In yesterday’s post I talked about the angst of reviewing routine radiographs during a hygiene visit to find that a restoration you placed has an open margin. So what do you do when this happens? There’s no question, if the margin is open you take a deep breath, explain it to the patient, and schedule them to come back and have you replace the restoration. Written in one sentence like that it seems pretty simple and straightforward, yet the when it happens in reality it’s not so easy. For me the first discomfort comes from explaining to the patient that something I did, turned out less than I would hope for. I also have to be willing to be with the patient;s discomfort and disappointment, as they also have unmet expectations and have to get themselves prepared for an additional dental procedure. Now layer on top of all the issues around confidence and competence, the reality of lost production. Our time is valuable in a dental practice, and too much time spent replacing work without generating production can be devastating to the practice.
One of the life lessons I learned many years ago, that has stuck with me and served me well is a simple quote from my friend Dr. Gary DeWood. “The practice of dentistry is always 49% business and 51% healthcare”. In a nutshell it means that when we are torn between business and healthcare, the health of the patient always wins. When the patient with the open margin is seen during your best production month ever, the only choice is replace it. When the patient with the open margin is seen during your worst production month ever, the only choice is replace it. Healthcare choices always outweigh business decisions.
With this said, the quote contains a very important component, 49% business. It means that during that very productive month we put away funds so that our practices have cash to operate on. This reserve allows us to easily make the 51% healthcare choices even in the months where production is not so good. it means we pay attention to the efficiency of our practices because being a good business person prevents us from ever feeling pressured to have healthcare represent less than 51%. We have a responsibility to our patients, team and families to be good business people and monitor the economic health of our practices. This alone takes economic pressure out of the equation of our healthcare recommendations.