Delivering bad news

Most dentists have gotten really good at the delivery of bad news. Most of us are pretty good at explaining our findings in a dispassionate way. We’re supposed to explain what we’re seeing, recommend different treatment options, explain the pros and cons of each option and then let the patient ask questions and make a choice. The trick is that you can’t own the patient’s problem. It’s really important that you don’t care more than the patient does.

Straightforward stuff, really. I mean, it’s not like we’re oncologists or something. The great majority of dental problems are not life and death.

I’m here to tell you…I still struggle. I’m not as good at delivering the bad news. I sometimes struggle because I do care more about the problem than the patient does. I think that’s because I understand the problem better.

Tooth decay doesn’t hurt until the tooth is in real trouble. Gum disease is painless right up until the teeth get wiggly. I see what’s going on in their mouth in HD. I use high powered loupes or even a microscope to see what’s going on and sometimes it’s hard for the patient to get as concerned about it as I do.

Some days I get really discouraged about it. I’ve got to let people know what I’m seeing. Modern dentistry can do some amazing things, but getting people to choose that is the difficult part, in my opinion. Some days I get burned out. Sometimes I have patients with multiple and serious problems that have no clue. That is so hard for me. It’s times like those where I don’t even know where to start.

But I’m a doctor. I owe my patients the truth. I don’t have to be mean about it, but I have to be truthful to the best of my ability. Patients need to understand that I don’t enjoy giving bad news any more than they enjoy hearing it. But we’re in this together. They always have the choice to do nothing, but my duty as a doctor is to let them know what’s going on and give them ideas on ways to treat it. We’ll get through this together.