Referring Doctor Dilemma

Referring Dentist Dilemma
What Would You Do?
I sent out an email recently sharing my experience I had with a patient I had acquired from the internet.
She needed a restorative dentist involved to help assist with the case. We referred her to a local GP and now he is doing the ENTIRE case.

Here’s a quick review of the situation:

Last month we saw a patient that came to our office via one of our “Google” Adword campaigns. She wanted options for her teeth and we developed a treatment plan that involved:

  • Several extractions/bone grafting
  • Scaling/root planning
  • Future implants
  • Temporary partial to be made by a GP

Chief complaint: She wanted to save what she could.

I asked her if she had a dentist that she currently sees and if so, they could make her temporary partial. She claimed that she had seen one off & on in the past and would more than likely go see him.

Our office called the dentist, explained the treatment plan and scheduled her both for her surgical appointment at our office and also her appointment for the temporary partial at their office. So far so good.

My team called her two days before her surgery appointment to confirm & was told that the other dentist decided it was BEST to remove ALL of her teeth (went against her chief complaint) and he was planning on performing ALL treatment including immediate dentures.

So my question to you is…How would you have handled this situation?

I’d love to hear you how you’d have handled it by typing in the box below.


Here are a few of the responses we’ve gotten thus far:

Dr. Peter Kim:  Call the dentist up and engage him in your treatment plan by explaining how much more  profitable it would be to restore implants. Most likely this dentist is not comfortable or  does not know how to restore implants. Let him know that you will make it as easy as possible to restore implants and guide him every step of the way.

Dr. Peter Calongne:  I’d leave it alone. He’s his own worst enemy.

Dr. Gregory LaMorte: I would call the patient myself and explain my concern about her going from no removable teeth to complete dentures.
I would also ask her permission to speak to the other dentist about treatment plans. BTW, I has a similar station recently.  I explained my concern and the patient accepted my plan.

Dr. Roger Parkes:  Jeff, thank you for the opportunity to reply to this situation. I also tried to follow through with a patient from our website and lost the patient because she was sent back to a doctor we don’t usually work with. Now, when I get a patient from the internet, which is average 24 a month, they are all mine unless there is a doctor on the other end that refers to me. I send them to who I want them to go to or I don’t do the treatment. Then I know that my treatment plan will be followed through on and that the patient will receive the best treatment.

Dr. Douglas Magner:  I am guessing this patient did not see this dentist on a routine basis and did not follow through with his treatment recommendations in the past. I think she may have been presented with a treatment plan to save her teeth that was unaffordable for her and was not given options on how to obtain financing or stage her treatment so this could be paid out over a period of time. She may have been told that she would spend this money but eventually lose her teeth anyway. I would call the patient , thanking her for the opportunity to try to achieve her dental needs and ask her what made her change her mind.  I would let her know that she might not be happy with dentures and implants could still be an option for her in the future and that bone grafting in conjunction with the extractions might help preserve her bone for that possibility.  I would also assure her that you are happy to work with her dentist to achieve a satisfactory result and you are concerned for her well being.  If she is ok with this, I would then speak directly with her dentist and let him know you are still involved with this patient’s treatment and wish to develop the treatment goals together with him.

Dr. Dan Barabas:  I actually had this happen to me not too long ago. I referred a patient back to gp to plan to extract all teeth and make a hybrid. The practice had just transitioned and she didn’t know the new guy, and I had only minor interaction with him. We had a phone call where I outlined my plan. The patient called me weeks later and said she had an appointment to do everything at the gp office three days later, and wanted to make sure I was comfortable with that. They told her that was why I sent her back there! Total lie! I explained I was a board certified implant surgeon and my role was to place the implants and extract teeth, and their’s was as restorative specialist. She liked my approach. In this case the patient saved me. She called them up and told them she couldn’t trust them and I found a restorative dentist both of us could. I placed 6 implants yesterday on her.

Dr. Leslie Paris:  Jeff- that’s a good one- I have had similar situations like that occur over the years.  My favorite “Oh no- we were planning on doing all of the treatment here in our office- we just wanted you to do the treatment planning”.

  1. Call the general dentist and communicate verbally what the situation is and ask why he/she  decided to go against the patient’s original wishes- or were they even informed of the patient’s wishes?
  2. Is there a reason he/she  didn’t communicate the change in the treatment plan with you?
  3. Don’t lose sleep over a “referring” dentist like this one-  they don’t change easily and your time is better spent empowering and educating those who appreciate your expertise!

Dr. Brian Secrist:

Dear (insert GP)

Thank you for seeing pt x that we referred to your office for coordinated multi-disciplinary treatment I understand the patient decided to have all of her teeth removed. When she came to our office from one of our external marketing ads she wanted to save as many of her teeth as possible. We have e mailed you a copy of her records for your files (provided she signed some hippa form allowing you to share her information )  Please let us know if we can be of further help to this most deserving mutual patient

Sincerely and respectfully

Your name

Dr. Dan Harper:  Unfortunately not much you can do … I used to get this one Doc who would refer me patients just so he could get my treatment plan and then have his staff personally call my office to cancel the procedure(s) … I did write him a very diplomatic letter saying I no longer wish to work with him ..

Dr. Alireza Khansari: 
If the GP is not your referral send her to your platinum referral and work together  on her case.  Usually a big case like that, especially a  “google search”  one are not very reliable.
This the era of the technology that you want to have.  More visibility online but most of online patient are just shopping around.


Thanks to everyone that contributed to this post. Keep em coming!

Dr. Jeff





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