When my patient is a lawyer, his attitude is more discomforting than my drills

He was willing to pay for better treatment options ; yet, what he meant was a better service rather than better treatment. 

By Shawn Huang

It was a Thursday afternoon, and a tall, strong man walked into my clinic with an unusual swagger for a routine full-mouth check-up. “He is slightly taller than I, and I am about 6 feet tall,” I observed. As usual, I first looked into his medical history—he was a lawyer in his forties with no chronic diseases or food or drug allergies. "Probably just another standard examination procedure," I thought to myself. After the full mouth check-up, I asked the patient to undergo a panoramic X-ray, which can reveal the underlying bony structure of the patient, to ensure I didn't overlook any issues that couldn't be seen orally. The X-rays showed that not only were his gum and bone tissue around the teeth compromised or damaged in everyday English, but also his teeth severely decayed in areas not visible to the naked eye. Therefore, he needed periodontal treatment, which can prevent the bony destruction from worsening, and root canal treatment, which will stop the decay from spreading deeper inside the tooth, causing further infection. That was my honest and professional opinion. 

Perhaps because the patient is a lawyer, even relatively technical terms didn't faze him. He could easily understand my explanations, and all the processes went so smoothly. After explaining the recommended treatment options, the patient voluntarily brought up his desire to receive LASER-assisted periodontal treatment, which is self-paid. Perhaps he realized the importance of periodontal health, or maybe he no longer trusted the effectiveness of treatments covered by his health insurance. Regardless, after explaining the treatment process and corresponding costs to the patient, he readily accepted the package–it cost around 40,000NTD– and scheduled all subsequent appointments without hesitation. "How straightforward! If only all patients were this wise!" I muttered quietly to my assistant. 

Soon, the day of the first treatment arrived. It was a data collection appointment, which meant taking numerous X-rays. During the scanning,  the lawyer quickly began to feel impatient and complained that since he had his wisdom teeth extracted just two weeks ago, the plastic film in his mouth made him feel very uncomfortable, and he didn't want to continue with the X-rays.  It was understandable. “We could finish the scanning next time,” I gently told him as I brought him back to the dental chair. I picked up a periodontal probe, a tool that can measure periodontal status, and I said, “Ok, so first we are going to measure your periodontal condition, and …” When I thought everything was going smoothly, the patient suddenly became furious and started yelling at me: "Don't you know I just had my wisdom teeth removed? Also, I could barely understand the relationship between so many X-rays and my periodontal treatment. It's just torturous and a complete waste of time!"

I didn’t know how to respond to his sudden outburst of wrath, so I froze there. After a moment of shock, I took a deep breath and calmly explained the necessity of these procedures to the patient again. “If your wound still hurts, we can postpone the data collection around that area to the next appointment,” I again explained. The patient not only didn't appreciate this but even scowled at me and gave me a nasty look, throwing his phone on his lap and continuing to vent his anger at me as if I were a medieval house servant. I even thought for a moment he was going to punch me.  I put down the instruments, took a deep breath again, and said, “You don't have to do this if you are upset about me; you can just leave now. I will give you all the money back, so you won't have to go through all this suffering.” He probably didn't expect that I would respond to him so rudely (pitch him a straight ball). He froze there for a second with his eyes wide open, fixated on me and what I just said to him. Soon, he picked up his phone and started dialing. “I am going to call my friend at the dental association and tell him how unprofessional you are,” he said, his tone condescending.   

“Is he just trying to threaten me by showing that he had a friend working in a dental association? Or is he really going to sue me?” I thought frantically. Unfortunately, or fortunately, he dialed the wrong number and awkwardly put down his phone.  

“I can understand how upset you are about the treatment, but I think that we have tried our best to give you all the information you need about the treatment thoroughly; if you still have problems and concerns, you can go home and think about it and tell me next time. I won't start the treatment today.” I tried to ease his anger and calm him down.  “There’s no need to ponder, you are the worst dentist I've ever met, and all of you suck! I won't step into this clinic forever.”  Sadly, the patient and I reached the only and the worst consensus, which was that we had no consensus. Until that moment, I realized that although I can treat a disease, I can not treat an irrational patient because a dentist is not a service provider. So, I asked him to go to the reception desk for a full refund and cancel all subsequent appointments. 

After the lawyer left, I discussed with the reception staff and assistant whether our procedure explanation wasn't clear enough, or if there were really any oversights in our operation. The conclusion we reached was that we had fulfilled our responsibility to explain clearly and had done our best to provide the patient with the highest quality and most comprehensive examination and treatment. To our disappointment, the patient might have expected that since he’d paid, we should provide him with more comfortable, more “dignifying” service and treat him with the utmost respect and our subservience. While we offered our sincerity and respect, we maintained our professional duty. Looking back at that particular episode, we all felt that what was laughable, though, was that the patient pretended not to know that all treatment processes inevitably involve some discomfort; it is common sense, even an elementary school student knows.  

Shawn Huang is a dentist by profession who has discovered a sharp wit and a passion for satire. His writing humorously critiques serious medical policy issues and the often transactional nature of doctor-patient relationships in Taiwan. Follow him for clever, incisive pieces that blend professional insight with a comic twist.