Nothing feels better than doing meaningful dentistry.
Most dental practices run like businesses. Sometimes the dentist must step back and treat people with some common sense.
In my book The Art of the Examination, I told the story about Audrey. She was a patient with whom I connected right away because of a shared love of reading. I restored Audrey more than twenty years ago. Since that time, her health has failed. She is on dialysis, lives in an assisted living facility and has just about used up all of her funds.
But she continued to come in for her cleaning appointments every six months. The one thing in life that she really loved, reading, has now turned to listening to audio books, as her eyesight limited her first love to large print and then to no print.
Her dentistry, after all these years, I am sad to say, began to fail. A long span fixed bridge on the upper left developed caries. I condemned it. Remaking the bridge would be cost prohibitive for her.
What do you do?
Audrey spent her life trying to save her teeth and dreaded wearing anything removable.
So I invoked The Barkley Rule.
Dr. Robert Barkley practiced in the small town of Macomb, Illinois during the sixties. Dr. Bob Frazier, wrote in Lynn Carlisle’s blog (In A Spirit of Caring), in a wonderful 2003 biographical article that had Barkley lived (he died prematurely in a plane crash in 1977), he would have been as popular as any of today’s dental luminaries.
I had the opportunity to hear Barkley speak at my alma mater, The University of Penn Dental School in 1973. I became an immediate fan…and always remembered one story he told about a young high school girl who came to him for help during his early years of practice.
Barkley quoted the girl and her father a fee to save the girl’s teeth that was not affordable.
He lost track of the patient until a few years later when he saw her in a local Dairy Queen. He asked what had happened to her. To his utter shock and surprise, she told him that it was too expensive, so she went and had all her teeth extracted…
She now had full upper and lower dentures…she was barely twenty years old. He was so disheartened that he vowed never to quote a fee that was more than it would cost for dentures…if money was a barrier.
So that’s what I did for Audrey…I replaced the doomed bridge with a fixed bridge…for the cost of a flipper. And she needed installments to pay…
Really it was pro bono.
I have a coaching client who faced a similar situation recently. He too invoked the Barkley Rule. He replaced a twenty-year-old 6-unit bridge with an 8-unit bridge just so he could prevent his patient from going into a partial upper. He told me that his patient cried when he let her know.
Tom Brokaw once said:
“It’s easy to make a buck. It’s a lot tougher to make a difference.”
The long-term collateral benefits are too numerous too mention…can you think of any?
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