Associate’s Corner: A Tale of Two Plumbers
By Dr. Helen Yang Meyer
Recently, my husband and I invited two plumbers to evaluate our new fixer upper and quote the costs to create a kitchen island and add a gas line. The two resultant very different consultations led me to reflect on my own communication style with patients.
The first plumber was middle-aged, affable, and confident. He said the job looked straightforward, took measurements, and told me the plan to bury the sink waterline under the floor and extend it three feet. He was in and out in 10 minutes with a promise to email me the quote in a few days. I felt confident and eager to get started.
The second plumber was older, grizzled, and more measured with his words. After evaluating the kitchen setup from above and below, he said that while our kitchen island plans sounded feasible, he couldn’t be 100% sure. He pointed to a section of basement air duct directly below and explained that it may get in the way and that “the original pipes were likely plumbed this way for a reason.” He described a few possible scenarios depending on what’s under the linoleum, and asked me to first get the floors ripped out so he could return and give me a more accurate quote.
My encounters with the plumbers parallel our patients’ experience with us endodontists (not in the least because we work on tooth pipes). Most patients come to us already aware of a problem, have an idea of the overall plan in which our specialized skills fit, and want our opinion on the feasibility and cost of treatment.
The first plumber reminded me of endodontists whose consultations are concise and decisive. Their patients leave with a plan, optimism, and typically proceed to treatment right away. The second plumber reminded me of endodontists whose consultations are lengthy and detailed and may ask the patient to first return to the general dentist to deconstruct the restorative work and assess restorability. Both approaches to consultations have pros and cons.
As an endodontist, most of the teeth referred to us are not straightforward, which is why I prefer to see patients for an initial consultation. I believe in covering all the ground efficiently so patients know what I know and can make a truly informed decision. We review what a questionable prognosis entails, especially for retreatments and teeth with suspected cracks. I touch on their future restorative plan and goals of care and how this tooth may (or may not) fit the plan or their goals. I encourage them to consider managing parafunctional habits or periodontal conditions that reduce the outcomes of those endodontically treated teeth.
However, being on the receiving end of the second plumber’s consult style, which seems closer to my own, made me feel annoyed. I wanted him to tell me that a kitchen island would be easy and painless (for my wallet). He was doing me a favor by not overpromising and underdelivering — a sign of a consummate professional — but he didn’t leave me wanting to work with him. Are my patients leaving consultations annoyed at me?
We doctors must be able to recognize the consultation style that’s appropriate for the specific patient and situation — indeed one size does not fit all. In predictable, routine cases, most patients benefit from a clear treatment plan and a doctor who expresses confidence. Excessive time spent talking and reviewing risks may lead the patient to question the doctor’s abilities, to decide against or delay treatment, which could be detrimental. On the other hand, in challenging, unusual cases where the diagnosis or prognosis is uncertain, or for patients who are more demanding or less tolerant of risks, doctors should tread more deliberately and spend extra time to ensure the patient is fully informed and onboard with treatment. The bottom line is, it’s our responsibility to work in tandem with the general dentist and help patients make the best decision for their dental treatment.
The kitchen island will be done next week, fingers crossed.