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5 Red Flags that Make Me Want to Fire a Patient

Have you ever been in a bad relationship?

You look back over the weeks/months/years you were with someone and you wonder… why you didn’t get out of it sooner?  Were there early warning signs that things were going to go badly?


We can draw comparisons to our relationships with patients.  A bad relationship with a patient can cost you more than just stress and money; it can end in litigation.

Sometimes we get off on the wrong foot with a patient and it’s our fault.  Check out this post for a list of things we can say that will steer a patient relationship in the wrong direction.  But other times the patient will give us important clues that they are going to be very difficult to work with.  Watch out for the following red flags in your first encounters with patients.  You may want to seriously consider ending the relationship before it begins…

(1) Dictating treatment

Patients can have some creative ideas about how dentistry is done.  When a patient asks, “Can’t you just…” and then describes an inexpensive way to patch their problem, I use it as an opportunity to explain their dentistry in greater detail.  I want them to learn about all the hard work that is being done for their benefit.  But some people aren’t curious; they’re just control freaks.  Patients that try to make us cut corners and skip steps to save time and money will only blame us when the treatment doesn’t go perfectly.

(2) Constant complaining

Some patients are anxious about treatment, especially if they’re going through a lot of dental work.  They may express their anxiety in some interesting ways, including lots of little complaints or a few big ones.  But if everything you do for someone is met with some level of criticism, you may want to let them leave your practice.  It’s depressing to feel like your best isn’t good enough, certainly.  But a true Debbie Downer is a red flag.  It’s only a matter of time before they start to feel entitled to discounts and refunds for work that is excellent.  It’s only a matter of time before you have to spend time and materials redoing work without good reason.  Which leads us to…

(3) Unreasonable expectations

There isn’t a single tooth whitening system on the planet that will turn your patient into Angelina Jolie.  Even the best veneers won’t make a guy look like Brad Pitt.  Despite you best efforts to paint a realistic picture of treatment, your patient may have something else in mind.  Unrealistic cosmetic expectations become apparent when patients say things like, “This will make me look younger, right?”  I’ve also encountered people that expect a full mouth reconstruction to be started and finished within a month.  They spent twenty years neglecting their teeth and I only have one month to make it perfect.  If I sense that this person can’t understand our timeline, then I’ll consider not doing the treatment at all. 

(4) Negative history with other dentists

My heart goes out to patients who have had bad experiences with other dentists.  They may take longer to build trust with you and that is certainly understandable.  But you may find some patients walk in with a long history of dental relationships that have always ended badly.  “Well that first one was always trying to rip me off.  The second one I had to take to court to settle a matter.  Then the third one cost way too much money.  And now I’m with you!”

(5) Rude to staff

I simply do not tolerate bullies in my office.  If a team member informs me that a patient made an inappropriate remark to them, I will consider speaking to the patient about the incident.  This can be a delicate matter and it depends on the nature of the comment.  Either way, I typically give the patient a second chance unless their behavior was really out of line.  But if the rudeness continues, I will fire the patient.  Your staff will appreciate you defending them and you’ll lose a headache.

So once you’ve decided to fire a patient, what do you say?  I’ll tell you what I’ve done in the next post…


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