and we get why they’re frustrated. We get why they’re upset. We would be too immediately that validates the patient’s complaint and they say, okay, well, they understand me. I don’t need to keep making a big deal about this because our patients, they want to raise their voice and it’s because it works. We’ve all got these patients. It’s amazing how many exceptions we make for our worst patients because they are so vocal. So it’s like they learn how to really rile up and this comes to us versus them. They’re fighting for getting their way. So they have to raise their voice. They have to get aggressive. They have to be intimidating. So after we validate that complaint, we just got to let them know that we’re on their side. They’re thinking us versus them and we need to bring them over into our us, which is essentially just saying, “Hey, I’m sorry this happened. You know, I get why you’re frustrated. I would be too,” and then saying, “We are going to take care of this or I am going to take care of this for you and you don’t need to know what you’re going to do. “Hey, I’m going to take care of this for you, Mr. Jones. I’m not sure how, but we are going to figure out something,” and immediately that patient is, the defenses are down, they’ve been validated and they know they’re going to get something and this was something I always did with my patients when they were upset about, “Hey, you touched this to hurt the tooth, didn’t hurt until you touched it. Uh, you crowned it. Now it needs a root canal,” things like that. As I would say, “Hey, I am so sorry this happened. You know what? This, these kinds of things happen. I totally get why you’re frustrated. I totally get that while you’re upset, we’re going to figure something out and just know, I’m going to take care of you. I don’t know what that is yet, but we’re going to figure something out,” and immediately it just diffuses them. They’re like, okay, I don’t need to fight anymore to get my way. They’re going to figure something out and then it’s just a matter of figuring exactly out what, what is that going to be? And sometimes that’s really easy. Sometimes it’s a refund. Sometimes it’s meeting in the middle on an insurance balance. Sometimes it’s just good. Like I’ve given people four or 5, 000 back before.

[00:15:44] Dr. Maggie Augustyn: The human part of me, the one that you heard at the beginning, you know, clearly we are also emotionally invested in this and we are also human and so the, the question that I have for you and clearly you’ve given it some thought and you’ve probably had an opportunity to practice this for a while but when you started, how difficult was it for you to shift this perspective? Because you did mention at the beginning that you humble yourself and so, uh, exercising humility is not always easy and certainly it isn’t easy when you, yourself, are humble. self feel like you’ve been taken advantage of? You’ve been, um, wronged yourself. You’ve been taken for granted, right? No, then you can kind of separate yourself and you can act as a business owner. And, you know, you’re looking out for your practice and people, but how, you know, on a human level, how difficult is it to shift that perspective from, you know, “Hey, I’m right. Two, I want to be paid for doing this exam. You have completely taken me for granted when I gave you that six or 7, 000 worth of implant work that I did for you and you can’t even pay me for the, you know, 77 for an exam and now you’re accusing me of withholding consent. Right?” So again, you’re hearing kind of emotionally aroused here, but how do you, how do you move and how long does it take for you to, to move that perspective?

[00:17:06] Dr. Paul Etchison: I think for me, it’s just been a lot of practice over the years of owning a practice and, you know, I just realized this because like I just said, this was a recent problem I practiced that I went and I investigated. I read some books on it. I did some courses and I’m like, I’m gonna learn everything there is to know about dealing with difficult people. And a lot of it was stuff that I was already doing. I have a management principle in my book. I think it’s in both of my books, but it says, “Get rid of the need to be right,” and that’s what I found out with my team is that I have looked at so many situations in my practice where I just realized it’s better that they feel good. Then me feel the need to be right because when I know that I’m right and defend that I’m right, we both feel bad, you know, so I’m offering them grace and what it comes down to is when we’ve got a conflict with people, it really comes down to what the other person’s perception is of motivations and that’s why it hurts us so bad is because somebody is questioning our intentions. They’re saying like, “Oh, you just want to build my insurance for whatever, you know, you just want to charge for doing nothing. You guys are also rich,” and it’s like, no, that’s not my intentions. We’re not trying to screw you over. We’re trying to take great care of people with respect and mutual care and when somebody questions our intentions, it hurts, you know, I have just found like in your situation, Maggie, and I’m not in your situation. I don’t want to speak totally towards it, but I’ve had similar situations where people have accused me of things and we had one where we did same day dentistry on an iron worker and he was so mad. because he didn’t like what his copay was and he didn’t get the option of getting an amalgams versus composites and the downgrade and he didn’t even want to do them that day. And just like you said, Maggie, he opened his mouth, my hygienist numbed him. We did a procedure. He didn’t put up a fight. He said, no, she made me get numb. I didn’t want to do that. I’m like, dude, you’re like 320 pounds of just man. And she’s like 110 pounds of little girl. Like you put up zero fight. Okay. Let’s, let’s call it what it is. But eventually we’ll get to these points where I will ask the patient and I’ll say, this is what I can do for you. What do you think of that? And for some people that’s no, that’s not good enough for me. And I say, “Okay, well, Mr. Jones, I’m willing to do whatever it takes. Tell me what you think is fair. And I just,

[00:19:03] Dr. Maggie Augustyn: yeah, is

[00:19:04] Dr. Paul Etchison: it really? Okay. I love it. And, uh, I’ve been using that for years. Tell me what you think is fair and I, whatever they say, I mean, I can think of one time in my entire 15 year career where what they thought was fair was not what I did in that one time it was this person wanted a whole new partial and it’s, it’s a really long story, but I honestly was not willing to give this part of the principle.

[00:19:26] Dr. Chad Johnson: Yeah.

[00:19:27] Dr. Paul Etchison: Yeah. I just couldn’t give it to this guy. Like, man, and you know, what’s weird is we split it halfway and he was a lifelong patient, you know, he’d stayed with us until he eventually passed away, but I did not want to give him that partial for free, but he paid the lab bill. So we, we redid it for him and he was a lifelong patient. I still see his son and his son and all those kids, the grandkids and stuff. I could tell you this story and I’m done with it. There is no emotion in that story. He, you know, we met in the middle and it was one of the things it was over. So for me, and this is one of the things I learned from Dr. Baird is that it is not worth me sitting up at night and being pissed off about it. No amount of money is worth that. No amount of heartlining or money is worth a lawsuit. No amount of money is worth just. Me getting pissed off every time that person is on the schedule. Any check I have to write is worth my peace of mind. And we’ve got the margins of dentistry where we can work with that. You know, some people might say, “Hey, you need to stick up for yourself. You need to not bend over for so many people and do whatever the hell they want,” and I disagree. I think

[00:20:23] Dr. Chad Johnson: There’s more than one way to skin the cat. If people want to do that, you know, then that could pan out for them, depending on their demeanor and everything like that and their systems and whatnot, but I’m with you, Paul, like I would rather be try and find a way to be magnanimous. We had a patient last week who sent in a request for a refund in the thousands refund. I don’t know if refund is the right word. He was like, you know, emotional damage. We had done all on five on four or something, you know, all next and we put in the first draft of his PMMA teeth. And he left and I wrote him a text and was like, “Hey, you know what you think?” No response. He had a follow up appointment a couple of weeks later where we are going to, you know, see what he thought after the test drive, you know, like, do you want to change the color? Do you want to change the shape, lower natural teeth? So the bite was kind of dictated by that. And he canceled the appointment, said his brother died. Um, And then a while later, uh, he had got a second opinion. They were like, “Oh yeah, you know, we need to redo this and this and that.” So then he writes and says, you know, you guys messed stuff up and everything. And the other dentist might not have said that. I always have to remind myself. What they say the other dentist said is their interpretation of what the other dentist said, not what actually the dentist said. So my team then says, “You know, what do you want to do about this?” They waited. I was gone for CE. I got back, they said, all right, so we need to kind of catch back up. So the guy finally gets ahold of us, says, “I want money back for, you know, the emotional damage to get this three done and this and that,” and I said, “Just pay him,” and you know, it, part of me, I want it to be like, let’s freaking fight. Let’s. Gloves off, you know, but I noticed the first night I was laying in bed thinking about it and I was just like, “Dog gone, he’s got me hostage,” and so I wrote a text the next morning. I said, “Just pay him.” She said, “Should we talk about it at our leadership team?” “Nope. Just pay him. I don’t want to talk about it. I want to be, I’ve decided, and I want to be done right now that aside from discussing this in a podcast, like we are right now, that I don’t want to put more headspace into it.” And so it was liberating to the cost of 5, 000 ish. Uh, not cool. But at the same time, I was just like, “I, you know what, he’s wrong, but I don’t need to be right. I don’t care. Just take the freaking money and go.”

[00:22:36] Dr. Paul Etchison: Yeah and now, and the thing is, is I doubt that would have been the last thing already set up for failure. There was no way.

[00:22:43] Dr. Chad Johnson: That’s the children’s story. You give the pig a pancake and then they want to, you know, sprinkles and if you give them sprinkles, they’ll want syrup and if they got served, yes, it is. They want butter.

[00:22:52] Regan Robertson: They want muffins. There’s like a whole series.

[00:22:53] Dr. Chad Johnson: Yeah, it’s a whole series.

[00:22:54] Dr. Paul Etchison:  I was going to say they’re like the hungry hippos. Like you just keep just grabbing them little marbles. So just keep grabbing them more and more.

[00:23:01] Dr. Chad Johnson: Sometimes I am like a hungry.

[00:23:02] Regan Robertson: I do try to run things through. Like I try to forge your kid like future cast because that’s exactly right. So if you’re going to just give something to make a problem go away, will that inherently create another problem down the road or a bigger problem down the road? So I do kind of try to flow it through that. I’m wondering though, if I shift gears a little bit, Paul, are there things that you do to like, have you shifted how you set expectations with the patients? to help that because I know my primary health care provider did something that I’ve never seen before. So my first visit to their independent practice, I was seated in the treatment room, waiting for the doctor and there was a letter addressed to me personally, and it explained their excitement for seeing me and what I could expect at that appointment, like quite long, actually, I, it blew me away because everything that was in that letter did happen when the doctor came in and it gave me very little room to question anything.

[00:23:58] Dr. Paul Etchison: Um, yeah, I wonder how many patients read it. I wondered.

[00:24:00] Regan Robertson: I wondered. Yeah. I wonder too. I don’t know that answer. People will read to their degree, but in, you know, when you were talking like fee for service, you mentioned dropping Delta. That’s, that’s another piece that requires delicate communication and opens the door for patients being upset and not understanding. I watched that at where I’m a patient at listening to these poor older people trying to understand and the front staff, I could tell, like, they’re not equipped to have this conversation and it’s just going to create a negative scenario if they come back and so how, since COVID, Paul, have you shifted setting expectations with patients so you don’t have to deal with the upset side on the other end?

[00:24:36] Dr. Paul Etchison: Yeah, so it’s funny because we’ve always approached everything in my practice that there are no mistakes that are not worth talking about. Like, one of our things is we always say grace over guilt. That’s one of our mantras. We say, “Okay, we, if you screw something up, I want to hear about it. We will not make the same mistake. If anyone feel guilty, all we need to do is we need to talk about it and find out what is the best way to not make it happen again.” So I think combined with this, people complaining, we’ve just started at a complaint log, which we’ve never had before. And I always thought they were kind of silly, like, why are we logging complaints? But we just started doing this two months ago because I was like, “You know what? If we log every upset patient, I bet we can’t find more than two or three things. That people were upset with the front about there’s probably two or three things that the people be upset in the back and if we could just come up with a protocol for handing each of these, I don’t think we’re going to come up with more than six or seven categories of, of things but at the same time, we’ve got to approach it. So like that doesn’t happen to try to avoid the problem, the upset patient.” So one thing that you mentioned, like about that letter. We started doing this maybe about two years ago on our treatment plans, just like everybody else. It says, this is an estimate and we have an initial thing, but this is not a, “Hey, it’s just initial. These are our things. This is what my team has to do it like this. This is our best estimate of your insurance. This clause right here, this lets you know that this is our best estimate. We cannot fully predict what it’s going to be and if there’s a change in insurance payments, you will be respond. You have to initial here. Do you understand that? Pause. Yes. Okay. Then initial there. It’s a conversation. It’s not a check the box thing because there is no amount of, you signed this where we’re gonna come out and say, but you signed it. Correct. Patient’s not gonna go, “Oh, got me. Sorry guys.” No, it doesn’t matter that they signed it. It has to be a conversation that happens and making it, this is important to us. This needs to be important to you. So there’s so much we can do. I just had an upset patient the other day with an implant. I’m not getting my tooth today and I don’t, I am at a loss of how I can set that expectation. I have one as far as like making a document, giving it to them. “You will get your screw. You will then get four months later, it will heal. We might have to do some tissue work and you will get your tooth probably in about eight months,” you know, something like that and I don’t know, it just always seems to happen. “What do you mean I’m not getting my tooth today? And I’m like, “Pull my hair out. Why can’t I not accept the expectation correctly?” But you know, we’re working on it.

[00:26:49] Dr. Chad Johnson:  Along that line specific to this one, I’ve noticed that and I just go, “Hey, something I’ve noticed patients think that the implant is the part you see the implant specifically is the synthetic root that’s screwed up into the bone. You’ll never see it and unless I showed you like, you know, like, “Hey, here’s the implant before I put it in. So it’s the part that you don’t see, we have an implant crown,” but I said, it’s a semantics thing, but I just thought I’d let you know when we are, you know, billing for the implant or anything like, or talking about the implant placement. That’s the synthetic root. That’s not the tooth that you’re expecting. So patients go, “When’s my implant coming in? It’s like, oh, your implant was placed four months ago.” No, but the implant, no, that’s your implant crown. And I kind of do this back and forth to make sure that it’s

[00:24:43] Dr. Paul Etchison: Where are they mailing it from?

[00:27:45] Dr. Chad Johnson:  What the hell? It’s this, this clunky communication thing that patients have heard of, for example, TMJ. My doctor said, I have TMJ. Yeah, everyone has two TMJs. You have TMD, but it’s like, it’s okay. You’ve been told that your gooms or so, you know, so when they hear words and they go, “my gooms?” yYou know, it’s like, who told you gooms? It’s like my dentist. It’s like, Oh my goodness. We’ve got some correcting to do.

[00:28:01] Regan Robertson: What is it? What is it? People

[00:28:03] Dr. Chad Johnson: call it. People call it their gums, gooms.

[00:28:05] Regan Robertson: They do not. They do. Older dentists. Is

[00:28:07] Dr. Chad Johnson: It’s an older dentist thing? It’s regional. It’s, it’s horrible. It’s horrible. Yes, in certain parts of Iowa. My

[00:28:15] Regan Robertson: Pacific Northwest is showing.

[00:28:17] Dr. Chad Johnson: My goons bleed. Oh, it’s horrible. I’ve got some payment in my goons. And it’s like,

[00:28:23] Regan Robertson: I’m tracking so well with you though. I always call a dental implant. I think of the whole entire unit.

[00:28:28] Dr. Chad Johnson: Correct.

[00:28:30] Regan Robertson: Yes. I think of the anchor

[00:28:31] Dr. Chad Johnson: And you’re not wrong. You’re not wrong. And that’s how patients have heard it talked about. So like, why is that wrong? Why are we right? Just because we’re, we own it. It’s like, well, we’re kind of right. But like at the same time, it’s like neither here nor there. Let’s just make sure that we’re on the same page.

[00:28:45] Regan Robertson:  I have wondered often for the people that do say full sets of veneers. Yeah. If they’re fully aware that those are not forever veneers, those will need to be replaced at some point. Just like boob implants, it’s the same thing. They don’t last forever. Are they being communicated? And if they are communicated, to your point, Paul, are they reading the whole letter? So are they really understanding what they’re signing up for? Yes,

[00:29:08] Dr. Paul Etchison: But then we got to come back to is that a reasonable expectation based on the conversations that we’ve had and how we presented it to the patient? Yeah, I mean I would say so so it’s it’s one of those things. It’s a tough one This has opened my eyes to so many things and i’m looking at so many elements of my practice differently thinking about this like where are we setting this expectation that’s going wrong? And where can we improve because if we can catch this problem upline and never get to the upset patient. Man, that’s fantastic. That’s great. You know? Yeah. You know, talking about goons, I’m thinking about a patient I had at dental school and she’s like, “My upper lower. When am I getting my upper lower?” And I’m like, she’s like upper, lower, lower. Yes, but it’s, it’s one unit. It’s an upper lower.

[00:29:48] Dr. Chad Johnson: Right. Up alone. Not today. It’s all one word. Not today.

[00:29:50] Dr. Paul Etchison: This isn’t dental school and this denture is clearly going to take me seven months to make.

[00:29:54] Dr. Maggie Augustyn:  You know what’s really cool about being a conscientious practice owner is that it doesn’t matter how long we’ve been a practice owner. You know, when you’re interested in growth and addicted to growth, which isn’t always a positive thing, it’s like you just love finding out new ways to improve. You don’t just sit down on your chair, lean back and you’re like, “Yeah, it’s done. We’re just going to keep going like this.” You really want to continue improving processes for the sake of your patients, for the sake of your team and for the sake of your own sanity.

[00:30:28] Dr. Paul Etchison: It’s so true. It’s one of those things that I do a lot of coaching with dentists and they say, I tell them about my stories and they’re like, “Gosh, when did this happen?” I’m like, “Two months ago.” They’re like, “I just so surprised you’ve had your practice for 12 years. All of your systems, you have issues like this and things happen all the time where,” I’m like, man, “I didn’t handle it the best. Sorry, guys. This was my first time handling a situation like everything, you know, I’ll get, I’ll get a new one.” “Wow. I don’t get that many new ones anymore this many years, but I do, you know, new situations.” Yeah. I love that, Maggie. That’s so true. I love growing and I love coming up with new solutions and systems. I think it’s awesome.

[00:30:59] Regan Robertson: I have a question for all three of you because all of you are what I would deem productive dentists. What in the heck is a productive dentist? I mean, the short of it is you are allowed to have some space from the way that you structure your systems in your schedule to have time to be with patients. So you truly have time to focus on the patient. And when you’re dealing with something that is contrarian, something that is a potential conflict for me personally, like I manage multiple people and you always can tell in that moment whether it is an invitation to slow down and actively listen. So validating feelings. Number one, that is an anchor that I’ve used for a long time, Paul, because it puts myself off a defensive mode. So I automatically validate feelings. feelings, but then there is that opportunity to listen deeper, which can feel like I don’t have time for this. I’ve got my schedules full today. I can’t do X, Y, Z, so I don’t have time to deal with this problem or this whatever right now. So I’m wondering from the three of your perspectives, how would you coach someone who isn’t productively scheduling who doesn’t feel like they have the time to slow down? And react with empathy, like you were saying, Paul, and then making an agreement, what feels right to you, what will make this right in that situation? How do you get doctors from there to where you’re at today?

[00:32:09] Dr. Paul Etchison: Well, I think doctors need to find time to do that. I think it’s a necessary task. Nothing in a hurry is ever done well and nothing is enjoyable to do in a hurry. So we don’t want to do it in a hurry, but my advice that anytime we have these situations, we can talk about what happened from our perspective. We can talk about the way it makes us feel, but we cannot tell the other person what their behavior means to us. We cannot tell them, like, this shows that you’re ungrateful, uh, this shows that you don’t care about your job. Like, I feel like you don’t care your job because you do this. Like, no, that’s, that’s what I call playing over the net. Our job is to say what the behavior, what we saw, our interpretation of the way it makes us feel and we are to be curious about. how the other person is. And I think most arguments we’re doing, this is another thing we’re doing in my office. We’re doing what we’re calling P2P. Uh, we’re, we’re P2Ping on each other. We’re peer to peer coaching.

[00:32:57] Regan Robertson: You’re P2Ping on each other? Wait, you just lost me.

[00:32:59] Dr. Paul Etchison: That is what we say. We say, “Hey, do you mind if I P2P on you?” This, it’s just like a cute way of saying that, um, see, we, we ended up there. We went where we said we weren’t going to go. We went to potty humor. Here we are. So, so, but we’re doing this thing and it’s all these arguments and all this like resentment that’s coming from my team or other people in the team are pissing them off and stuff They’re starting to have these conversations and we’re encouraging them and my goal is the hope that everybody can start having them but so many conversations have happened this past month. We just talked about a meeting yesterday and it was every single time I felt hurt because you did this in the person says that was not my intentions at all. This is why I did this thing. Oh my God. I’m so glad we talked about this and it’s so much better than letting it build up, build up, build up. So I don’t know if that answered the question. I think it’s just important conversations. We have to be empathetically listening and be curious to what the other person’s intentions are cause when we get pissed off, it’s because we’re assuming their attentions and we don’t, we don’t know what they are and most people are nice, good people. Um, most people are not psychotic. I don’t know about this guy that just. Maggie’s patient, he’s kind of sounds like a nut in a, but you know, and that’s what I would say about it. I’d love to hear what you guys think too.

[00:34:05] Dr. Maggie Augustyn: When it comes to finding the time to be present with your patient, as opposed to staying busy and not making the time to be compassionate with your patients, everybody wants to know how do I make money on that? Because what you’re asking me to do is I’m not holding a pan piece when I’m being present with my patient and I ran my life like that as an HMO in public aid office. And I, and I moved, um, in a different direction. I saw a patient about a year ago and, uh, every single molar and most of her bicuspids were cracked and I proposed a crown on every one of those because I practice comprehensive dentistry and preventative dentistry. And she did not follow through on any of my recommendations. She came back a year later, not six months later. And I asked her, you know, why didn’t she follow through? And she didn’t really answer me, but she did schedule to get two fillings done. And, um, a part of me was a little. a little annoyed. Um, but I didn’t have time to be annoyed. And so when she came in, I started to talk to her and they were class five lesions where I could really see the pulp chamber. And I, and I said, look, just want to let you know, I’ll place these fillings here, but there’s a pretty strong chance that this might eventually need a root canal. And I took pictures before and I, and I talked to her about it. And after I was done with the procedure, I said, “Let me just ask you this and I, and I really, this is not me being pushy in any way, but this is just kind of Curiosity. I, as a human, I want to know what’s holding you back in getting some of some of this treatment done and getting these cracks, um, taken care of?” And she said, “Well, I had been going to a dentist for 10 years and they never talked to me about any of this. And so when you told me about these cracks and you know, it was like a, you know, 40, 000 treatment plan. I lost trust in my last doctor and in all doctors,” and so, and I said, “You know what, The same thing would happen to me. And so I said, but you know what complicates things a lot for you, which makes you different is that you have been on Prolia and before that Fosomax. And so what nobody might’ve told you and what I told you last time, and I’ll remind you again, is that you cracking a tooth is not as simple as having a tooth extracted and then an implant,” and so we talked about that. And when we talked about, I understand that you lost faith. I do and if you want to, again, You know, introduce you to a third doctor to examine you. And it’s okay if you choose not to go with me. I’m busy enough. I just want you to understand the risks that you’re taking and I told her about a patient that came in and she was on Prolia, and I immediately had to almost drive her to the oral surgeon’s office because she could have potentially lost her jaw in her life and so I don’t know what this lady is going to do, but I will tell you, it’s redefined the way that I live my life. It’s an honor for me to take care of my patients and um, I needed to have that conversation with her. Chances are that she’s going to be more likely to get some of this stuff followed through with, and that as a result of that conversation, even if she doesn’t follow through on that, on that treatment, she will have gained some faith in the way that she looks at providers. Right and so that’s why having these conversations, even though I’m not making money while I’m holding a handpiece, that’s why they’re so important.

[00:37:05] Dr. Paul Etchison: Yeah and you guys both shared your motivations and tensions and, and she might’ve been thinking, no, I don’t trust doctors or dentists and from my perspective, this person just wants to cut four crowns on me and make a bunch of money, pay for her lake house. You know, it’s, but here you are saying “I care about your teeth and this is why.” So I love that. That’s a great, that’s a great example.

[00:37:28] Dr. Chad Johnson: Already been paid for. She’s working on the yacht. Yeah. Yeah.

[00:37:32] Regan Robertson: Well, I, that, that story is inspiring to me from a marketing perspective because we were, you know, discussing TikTok and, and different social media platforms and how we get our voice out there. And there is so many opportunities from a storytelling perspective to, to educate. patients and help them understand what makes you different and the listening component, people just want to be seen and heard and by telling that story, you’re showcasing, you know, that you are making sure first and foremost that they’re seen and they’re heard and you’re taking the time, you’re investing the time, um, that goes beyond the handpiece hours to build.

[00:38:06] Dr. Paul Etchison: I love that. I think that’s, uh, everybody can aspire to having those conversations with their patients. I feel like as I’ve becoming older and more cynical, I’m more like, we’ll just see more patients and I don’t care if they see us, we’re just going to keep, we’ll just keep running them through.

[00:38:20] Regan Robertson: I don’t believe that at all. Maybe one piece of yours like that. You mentioned earlier, you said that, you know, you have a couple of books and some of this is in the books that you’ve written and then you’ve also read books and I think taking courses. What are some, some little nuggets there? Oh,

[00:38:35] Dr. Chad Johnson: The questioner has become the questionee because this is a question that Paul has on his podcast.

[00:38:42] Regan Robertson: Oh really? Really?

[00:38:43] Dr. Paul Etchison: I always I love do I love books I read so much and now I’ve realized that with audiobooks I can like 2x them Oh, yeah fastums and I become more of a person which I was so gung ho on my kindle for the longest time But now like time wise I’m like I can listen to this faster than I can read it, but that’s right

[00:39:01] Regan Robertson: The best gift. Chad got me hooked and we did this big book reading challenge together. And he’s like, “I’ll just read him again.” Like that’s, you know, overachiever there but, uh, yeah Audible best hack ever. I do it. People ask me how I read so much now and I’m like, “Oh, you can, there are so many times when you can put that in and get a chapter done in between whatever you’re doing.” Okay. So Paul,

[00:39:20] Dr. Paul Etchison: I would say, okay. Fantastic. Yeah. Fantastic books. Uh, my two books. Dental Practice Hero One and Dental Practice Hero Two. You do not need to read them in order. They’re on Amazon. Second one is more focused on running a three day practice where you’re just, do you see inpatients three days a week books that I have read that I really loved on this topic, crucial conversations, a crucial accountability and crucial influence. It’s a whole crucial series. I knew about crucial conversations, right? I just read the other two and they’re, they’re great too. They’ve got all the points on there. Um, and it’s just, this is stuff that it’s not going to like, Increase your production to X, you know, by in three months, but it’s going to make your life so much better and everything run well at your practice for the listeners. If they want, I have a two page guide that I provided to my team of just a summary of everything I talked about today and if they want, they can go to dentalpracticeheroes.com/every day for everyday practices. So just every dental bacterials. com slash every day. There is a, uh, my two page guide that I wrote with the help of my chatty GPT, of course, cause we never write a solo anymore, but, um, I, I penned most of it.

[00:40:24] Regan Robertson: Did you, did you name your chatGPT?

[00:40:25] Dr. Paul Etchison:  Oh yeah. I, I, me and Chad, me and Chad talk, uh, often about our chatties. All right, Matt, I don’t know if you’re going to name Chaddy. I sent him some screenshots of me and like, “Thanks, Chaddy. That is so good. I love it. You’re the best. What would I do without you?” I like, that’s right. I have to say, thank you.

[00:40:40] Dr. Chad Johnson: Yes. Yes.

[00:40:41] Dr. Paul Etchison: Yeah and then Chad speaks Portuguese to his,

[00:40:43] Dr. Chad Johnson: And it responds. It, it. It’s funny. It will respond. Yes.

[00:40:48] Regan Robertson: Did you name yours? Chad? So Paul’s is Chatty.

[00:40:50] Dr. Chad Johnson: No, I didn’t think to name it. I’ve, but now like

[00:40:55] Regan Robertson: I asked if it, if it wanted a name and then, and then it said, yes, it thought that that would be a great idea. And so I named, I said, what do you think about Zora? And it said that, and it explained to me what Zora means and how grateful it was and it was. It was honored to have that name. So now it’s always “Good morning, Zora. I’ve got a project for you today.”

[00:41:15] Dr. Paul Etchison: You know what? I want to chat GPT like robot that just follows me around, laughs at all my jokes. I feel like that just like a personal cheerleader, just to, just to pump up my ego all day long. That’s what I’m looking for. Someone needs to come out with that.

[00:41:27] Dr. Maggie Augustyn: Well, I think I’m the only asking Jasper. Jasper.

[00:41:30] Dr. Chad Johnson: My team has an understanding that, um, that they are to laugh at my jokes. Yeah. Just to make, I’m just, yeah but I’m, I’m like, I don’t care how humoring it might seem or whatever. I, you laugh and I’ll pay you. It’ll be great.

[00:41:43] Dr. Paul Etchison: I went to. I went up to the front desk the other day to say, to ask my front desk girl, Karina, and I said, “Hey, what’s happening, girly pop,” and they all just, I’m like, “What does girly pop mean something? I don’t know what it means.” I’m like, “I hear my daughter say it. She’s 14.” They’re like, “No, it’s just funny to hear you talk like that.” I’m like, “Okay, I wasn’t trying to be funny, but just calling you girly pop.”

[00:42:03] Regan Robertson: I’m officially, I think we all are officially at that age where we get to torment our children with lingo that they use and that is my favorite. If you ever, that is my tip of this podcast. Here’s what I will give as a gift. If you want your children. to stop saying something. Just use it.

[00:42:17] Dr. Chad Johnson: For real. For real. That’s my daughter. She’s like, she’s like, no one says that dad. I’m like, for real, for real. They don’t.

[00:42:24] Regan Robertson: I didn’t know for the first day of school, you can write a little note of inspiration to your children and what they didn’t tell me is that it was face up on their desks. So, yeah, so I, I talked about the grizzler and phantom tax and BET and I, you know, obviously in the incorrectly as well.

[00:42:42] Dr. Paul Etchison:  Ohio as well.

[00:42:43] Regan Robertson: Yes. Oh, I think there was a skibbe in there. Yeah, that scuba, the gi SC toilet, I think it was. Yeah. You’ll be a Sigma something, something. I just did it to be funny ’cause it would make him cringe. But he came home and he was like, “Mom, my two best friends were on each side of me. Read what you wrote. And I was like, “Oh,

[00:43:00] Dr. Paul Etchison: And, and we’re not, now we’re not cool.

[00:43:02] Regan Robertson: I don’t, I don’t hear Skibbity Rizzler, whatever as much,

[00:43:07] Dr. Chad Johnson: They’re going to keep it a secret secret lingo. For real, for real. I hope my daughter hears this someday for real, for real,

[00:43:14] Dr. Paul Etchison: For real, for real, for real. I’m just trying to relate on their level. You know, we’re just trying kids

[00:43:17] Dr. Chad Johnson: Making a connection. I’m just trying to be here. I’m just trying to be cool.

[00:43:21] Dr. Paul Etchison: Yeah she told me I wasn’t funny to her friends. I’m like all your friends think I’m funny she’s like, “No, they don’t and i’m like, “they do and you know what? I was way cooler than all of them when I was your age.” Oh Yeah So like much cooler. She finds that very hard to believe. I’m like, believe it or not. Yeah. I,

[00:43:36] Dr. Chad Johnson: uh, they need to see your, your picture with the tips, .

[00:43:40] Regan Robertson Oh, no.

[00:43:42] Dr. Paul Etchison: Going back to that full circle. Bye. Bye. Bye. Also, I love, good bye. Bye.

[00:43:48] Regan Robertson: Uh, your time has been so valuable, Paul. Thank you. Thank you so much. Go grab listeners to go grab the, the two pager that, that will be really something that you can play around with. You can implement and give it a try. Paul, if somebody wants to reach out to you directly, where do they go?

[00:44:01] Dr. Paul Etchison: Yeah. Go to my website, dentalpracticeheroes.com and there’s a contact page there and I read them all personally.

I will respond to every single one. So go check out the website. Happy to reach out or talk to anybody.

[00:44:12] Dr. Chad Johnson: Thank you very much. Last silly question. Paul, what’s your favorite Chicago team? Who do you support?

[00:44:17] Dr. Paul Etchison:  White socks, but I think they’re going to get rid of them. I think they’re going to, I think they’re going to, they’re talking about getting rid of them.

[00:44:24] Dr. Chad Johnson: Oh, I hadn’t heard that.

[00:44:25] Dr. Paul Etchison: Well, it’s, it’s, it’s, it’s underground, man. Sources are saying

[00:44:27] Dr. Chad Johnson: That’s going to be some South side

[00:44:28] Dr. Paul Etchison: Trembles, you know, it’s not the nicest place down there.

[00:44:32] Dr. Chad Johnson: No, but they need their white neighborhood.

[00:44:34] Dr. Paul Etchison: I know. I’m not going to be a Cubs fan. I will not be a Cubs fan. You don’t want to talk about us versus them. That’s an us versus them. That’s never going away.

[00:44:43] Dr. Chad Johnson: Right. Yeah. You should be an Iowa Cubs fan.

[00:44:45] Dr. Paul Etchison: Yeah,

[00:44:46] Dr. Chad Johnson: Cause it’ll be kind of supportive, but not, it’ll stick it to them. You know, then you can come watch Iowa. Yeah.

[00:44:52] Dr. Paul Etchison: Yeah, totally.

[00:44:53] Dr. Chad Johnson: Thanks for joining us, Paul, listeners look forward to next week. And remember up in March, 2025 PDA conference down in the Dallas, Fort Worth area, right?Regan.

[00:45:03] Regan Robertson: That’s right. That is absolutely correct. It is March 13th through the 15th,

[00:45:07] Dr. Chad Johnson: 13th through the 15th.

[00:45:08] Regan Robertson: We have Dr. Maggie, uh, slated to speak as well. So she’s going to keynote on Saturday. Thank you, Maggie, for doing that. Yeah. Yeah, it’s going to be fun. We’re going to talk about authenticity too. So, uh, yeah, the psycho risk is, is Dr. Bruce would say how to deal with your patients and, uh, and the other aspects of your business. So,

[00:45:26] Dr. Chad Johnson: And let me announce here publicly, uh, I am co-emceeing with Sarah again.

[00:45:33] Regan Robertson: That’s going to be amazing. Oh, that’s going to be fun. Well, thank you, Paul. We look forward to hopefully seeing you in person sometime in the next year.

[00:45:42] Dr. Paul Etchison: It’s been too long. We got to do something. Well, thank you so much for having me on. Had a great time.

[00:45:46] Regan Robertson: Thanks,

[00:45:47] Dr. Paul Etchison: Paul. Thanks, buddy.

[00:45:49] Regan Robertson: Thank you for listening to another episode of Everyday Practice’s Podcast. It would mean the world if you can help spread the word by sharing this episode with a fellow dentist and leave us a review on iTunes or Spotify. Do you have an extraordinary story you’d like to share or feedback on how we can make this podcast even more awesome? Drop us an email at podcast@productivedentist.com and don’t forget to check out our other podcasts from Productive Dentist Academy at productivedentist.com/podcasts. See you next week.