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Do All New Dental Patients Need X-Rays What if Your Patient Refuses

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A new patient comes into your office and one of the first things she says is “I don’t want x-rays!” When questioned why not, the reason is that she simply feels that she does not need them, nor does she want the radiation. What would YOU do?  This is a question that we received, so please listen in to what Dr. Richard Madow and Dr. David Madow have to say. Then of course we do the call of the week. Since we are on this topic, we call an office asking if we could come in as a new patient and not have any radiographs taken. Listen in to see how they handle it! If you have a question that you would like answered on our podcast, please send it in to podcast@madow.com. We will do our best to get yours answered!


Do All New Dental Patients Need X-Rays What if Your Patient Refuses

Female Voice: The Dental Practice Fixers Podcast is brought to you by the Madow Center for Dental Practice Success. To find out how we can help increase the success of your practice, check out madow.com or call us at 1-800-258-0060.
 [music playing]
 Dr. David Madow: A new patient is in your chair. Everything seems great, although they say I do not want any x-rays. What do you do? We’re going to answer that in Episode 12 of the Dental Practice Fixers. Welcome, welcome, welcome. I am Dr. David Madow, along with…
 Dr. Richard Madow: Dr. Richard Madow, your co-host and fellow Dental Practice Fixer. Thanks so much everybody for being with us today. And thanks most of all for all your great comments about the Dental Practice Fixers, and going on iTunes and giving us a good rating. Feel free to do that all you like and tell your friends. Most of all, send us your questions. It may just wind up on an episode of the Dental Practice Fixers. We’ve got a great question for Episode 12. I’m just going to get right down to it. And here’s our question for today. It says, Dental Practice Fixers, I had a new patient recently. A young woman who absolutely refused to have radiographs taken. She assured me that she was not pregnant. No way in hell was her exact phrase. No way in hell. She didn’t believe in x-rays. She felt they could be dangerous and didn’t want them; she wasn’t having any problems. If her dental condition was 100% immaculate, I could maybe have let it slide. But she did have two crowns, a few restorations and mild gingivitis. I loved that. Mild.
 Dr. David Madow: Little mild gingivitis. Very mild.
 Dr. Richard Madow: Garden variety gingivitis. I told her I could not see her as a patient without x-rays, and she raised a big fuss and walked out. Loved that. Could this have been handled differently? From Dr. Amy in Aurora. Dr. Amy in Aurora, we don’t know if that’s Aurora, Illinois, Aurora, Colorado. Maybe there’s some other Auroras out there, but it doesn’t matter Dr. Amy. Great question. So after that whole scenario, let’s start by her main question and see where it goes. And that is could this have been handled differently? What do you think?
 Dr. David Madow: I’ll tell you something, from what Dr. Amy in Aurora…
 Dr. Richard Madow: Dr. Amy in Aurora or is it Dr. Aurora in Amy.
 Dr. David Madow: It could be Aurora – maybe Aurora Borealis?
 Dr. Richard Madow: Maybe Aurora Miracle. 
 Dr. David Madow: Maybe. I know it’s always limited because when somebody’s writing in a question, they don’t write a whole dissertation. They don’t know everything. But from what I heard in the questions; Rich I think she handled it right. I mean could she have tweaked the language a little bit, could she have done something? Maybe. But here’s what I’m going to say, and maybe we’re not this deep into it yet. But I’ve got a general feeling and I’ve got to let this out. I’ve got to let it out. 
 Dr. Richard Madow: Hold on, go ahead. 
 Dr. David Madow: Generally, generally speaking, a patient like this that just refuses x-rays because they say they’re dangerous. I think a patient like that is going to be trouble all along, I think, and she absolutely refused even after some education, you’re going to keep them in the practice. I’m not so sure.
 Dr. Richard Madow: Well I think that’s a really good point. And that’s the main point in this as well. And that is if a patient is trying to tell you what to do, they’re dictating how you do your diagnosis, how you treat them or whatever. Is this patient right for your practice? We’ll get to that. But I think the sidebar is, did Dr. Amy do anything to try to inform this patient? Some would say educate, that these days x-rays are incredibly not harmful. If she didn’t, she should say we use digital x-rays. It’s not like the old days. The amount of radiation is insignificant and without them, there could be cavities under that crown you have and if we don’t find those cavities, that can lead to much worse problems including a root canal or an extraction. And that’s why we like to do x-rays. That’s why we require x-rays, whatever. Could Amy have done a little more? We’re not sure about that because she’s not on the show with us today. But the way this question is phrased, it seemed like she just said, okay you don’t want x-rays, get the hell out of here. So I’m not so sure I’m a big fan of… 
 Dr. David Madow: Well again, yeah we’re not sure to the extent of what Dr. Amy did. But I think when we read a question like this and we’re only limited to the information, a lot of times we just have to go on our gut feeling. And my gut feeling, again just from what you said, is that this patient is a nutcase. And even if Dr. Amy would have explained more and more. Like, okay there’s not as much – there’s not nearly as much radiation with digital radiographs as it was in the past. I think this patient; she comes in as she’s dictating how Dr. Amy needs to do her treatment or diagnosis and treatment. I say get rid of her. If you’re a busy practice, you don’t even need to take every patient. And why deal with a nutcase that’s going to be probably problems all along when you’ve got so many good patients that are going listen to you and do what you recommend. That’s my feeling. 
 Dr. Richard Madow: A nutcase.
 Dr. David Madow: Yeah I’m going out on a limb saying this patient sounds like a nutcase. 
 Dr. Richard Madow: And so she’s an antivaxxer or a flat Earther or something.
 Dr. David Madow: So get rid of her. Get rid of her. Now look, there might be people listening to this show that don’t care if they take radiographs on a patient or not. I’m not saying that’s good, but if you don’t care and if you want to set yourself up for potential problems, then see her. But if you’ve got a good practice and you really try to diagnose properly and do the right thing. And you got somebody that comes in and telling you what to do, then what else is she going to want? There’s probably some material or some kind of impression or something that you – I don’t want that either. I think get rid of her. 
 Dr. Richard Madow: Okay that leads to two questions now. So I hope I remember both. One is I know some practices have the refusal to have x-rays for them and they say, okay well we really recommend them. If you don’t want them, you need to sign this and then we’ll go ahead and treat you. I am not a fan of that. I think that can come back to haunt you in so many ways. First of all, I think that you would get killed in court if you treat a patient…
 Dr. David Madow: Absolutely.
 Dr. Richard Madow: They’re going to have – a fantastic lawyer. I think that’s a mistake. It’s almost like saying I give you permission not to do what you need to do. Does that really count? I don’t think it counts. In a court of law, I think you’re really hanging on iffy ground there. So, now that leads to some more issues. What if you recommend treatment for patient if they say, well I don’t like that. Is there any other way to do it differently? Can you do that more cheaply? Can you only do what my insurance covers? Now we’re still talking about a patient dictating treatment here. 
 Dr. David Madow: I agree. That’s why I said, I don’t have a good feeling about this patient at all. And I still go back to what I said originally. If you’ve got a decent practice and you’ve got other patients coming in that are going to listen to you and agree and be reasonable, then those are the kind of patients you want to see all day long. And these patients that are refusing this and that and making you change your philosophy; we don’t need patients like that. I mean, Rich you and I have been preaching for a long time about how to have a more successful, a busier practice, yeah teaching, preaching, whatever. Forget the semantics, you know what I mean. I think dentists for some reason, feel that they need – a lot of dentists feel that they need to take everybody that walks in that door. I don’t feel that way.
 Dr. Richard Madow: Well I don’t either. I think that’s one of the big lessons as well. I feel like I’m saying this all the time. So maybe this is preaching: we are not obligated to see every single patient. Unless somebody is bleeding, swollen and in severe pain. That’s our debt to society, to take care of these people. In my opinion, I think you agree, whether they can pay or not. If somebody comes in and they’re bleeding or in horrible pain. It’s great to be able to help someone like that. But what about some grey areas? What if a patient has got a really destroyed tooth, missing a lot of structures? It’s just a mess. We’ve seen all these before, and we want to do a crown and we recommend a crown and the patient said can you just do a filling? Well, we could do a large filling. It might not last, it might not be a good restoration, it could cause bigger problems in the future. It’s than better than nothing. Is this patient now dictating treatment?
 Dr. David Madow: That’s a great question. I would feel better with something like that as long as if it’s a purely financial thing and they just can’t afford a crown but something needs to be done. And they’ve realized it’s not ideal treatment and you’re telling them, you’re educating; you’re documenting everything. I feel better with that because that patient is really not trying to – the way I look at it they’re not really dictating treatment. They’re just saying, hey I can’t afford the Cadillac, give me the Buick or something like that. 
 Dr. Richard Madow: But a filling is not a Buick, Tom.
 Dr. David Madow: It’s not a Buick, okay give me the Chevrolet Chevette.
 Dr. Richard Madow: Ford Pinto, is that where we’re going here? 
 Dr. David Madow: Hey I loved those Pintos, they’re great. 
 Dr. Richard Madow: Yeah I loved those Pinto Station Wagons. I know in California it seems to be very in to restore some of those cars like a beautifully restored Ford Maverick or a Pinto Wagon.
 Dr. David Madow: How about the Mavericks with like the real big bumpers? That was…
 Dr. Richard Madow: Oh yeah the JS model. 
 Dr. David Madow: It’s 1974 JS. 
 Dr. Richard Madow: They must be maintenance nightmares though and they don’t have the safety features of modern cars, but they look cool.
 Dr. David Madow: They look cool. But I feel that it was somewhere like that and they’re going into it. No, okay. I mean, you’re not doing anything – okay let’s face it. I don’t think there’s anything – there’s no malpractice there if you’re telling your patient they need a crown but you’re going to attempt the large filling. I don’t think it’s malpractice. 
 Dr. Richard Madow: I think if it leads to a root fracture, they lose they the tooth. 
 Dr. David Madow: I don’t think it’s in the same league as just saying, okay we won’t do radiographs. I don’t think it’s in the same league. 
 Dr. Richard Madow: Well I think one of the big differences is treatment versus diagnosis. And if somebody refuses radiographs, you can’t even do your proper diagnosis. So maybe that’s a line that could be drawn, kind of a demarcation there. Treatment – if you inform the patient of the best treatment they can get and they want some compromise, maybe you can learn to make that choice. I’m not a big fan of it, but maybe you can do that. When it comes to diagnosis, draw the line.
 Dr. David Madow: Agree. I would. And bottom line, I’d kick that woman out of the practice so fast. It wouldn’t be funny. 
 Dr. Richard Madow: Okay well let’s have that nutcases then. You use that phrase, that extremely derogatory phrase.
 Dr. David Madow: Nutcase. Total nutcase. I’m not PC. I don’t care. I’m not PC.
 Dr. Richard Madow: How about other nutcases?
 Dr. David Madow: Get rid of all nutcases. Give me an example. Give me example of a nutcase.
 Dr. Richard Madow: A patient that’s – okay, I don’t know if you call this a nutcase. I think we’ve all had these patients. I had them in my past practice. Patient has said I don’t want any anesthetic. Just treat me. I remember one guy who specifically – he happened to be a relative. The guy was flailing around like he was in a torture chamber. It took me five times as long. I was totally stressed out. He was totally stressed out. I don’t think I did my best work and then to make it worse I didn’t even charge them because he was a relative. If you’re watching, I doubt you are, but you know who you are. In retrospect I should have said no. I insist on treating patients who are numb and comfortable and comfortably numb. Is that a nutcase? Somebody said I don’t want any anesthetic.
 Dr. David Madow: Not necessarily. However, I would treat them up to the point where if they don’t want no anesthetic and they’re comfortable and they’re sitting back, no problem. Once they start flailing around like you just described and you can’t do your best work, I’d say it’s either anesthetic or you’re out of here buddy. I don’t care if you’re my relative or not. Get the hell out of here.
 Dr. Richard Madow: That’s not a nutcase. 
 Dr. David Madow: Not it’s not necessarily a nutcase. It’s somebody who just doesn’t want anesthesia. 
 Dr. Richard Madow: I think some people would say that 90% of TMJ and facial pain patients are nutcases. 
 Dr. David Madow: Yeah. And then what’s the other malady that people have? I think a lot of people – I’m not saying this isn’t true but a lot of people would say – what’s that…
 Dr. Richard Madow: Fibromyalgia?
 Dr. David Madow: Fibromyalgia. Is that a nutcase patient? I don’t know. I don’t know the answer.
 Dr. Richard Madow: I think before judging that, we might say a fibromyalgia patient would have inherent difficulties in treating them that’s for sure.
 Dr. David Madow: So you’re saying our practice does not accept fibromyalgia patients or TMJ patients, or any of those. 
 Dr. Richard Madow: Wow. Kind of like that sushi bar that had a big sign on the door that said no California roll, no spicy tuna roll. It’s like eliminating people that they don’t want, right from the get go.
 Dr. David Madow: Well are you going to treat somebody with many year syndrome
 Dr. Richard Madow: I don’t even know what it is. So I guess I’ll say yes. 
 Dr. David Madow: Here’s where I limit it. I would absolutely not treat somebody that came into my office that had groats disease. They’re gone. You just can’t treat groats. 
 Dr. Richard Madow: Okay. But that’s a management issue. I think more than anything else. 
 Dr. David Madow: Anyway, I’m going to say…
 Dr. Richard Madow: Before long, you won’t have any patients. 
 Dr. David Madow: I’m just not going to accept a nutcase. That’s all.
 Dr. Richard Madow: Okay, well with that said…
 Dr. David Madow: That’s the conclusion.
 Dr. Richard Madow: We’ve reached the logical conclusion, but again, I think that maybe Dr. Amy didn’t try hard enough to let this patient know how safe and important radiographs are. But at that point, if you like to use all those opportunities and your patient said no, I agree. I don’t like signing the little things like I refuse x-rays. I think you can come back and [inaudible - 0:14:08.9] big time. 
 Dr. David Madow: I’d say 30 seconds. If she can’t explain in 30 seconds, you don’t have to go into like a 5 minute…
 Dr. Richard Madow: Oh no no. No scientific. You don’t have to talk about Dr. Redken. 
 Dr. David Madow: 15 or 30 seconds if this patient still said I don’t care, I don’t want them. You’re out of here buddy. Next.
 Dr. Richard Madow: Why can’t it be any different than a patient saying I don’t want you to use the periodontal probe on me. Would you have that patient in your practice? Absolutely not. 
 Dr. David Madow: No way. Zero chance. 
 Dr. Richard Madow: Especially that you come in knowing the term periodontal probe. That’s asking for trouble. 
 Dr. David Madow: How about if patients said I don’t want you checking for fremitus? I do not want anybody here checking my mouth for fremitus. 
 Dr. Richard Madow: I think I’d want that patient in my practice. 
 Dr. David Madow. Let’s do a phone call man. 
 Dr. Richard Madow: Before we do the phone call, hey we’ve got a Masterclass coming up. It’s going to be in Baltimore. We are doing one for the first time on a Saturday. I know some people kind of complain. I can’t come to the Masterclass. I can’t take off too much work. It’s totally worth it but for you or for anyone else, go to masterclass.madow.com to see what the whole thing is about. This is no exaggeration. It really could be the most important day you’ve ever had in your years of practicing dentistry. Masterclass is for docs only, for practice owners only, looking to make some major improvements, kind of turn that corner. Maybe take your practice from good to great or mediocre to good or from downright shitty to fantastic, whatever it is. If you’re really looking for some positive changes in your practice, check it out, masterclass.madow.com. It’s a small intimate group and really, really good things happen. We’d love to see you there.
 Dr. David Madow: There you go. While we’re giving tips. Rich and I love – even the small tips are good and here’s one that’s going to change the way you’re doing credit card processing in your office and save you some money every single month. It’s very simple math. It’s very simple. We believe in our partners at Fattmerchant. Just a modern cool way – I don’t even have to go into the detail because we promise you you will save money every single month and it’s simple to switch over. We have a lot of our friends and followers and doctors that have switched over to Fattmerchant already. Check them out, we’ve set up very simple link, and I want to make sure I get it raise this time. It’s BIT.LY and if you’re watching the video, we’re going to have it right below us. BIT.LY/FATTMAD and fattmad is spelled FATTMAD. Check them out, the link right there. BIT.LY/FATTMAD. You will change your credit card processing forever in your practice and make money every month. We promise.
 Dr. Richard Madow: Alright. 
 Dr. David Madow: Do the call.
 Dr. Richard Madow: Let’s do the phone call. It happens to be thematically linked to Dr. Amy’s question. So let’s see what happens.
 Voice Recording: To serve you better, this call maybe recorded for training and quality purposes.
 [phone ringing]
 Female Speaker: Good morning. This is Amy.
 Dr. Richard Madow: Hi, I’ve got a quick question for you. I want to come in as a dental patient but I’m not sure about dental x-rays. I know that dentists usually insist on taking x-rays. Is that the way at your office? 
 Female Speaker: Have you had them anywhere else that could we kind of get emailed here so we at least have a baseline? 
 Dr. Richard Madow: Yeah I haven’t had x-rays for a while. 
 Female Speaker: What we could do is kind of take the minimum of just the T18 side and that will help him just to make it for him to do the exam. He wouldn’t want to miss any cavities. So that will help him see between the teeth. And then the rest [inaudible - 0:17:42.8] to see from looking in there. 
 Dr. Richard Madow: Yeah. Are those safe? 
 Female Speaker: Excuse me?
 Dr. Richard Madow: Is that safe? I’m just really concerned about radiation and x-rays.
 Female Speaker: Yeah. So the thing is actually digital. So when it’s a digital x-ray, it takes a lot less radiation. You can get more radiation from being outside or if you’re on a plane. So especially if you’re just taking the T18 side, you wouldn’t have any issues at all with that. Back when they were film, it took a little more radiation to expose it. But now that’s everything is digital, it’s very very minimal. 
 Dr. Richard Madow: Oh cool. What if I decide I just don’t want them at all. Is that still okay? 
 Female Speaker: It’s just – I’m pretty sure that legally you’d have to have them to do an exam, but hold on one second. 
 Voice Recording: Without metal wires or brackets. Invisalign is removable so you can eat and drink what you want while in treatment. Plus brushing and flossing are no problem. Invisalign is comfortable because it has no metal to cause mouth abrasions during treatment. And no metal and wires usually means you spend less time in our office getting adjustments. Find out if you’re a candidate. Ask about Invisalign today. We’d be happy to tell you more. 
 Female Voice: So yes he would have to have them just for legal reasons. He wouldn’t be able to do an exam and then we also wouldn’t be able do a cleaning without an exam. 
 Dr. Richard Madow: Okay. So I don’t want them maybe I’d probably – maybe she’d find another office. 
 Female Speaker: Thing is I don’t know if there would be one since that is the law in South Carolina under standard care, but yeah that’s it.
 Dr. Richard Madow: It’s actually a law. Wow, interesting. 
 Female Speaker: Yes. So what the American Dental Association requires is an exam by the dentist once a year, and you must have that before you could even have any cleaning or anything from us. And to do a proper exam, you have to have x-rays or in other words to do an exam where you’re not able to diagnose so you kind of – it’s kind of a little bit of fraud because they’re saying you’re doing an exam but you can’t really do an exam. 
 Dr. Richard Madow: Wow it’s fraud. That’s really – I mean the American Dental Association requires that? Wow, interesting.
 Female Speaker: And they actually have a website which shows all the different ones that they recommend and then also, it has a little chart on the radiation to where actually explains what x-rays are equal to, kind of like just eating a banana you get radiation from just one x-ray at a dental office. And then it’s a nice chart to take a look at.
 Dr. Richard Madow: You get radiations from eating a banana?
 Female Speaker: Yes. And then airplane…
 Dr. Richard Madow: How do you get radiations from eating a banana?
 Female Speaker: I have no clue. It’s just like a pretty chart that says…
 Dr. Richard Madow: So it’s not like a microwave banana. It’s just a regular banana. 
 Female Speaker: Yeah and I don’t know what it is, but apparently, you can get radiation from that. Just one plane ride is equal to like a full series of dental x-rays.
 Dr. Richard Madow: Yeah that makes sense. 
 Female Speaker: Yeah. So at times that shows the different – just a pretty cool chart. But now it just takes very little radiation to get an image.
 Dr. Richard Madow: Well very informative. Maybe I’ll find a dentist that’s not a member of the American Dental Association.
 Female Speaker: Alright. Thank you.
 Dr. Richard Madow: Thank you, bye.
 Female Speaker: Bye.
 Dr. David Madow: You know, I think I always say this after a call – oh my god…
 Dr. Richard Madow: But it had some twists and turns too. That’s for sure.
 Dr. David Madow: What is the story with that thing? 
 Dr. Richard Madow: I have a few comments. I like the on-hold message for Invisalign. That’s a nice touch.
 Dr. David Madow: Very nice.
 Dr. Richard Madow: Yeah. I mean, how frequently do we actually hear a good on-hold message when we do these calls? 
 Dr. David Madow: Almost never. So yeah that’s good, that’s good.
 Dr. Richard Madow: Okay she was very nice, she was pretty knowledgeable.
 Dr. David Madow: She was nice, she was cute.
 Dr. Richard Madow: She was knowledgeable. She knew what she was talking about.
 Dr. David Madow: Kind of.
 Dr. Richard Madow: I think that puts her ahead of many many people. But then she kind of started going off the deep end when she brought up that this is the law, and the American Dental Association requires that you do this, and that it’s fraud if you don’t. I’m not so sure about that.
 Dr. David Madow: Right. Let’s take it back to the beginning. What would you like to have – how should she have handled this? She got a potential new patient on the phone who wants to come to the practice but is stating that he doesn’t really want radiographs. What do you do? Do you try to explain everything on the phone or do you try to just get them into the office and do the explanation there?
 Dr. Richard Madow: Okay great question. I’m going to go back to your term of nutcase earlier. I think even you can even tell on the phone the patient is just a wacko and they’re not going to fit in your practice and just cut your losses. But I think if the patient’s really – and I sounded pretty reasonable. I just got some questions about x-rays. I think if the patient sounds reasonable, you think they might be a good fit for your practice? I agree. Let’s get them in, have them meet the doctor. The doctor can just explain a little bit about x-rays/radiographs, whatever you want to call them. It might be worth a shot. Do you agree?
 Dr. David Madow: Yeah. Because once they’re in the practice, I think there’s a better chance of a true connection. Let’s face it, when we’re on the phone, there’s not really like a true connection yet. Once you’re there, and you see these people are good and they really care and they explain a little bit about this minimal radiation. I think there’s a much better chance of somebody saying, okay I get it, let’s do it. As opposed to on the phone which she talked about bananas and fraud and the ADA. Not just it’s ridiculous. You can’t do that on the phone.
 Dr. Richard Madow: Yeah I totally agree. Again, I’m not a lawyer, you’re not a lawyer. But I think when you start to say things like this is fraud and the ADA requires that it’s done this way. I think that it’s kind of combative type talk. I didn’t care for that at all. I don’t think it’s accurate. I remember a few episodes ago somebody was saying, I can get sued if I do this. Why are you going to bring up things like fraud and the ADA requires? I just don’t – I don’t think anything good can come up with that conversation. 
 Dr. David Madow: Well you had the best comeback ever. It was hilarious. I think I’m going to find a dentist who’s not a member of the ADA.
 Dr. Richard Madow: I know, and then she said okay bye. We can’t let this go without talking about the banana thing. 
 Dr. David Madow: Right. What’s the story on the banana? I mean come on.
 Dr. Richard Madow: She said you’ll get more radiation eating a banana. I said, like a microwave banana? But I’ve never heard of that before. Have you ever heard of that before?
 Dr. David Madow: No. I’m a little bit worried because I had a banana just a little while ago. I’m a little concerned. 
 Dr. Richard Madow: I had two bananas today already. It’s one of my favorite foods. Favorite of all time. I googled it and there are people claiming and maybe this is on the ADA website. I didn’t check that out. But a small percentage of the potassium in bananas are like ionized potassium molecules. Technically they are radioactive and they enter your body when you eat a banana. But if you read a little further, you’ll see there’s no scientific basis for that because your body has a way of keeping the amount of radiation – and again I’m getting all this wrong. But essentially, the bottom line is you don’t get radiation from eating a banana. Your body has a way of regulating that.
 Dr. David Madow: I feel better now.
 Dr. Richard Madow: I know. Actually, you’re glowing a little bit. 
 Dr. David Madow: I didn’t tell you what I had a little while before we started recording. I had one banana; it might have been radioactive and I had a nice big glass of heavy water. 
 Dr. Richard Madow: Wow. How heavy was it?
 Dr. David Madow: It was pretty heavy.
 Dr. Richard Madow: You do a – I actually had a couple of isotopes. 
 Dr. David Madow: Do you know where that new restaurant called Teledyne Isotopes?
 Dr. Richard Madow: Yeah I have a friend of mine who works at Teledyne Isotopes. I ordered a few to go, Grubhub just delivered them. 
 Dr. David Madow: Sir here are your isotopes. 
 Dr. Richard Madow: Thank you.
 Dr. David Madow: Tip the driver please. 
 Dr. Richard Madow: So bottom line, I said I’m going to find a dentist that’s not a member of the American Dental Association. She just kind of chuckled. At that point, I think she probably did the right thing. 
 Dr. David Madow: I think it turned out that you were perceived as a nutcase. Let’s face it.
 Dr. Richard Madow: Exactly. 
 Dr. David Madow: She did the right thing. 
 Dr. Richard Madow: I’m not sure I want to even give her a grade. 
 Dr. David Madow: Yeah I think grading her might be difficult because there’s so many twists and turns, and then at the end you said I’m going to find a dentist that’s not a member. And so, she had to just say okay bye. So maybe she should get an A for that part. For that part at least.
 Dr. Richard Madow: Yeah I’m going to give her not bad. I didn’t like the whole fraud thing. That was kind of biased. 
 Dr. David Madow: Okay so just to summarize, I think we can both agree that she should have done everything possible. Be kind, invite you in to the office for your initial exam, even for a consultation to talk about it. And then once you’re there, that’s when they handle the whole thing. Not on the phone. 
 Dr. Richard Madow: Right. So I’m never sure if it got into the phase of maybe you should find – I want to find a dentist that’s not a member of the ADA or eating a banana, or that biased. So again, I’m going to lower her grade now to a B, maybe a radioactive B. I’ll give her a B+. But maybe it’s like a charge Ion on a B-, I don’t know. Whatever it is. Not bad though. Certainly not bad.
 Dr. David Madow: That was a fine grade because she probably did – I’m not going to give her a good grade because if she did it right, she would have gotten you in for some type of consultation or first visit to discuss in the office. I think she didn’t do it right so I’m going to have to go with a D. I’m sorry.
 Dr. Richard Madow: Okay. I think she said our office is right next to the tanning center. That maybe would have been good. Okay, well hey. Interesting stuff today. That wraps up Episode 12 of Season 2 of the Dental Practice Fixers. Thanks so much everybody for all your kind comments and ratings and all those great things. We really really love it and we hope this show is informative to you and helps your practice. So hey, I’m Dr. Richard Madow.
 Dr. David Madow: Dr. David Madow, we will see you next time. 
 [music playing]
  
   

You Sold Your Dental Practice – The Best Way to Announce the Change to Your Patients and Your Team

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Welcome back to The Dental Practice Fixers podcast, dentistry’s most unique show! Today we have a question from a long time follower asking us the best way to tell his patients and his team that he has sold his dental practice and is out of there! This is actually a fairly common question we are asked and when we hear how most docs are doing it, we cringe. In this episode we share with you the very best way to communicate to the world that you are leaving, and do it in such a way that your team and patients will mostly stay with the practice!  Then of course we do the call of the week.  Witness what happens when a simple question is asked such as “Are you really doing dentures and repairs in your oral surgery office?” If you have a question that you would like answered on our podcast, please send it in to podcast@madow.com. We will do our best to get yours answered!

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You Sold Your Dental Practice – The Best Way to Announce the Change to Your Patients and Your Team

The Dental Practice Fixers podcast is brought to you by the Madow Center for Dental Practice Success. To find out how we can help increase the success of your practice, check out madow.com or call us at 1-800-258–0060.
 Dr. Rich Madow: Hello everybody out there in podcast land and welcome to season 2 episode 2 of the Dental Practice Fixers Podcast. I am Dr. Richard Madow, I am here in the studio in beautiful Reisterstown, Maryland with my esteemed co - host, and business partner and brother Dr. David Madow. How is it going today Dave?
 Dr. Dave Madow: Don’t forget the brother part.
 Dr. Rich Madow:  How could I forget that.
 Dr. Dave Madow: I have been your brother almost all your life. 
 Dr. Rich Madow:  All my life, almost all your life. Isn’t that how it would go.
 Dr. Dave Madow: I think so.  So, what’s going on? It is good to be back in the studio with you man, really good.
 Dr. Rich Madow:  It is fantastic; season 2 is rolling on.
 Dr. Dave Madow: I am excited; season 2 is turning out to be great so far.
 Dr. Rich Madow:  Thank you much for your comments not just about the special episode, but season 2 episode 1.
 Dr. Dave Madow: Wow, that very first phone call we did on episode 1, crazy.
 Dr. Rich Madow:  It was nuts people seemed to enjoy it except for one person who found it offensive for some reason. I am not sure why but hey, 
 Dr. Dave Madow: You know what they say, when you are not offending somebody you are not doing your job right. But this there is something like that right?
 Dr. Rich Madow:  Is that your motto?
 Dr. Dave Madow: Kind of like, I am trying to offend 50%.
 Dr. Rich Madow:  You have already offended me today; I don’t know if you are doing your job perfectly.
 Dr. Dave Madow: Perfect, perfect. 
 Dr. Rich Madow:  Fantastic, well let’s get down to a really, really fantastic listener question for season 2 episode 2, what do you say Dave, you wanna take it away? 
 Dr. Dave Madow: I will take it away and by the way, thank you so much for your question. We are gonnawithhold your name as per your request so, just to let you know, if youever have a question and let’s say it is of a very personal nature,just send it in to us, if you wanna do it privately that's fine by email. And the email for our podcast is again it's  podcast@madow.com  I believe right, we haven't used it for a little while.
 Dr. Rich Madow:  Well yeah that's right you can always do info@madow.com  I-N-F-O @madow.com and Hope, who handles the info emails will be sure it gets to the right place.
 Dr. Dave Madow: Yeah, but if they just checked also, I’m pretty short its podcast singular because then I think on our website it’s podcasts 
 Dr. Rich Madow:  You know why can’t we get this uniform, you know we got a podcast.
 Dr. Dave Madow: I tell you something, we got to talk to our web guy, it’s just unacceptable, I think.
 Dr. Rich Madow:   I agree, but the point why can't we make it so if somebody sends an email to podcast or podcasts@madow.com it goes to the right place? How tough would that be? Is that asking too much?
 Dr. Dave Madow:  I think it's a high level very, very high level.
 Dr. Rich Madow:   That's higher than my level but I think somebody could do it.
 Dr. Dave Madow:   I think the point is if you want to send us a private question just tell us to please withhold your name, keep it confidential because they're so, there could be some questions that are very confidential so you don't want your team knowing that it's actually you.
 Dr. Rich Madow:   Or if you are a team member, you don't when your doctor knowing it's actually you, we would take those as well.
 Dr. Dave Madow:  That's very true but let’s get into today's so we're gonna read this and we will withhold the name, “Hey guys, let me start by thanking you guys for the past 15 years, maybe more, since I started getting the original Richards Reports, most of which I still have on my office shelf in the attractive gray three-ring binders. I appreciate the fact that you were wet finger dentists and had very practical tried-and-true advice. Plus, you were funny; reading back through a few of your old newsletters and didn't think you were God’s gift to dentistry.” You know that’s, I like that first of all Rich because I think we always try even back in those days, we try to come across as and we really are just regular guys, we're not like these you know superstar wanna-be type people or just history.
 Dr. Rich Madow:   Especially when it comes to clinical dentistry. I mean we were both good dentists but we certainly weren't you know the Dawson and Rose and Falls and Hornbooks of the world.
 Dr. Dave Madow:  Right exactly so, hey I appreciate that compliment. Keeping your anonymous doctor, “I’m ready to say that I'm planning on changing careers also known as retirement sometime early next year. I will stay on as an employee for about six months to ease the transition; this has not been made public yet for fear of patients scrambling to find someone else and depleting my patient base. Although I’m hoping my base is loyal enough to at least try the new owner before leaving. Anyway, how do other offices handle this transition? When do they announce to their employees who don't know yet either and to their patients? The most people send out letters to patients, a record and when do they, if they send letters?  I'm not sure how to proceed here but with your vast network of doc's, I would assume you’ve run into this before, thanks so much.” doctor beep, we can't give his name or her name, we can't even say it to he or her; we're not allowed to do that.
 Dr. Rich Madow:    I think you pretty much spilled the beans one of being a he though, let's face it.
 Dr. Dave Madow:  How did I do that again? 
 Dr. Rich Madow:    When you said we can't give his name
 Dr. Dave Madow:  Or her.
 Dr. Rich Madow:    That’s okay, it doesn't narrow it down all that much.
 Dr. Dave Madow:  We are not sure of the gender, let’s just say that.
 Dr. Rich Madow:     I okay it might be one of those names where you can't tell the gender either like you know Pat.
 Dr. Dave Madow:  Dr. Pat.  
 Dr. Rich Madow:     Terry were some other. 
 Dr. Dave Madow:  Pat Terry.
 Dr. Rich Madow:     Dr. Pat Terry, Marian used to be a man's name way back in the day, right? I think these days I don't think even women are named Marian anymore. But remember one Marian was
 Dr. Dave Madow:  That’s you dear.
 Dr. Rich Madow:     A grandma, was there of a faculty member at University of Maryland Dental School…
 Dr. Dave Madow:   Marion, Marion Barry. There's Marion Ratliff, he was the he was in Period Department at the Omarion, well anyway let's get back to the question from him or her, you know do we send, how do we how do we let our patients know, do we send a letter and?
 Dr. Rich Madow:     First of all, there was something that he or she first I think is really important and that is when do you tell the team? And I know I certainly went through this when I sold my practice Dave, I'm not sure if you went through because you sold your practice to your partner so it's a little bit of a different situation.
 Dr. Dave Madow:   Yeah, I never told my team I was just out of there.
 Dr. Rich Madow:     They didn’t even, they didn’t even notice.
 Dr. Dave Madow:   They didn't know I was gone; just darted out of there one day.
 Dr. Rich Madow:     This is something I really struggle with because my team and I were tight Dave, as you know we were great. I really loved and respected every one of them. Some of them loved and respected me maybe not all, but in any case, I didn't want to just surprise them or you know come in one day and say hey guess what the practice is sold here's your new boss. But the thing is I had to do it that way and this is something that the practice broker that I worked with advised me on, and once you understand the logic it makes sense because, let's just say you tell your team hey in two months I'm, the practice is gonna be sold. I won't be here anymore; you're gonna have a new boss. They might start scrambling looking for new jobs you know, no matter how much you ask people to keep things quiet, you know they tell a spouse then the spouse tells a friend and a friend tells, so the word gets out. And it's just not something you can risk because that’s not fair to the buyer; it can decrease the value of the practice; all kinds of bad things can happen. So as tough as it was for me and it’s difficult Dr. Anonymous as I'm sure it will be for you, I would recommend, I'm not happy with this recommendation but I think you cannot tell anybody until the ink is on the contract, do you agree Dave?
 Dr. Dave Madow:   There's no other way around it; you have too many, too many problems are gonna arise if people know early so yeah totally agree.
 Dr. Rich Madow:     You know you may remember we had already started doing TBSE when I sold my practice. And at that time a lot of my practice team members came out to help us with TBSE.
 Dr. Dave Madow:    I remember that.
 Dr. Rich Madow:     And I sold the practice right before one of the TBSE’s and then had to go in and announce it to them and one of them got so pissed that she didn't even show up at TBSE, she just kept on yelling, “Screw you!”
 Dr. Dave Madow:   Who is that?
 Dr. Rich Madow:      I'm not gonna mention any names.
  Dr. Dave Madow:   She's not listening to this podcast.
 Dr. Rich Madow:     You never know, you never, she was really sweet, and I felt really guilty because it just was the wrong side of her and it was, it was not a cool thing, well cool or no cool, but something that had to be done.
 Dr. Dave Madow:   You had no choice, there's really no other way to do it?
 Dr. Rich Madow:     And I agree I totally agree. So, how about contacting the patients?
 Dr. Dave Madow:   Yeah, I think a letter should just be sent down said I've sold my practice I found somebody to buy it and he's really good; hopefully try them, see you later.
 Dr. Rich Madow:       I was thinking god I hope he's kidding.
 Dr. Dave Madow:   See you later I'm out of here bye, it’s been a great twenty years. 
 Dr. Rich Madow:        But yeah letter, letters are always great. I think in the lot you know it’s funny I think people like patients, whatever don't really think of a dental practice as an entity that could be sold necessarily. I think what they like to hear is that you've, after careful thought about your retirement and the direction you want to take, you’ve carefully selected Dr. Big Check to come in and be entrusted with the patients’ care.
 So, let me ask you doctor, how did you, how did you select this person, this doctor is it, was he, did he have like the best clinical skills; did he, was he like number one in his dental class, is he just an incredible personable person?
 Dr. Dave Madow:   He's not called Dr. Big Check for nothing, though he's the one that gave me the most money, you never say that though. No but hopefully, but all kidding aside, hopefully this doctor that you’re selling your practice to, is gonna be a good guy or good woman and 
 Dr. Rich Madow:       You've got to feel good about.
 Dr. Dave Madow:   You got to feel great about good clinical skills, personable you got, you got it, yet hopefully or else you know it's not really fair to them either because it practices, let's face it, it’s a kind of a loser; the practice is gonna go downhill it’s not a good thing for anybody. And you and you like your patients, you love your patients; you really do want the best for them after your retirement.
 Dr. Rich Madow:       Absolutely, and in some cases the selling doctor will come in and putz around, as we say, a few days a week and it would really be heartbreaking to see the owner taking the practice in a direction that you don't care for. So, there should be a philosophical simpatico between the seller and the buyer.
 Dr. Dave Madow:   But here's a philosophical question, suppose you get clearly a great, great offer from somebody who in your heart you just feel yeah, I just I just don't feel great about this guy, but then the next person who maybe feel great about it offering you a hundred thousand dollars making that number up a hundred thousand dollars less for the practice,
 Dr. Rich Madow:       What serious cash over.
 Dr. Dave Madow:   It is, it is I mean who is not gonna sell to the highest bidder, the highest buyer, who's not going to?
 Dr. Rich Madow:        Well I think so many of us count on the practice sales part of our retirement. And it becomes a business decision, right?
 Dr. Dave Madow:   Yeah and is it really, I may hate to say like this, it sounds kind of cold, is it really your responsibility to like vet the person for all, you know clinical personality, business skill, is it, is it fair just look you're selling your practice and somebody comes in with a green offer. Are you gonna turn it down as you say, I just don't think you’re right for my patients? Well I don't know; I think you know personality and business skills are one thing. If you have reason to suspect they're an incompetent dentist, I'm just not so sure I’d feel good about taking that check. I mean really incompetent.
 Dr. Rich Madow:       Yeah but it’s a tough one because again making numbers up the person comes in and offers you two million dollars in cash.
 Dr. Dave Madow:   And the next best person is offering 1.1 
 Dr. Rich Madow:       Examine, what do you do?  
 Dr. Dave Madow:   You sell.
 Dr. Rich Madow:       You know but I hope that's not gonna come up with any I'm yeah, I’m assuming with this doctor that wrote to us, it's you know selling to it to a good buyer, somebody that's gonna be, he's very comfortable with, I'm at worst scene is not the case here.
 Dr. Dave Madow: I hope so.   Let's go back to the letter for a second because we've seen good, we’ve seen bad, we've seen practices where the buyer, the new dentist is responsible for sending out a letter to the patients introducing themselves, big, big, big mistake yeah. It's really great if the selling dentist who the patients know and love sends out a really sincere letter saying you know after 23 years of servicing the community, meeting so many fantastic patients, I've decided it’s time for me to move on and I've selected the best dentist. Now here's the thing, what did you say that and you know the dentist is a shit dentist, what do you do?
 Dr. Rich Madow:       I still think you know, is it up to you to really evaluate?  I don’t know but I think you have to say, yeah you have to say that you’ve selected a great dentist, I think you have to. And not only that, does the dentist that's buying the practice get editing rights, does he get to look at the letter and say I think you need to change this a little bit or I guess it has to all come up in the deal, but should they get editing rights?
 Dr. Dave Madow:  I'm not sure that would actually be included in the contract of the sale that the buying dentist gets editing rights to the intro letter.
 Dr. Rich Madow: Because we looked, you and I know how to  write letters but let's say you, let's  say you were buying a dental practice  right now from a dentist and that  dentist was about to  send a letter to his or her patient base,  and you looked at the letter, just sucked, it was horrible, it  was gonna hurt your practice, wouldn't you feel like you have the right to say,  look this letter just isn't right,  don't you feel that's a courtesy that  should be extended to anyone?
 Dr. Dave Madow:        I would think so too.
 Dr. Rich Madow: It kind of has to be negotiated because suppose that selling dentist, just know this is a letter I'm sending out, it is from, it's from me is what I'm saying but that could, that could like hurt the practice by you know 20 percent, 30 percent way…
 Dr. Dave Madow:        It could be horrible and we’ve seen some really bad ones pretty much saying you know I'm retiring I’ve sold to this dentist, it's all the wrong words. So, if you are a dentist who’s in the position that you'll be buying a practice soon, keep that in mind.
 Dr. Rich Madow: Got it because you know they see that letter they talk about like you know I just I just wrote a letter that um I made I made fifty thousand dollars from writing one letter. I mean well this could be that letter I mean it's it could be serious money because if you’re turning off your patient base and they all go elsewhere, guess what the doctor that just bought the practice got ripped off or got you know it's short ended or something, it’s just, it's not cool. Yeah, we've seen that happen before to where a dentist purchases a good healthy practice and within the next six months to a year so many patients have left, so many bad things have happened and you just feel sorry for that dentist that spent top dollar and then didn't really know the proper way to do the transition. And you're right it could be the fault of these selling dentists as well maybe they didn't… 
 Dr. Dave Madow:        Nobody ever thinks of that but yeah think about this dentist is possibly  buying this practice with his or her life savings or taken out a tremendous loan or whatever it might be and this is everything. That letter means a lot, you know it's sad to say we’ve seen situations where we’ve been working with her, talking to the selling dentist and they have a purchaser for the practice and we meet the purchaser, and we just know that they are not going to succeed in that practice. We just know it then what do you do? You still have to take the, you have to let them purchase it right?
 Dr. Rich Madow: You have to let them purchase it and not only that, I think you have to write the letter that you think is gonna be the absolute best and do everything you can in the transition to help this person who's paying you a lot of money.
 Dr. Dave Madow:        Like for example I’m thinking of a dentist that we were friends with, working with, he just had one of those big lovable personalities, and he was selling his practice and the buyer just had no personality well how are these patients gonna feel after all those years, it’s not easy.
 Dr. Rich Madow: Yeah, I think the selling dentist has to do the best that he or she can but after if that from that point on it’s, I hate to say, it's not really their responsibility
 Dr. Dave Madow:        Not my problem.
 Dr. Rich Madow: It's really not of me; you sold, it’s not my problem the incoming dentist is devoid of personality or void or devoid, I don't know. 
 Dr. Dave Madow:        I think void and devoid mean kind of the same thing, kind of flammable and inflammable, why do they mean the same thing was always very confusing. I don’t know. 
 Dr. Rich Madow:   You don’t see the word flammable too much anyway.
 Dr. Dave Madow:        Oh, I see it a lot, all over the place, oh it's coming back, it's making a big comeback that word.
 Dr. Rich Madow:   Flammable and inflammable same thing.
 Dr. Dave Madow:        Gruntled disgruntled.
 Dr. Rich Madow:   Those are total opposites.
 Dr. Dave Madow:        Are you ever gruntled?
 Dr. Rich Madow:    I am gruntled right now, I am entirely gruntled.
 Dr. Dave Madow:         I feel good then.
 Dr. Rich Madow:    Good, you and James Brown. Hold on, now we're talking about something before we got off topic here.
 Dr. Dave Madow:         I will tell you where we are, I think we want to get into the call because whether we've we think we said everything has to be said about this dead horse, I think we have, but I mean do you have anything else to say about, I mean I think we've given this doctor great information.
 Dr. Rich Madow:     I was just gonna bring up   not memory as a closing point but  in case you are the seller we talked  about you know how do you feel about the  buyer blah blah blah blah blah, like how  much due diligence do you have to do if  they're licensed, if they you know, they  graduated an accredited dental school , they're a licensed dentist in your state, they are by law proficient and  technically allowed the practice of dentistry by law.
 Dr. Dave Madow: Right, yeah what would you do like you check their lab cases; what do you think, you’re not responsible for that?
 Dr. Rich Madow:      I think you’re not.
 Dr. Rich Madow: Now if they were like an associate in your practice, and you knew they sucked 
 Dr. Dave Madow: Well that never happens.
 Dr. Rich Madow:  Every associate sucks once they leave right, that's not the truth everything goes bad is blamed on the associate after they leave.
 Dr. Dave Madow: That's right.
 Dr. Rich Madow:  Yeah so, it’s a tough question but yeah make sure that you can't tell the team members until the contract is signed, the really nice well-written letter goes out on behalf of the selling dentist, explaining what happened, intro on the purchasing dentist.
 Dr. Dave Madow: Yeah do it the right way, great question Dr.  Anonymous. 
 Dr. Rich Madow:  Let's do a call. 
 Dr. Dave Madow: Excellent. Hey just a quick second before Rich and  I do the call,  real quick little  announcement here about some friends of  ours and group that we're very close  with them, they can really help you out  quite a bit,  dentistadvisors.com,  you know for  many years, probably several decades now,  Rich and I have been very serious about  our future and we've worked with  financial planners for quite some time. We wouldn't really do this ourselves because we're dentists and we don’t really know the ins and outs of financial planning. So, when we recommend financial planners, we generally recommend a group that, number 1, works exclusively with dentists here, they know the ins and the outs of your dental practice and what dentists are going through in their lives, they only work with dentists, they only do financial planning; they're not there to sell you all kinds of different products and talk about other weird things. They are financial planners and not only that they are fiduciaries which means legally they always have to do what's in your best interest.
 So, if you're looking to make sure your future is what it should be, where you want to go with your goals then you need a really good financial planner and we highly, highly recommend checking out Dentists Advisors, is really easy go to dentistadvisors.com, all one-word dentistadvisors.com check them out. By the way when you speak to them let them know that you listen to the Dental Practice Fixers podcast and that you are friends of the Madow brothers, I don't know what that'll get you exactly but give it a try and see.
 Dr. Rich Madow:  Good stuff. 
 Dr. Dave Madow:  Actually happen if we do the phone call.
 Dr. Rich Madow:  Let’s do a phone call today. Okay I'm not sure what to expect here, this is an oral surgeon’s office in Indiana that's placed some ads on Facebook and I think some other places as well saying that they do dentures, denture repairs and denture realigns. Which to me sounds a little odd for an oral surgeon in the office so let's give them a call and see what this is all about.
 Nikki: Oral Surgery this is Nikki how may I help you?
 Dr. Dave Madow:   I have a quick question for you.
 Nikki: Okay.  
 Dr. Dave Madow:    I saw on, I think it was on Facebook or somewhere that you are doing dentures and denture repairs.
 Nikki: We are in our Seymour office yes.
 Dr. Dave Madow:    Yeah, I told it to my dad because he might need a new denture and he told me that he didn’t think oral surgeons did dentures so I didn’t know so I thought I'd call and find out what is that what's going on.
 Nikki: Yeah, well we have we actually have someone that comes in specifically on Mondays and he fits our patients for dentures. So, are - they still have to see our doctor because our doctor has to do the initial exam because Mark is the one that does our dentures but he's not a doctor so he just works out of our office. But he is the one that fits our patients for dentures and you know that sends everything to the lab and then they do come to our office.
 Dr. Dave Madow:    Right so I don’t understand he's not a doctor what is he? 
 Nikki:  Mark is just the gentleman that, I mean he is just the one that fits us for dentures and he just fits our patients for the dentures.
 Dr. Dave Madow:     So again, I’m not trying to be flip here he's not a dentist but he comes into your office and he fits your patients for dentures.
 Nikki: Correct.
 Dr. Dave Madow:     And then what if the denture needs like to be adjusted or it's not right, he also
 Nikki:  That’s what he does, he does that as well yes. 
 Dr. Dave Madow:     So, what is it but what kind of training does he have?
 Nikki:  I mean I have no idea. I mean you could ask you could I mean I don't even know what’s Mark’s last name?  Okay I mean if you want to look him up his name is Mark [ / ] 
 Dr. Dave Madow:     So, okay so you're suggesting I just like google Mark  [ / ] ?
 Nikki:  Yeah, I mean I unfortunately I don’t know what Mark's training is before he came to our office, I had no what do you know how much you know how much training Mark had before he came to our office?  I told him to Google because I had no idea to be honest.
 I don’t know. He works in a couple different offices.
 Dr. Dave Madow:     So, just kind of like travels around with a little suitcase and dentures in different offices?
 Nikki:  I mean I don’t I mean I guess you could put it like that. I mean I don't really know I couldn’t give you any background information on Mark's training or where he went to school or anything like that, I have no idea.
 Dr. Dave Madow:     Okay but then one of the oral surgeons also looks at the denture?
 Nikki: Yes.
 Dr. Dave Madow:     Are there oral surgeon?
 Nikki: There are oral surgeons in our office right.
 Dr. Dave Madow:     And they know about dentures the oral surgeons?
 Nikki: Yeah, I mean they wouldn't have - Mark wouldn't work in our office if our doctors didn't feel confident that they knew what was going on.
 Dr. Dave Madow:     Okay I think I get the picture thanks so much for your information.
 Nikki: You're welcome, bye. 
 Dr. Rich Madow:     Wow that's a little scary isn't it ,  they've got this guy Mark coming into  the oral surgeons office, he's doing the  dentures from start to finish it sounds  like and they have no idea who he is,   what his training is, what kind of degree  he has if any, and it sounds like maybe  he's a lab tech I don't know if they  have denturist in that state not sure  exactly what's going on there. But that was pretty creepy wasn’t it?  I'm not so sure how much confidence I would have in that and if I were a general dentist in that area would I be too happy about that having some kind of non-dentist coming in to an oral surgeon’s office and doing dentures?  I'm not sure, but you know what, anything goes on the Dental Practice Fixers so you decide what you think is going on in this practice and get back to us with your comments podcast@madow.com 
 And that concludes another episode of the Dental Practice Fixers, I’m Dr. Richard Madow, I'm here with my co-host Dr.  David Madow and we will see you soon.

 

Season 1 Episode 17 – Paying Team Members and More!

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We answer a couple of really good questions sent in by listeners in today’s episode. One has to do with paying team members during meetings, CE and down time. The other addresses coverage when the doc is out of the office so you don’t lose any patients. And of course we start each show with a great money making tip for you and end with our “Call of the Week!” Please join us! If you like what you are hearing, please do us a favor and give us an honest review on iTunes! And share with your dental friends!