A True Story About Patient Trust

He was an older man of obviously meager means. He drove an old car, and he showed up for his maintenance appointments — always on time — in well-worn clothes. On his feet were scuffed shoes; in his mouth was a history of amalgams and heroic “let’s do what we can to preserve this with minimal intervention” dentistry.

The entire team loved him and wanted to do what they could to make it easy for him to keep coming. The dentist never explained to him the true nature of his oral health condition or discussed the full range of treatment possibilities. What would be the point?

I’ve been assured this is a true story, and that what follows next actually happened. How it’s discovered one day that the old man had won a lottery grand prize. How the next time his name appeared in the appointment schedule, the dentist strategized with his team to determine the man’s ideal possibilities and put together a treatment plan worthy of a patient with unlimited resources.

Then came the presentation, after which the dentist sat back with satisfaction and waited for this newly rich patient to express his excitement for what he could do now. Instead, the old man smiled and without a word got up and left.

A day later, totally perplexed, the dentist called the patient and asked what had happened. The old man said, “When you thought I had no money, you didn’t tell me the truth. Now that I have money, you want me to trust you. I don’t.”

The lesson, I think, is obvious: Never assume, never hold back, never compromise on a diagnosis. The only way to really be true to your patients and earn their trust is to be true to yourself and your professional integrity. It is what it is. Tell them.