• Goodwill and not-so-good dentistry in practice sales
Apr 3 2019 - Simon Palmer - Buying a dental practicePractice sales

 When you’ve bought a practice off another dentist, it will always be a little nerve-racking to step into the old owner’s shoes. Both the patients and staff are used to one way of doing things and, as the new owner, you’re bound to have new ideas. It feels like all eyes are on you, to see if you are going to do things differently. At this stressful time, one of the hardest tests that a buying dentist will face is if they start seeing the existing patient base and see:

  • Clinical work that they do not agree with
  • Under-diagnosis
  • Subpar clinical work 
  • Some combination of the above

On the one hand, you might feel like you have an obligation to bluntly communicate what you are seeing…on the other hand, if this communication is handled badly, it might cripple the goodwill transfer process at a crucial juncture in your relationship-building with the community.

There are three reasons why this disclosure may not be such a good idea:

1. You should never judge a person till you’ve walked a mile in their shoes

If the treatment provided does not appear to have reached the desired outcome, do not assume that the other dentist is at fault. It is easy for a dentist to look at less-than-optimal clinical work and secretly pat themselves on the back for being a better clinician. However, looking at the clinical work doesn’t give you the context under which that treatment was delivered. All dentists have had patients who are challenging to manage when they get in the chair, and no one should be expected to do their best possible work under all conditions and circumstances.

  • It could’ve been 5pm on a Friday and the patient wanted a quick fix for a wedding the next day and the dentist did an emergency temporary treatment, but the patient didn’t come back for two years. The patient may not remember or disclose the circumstances of the treatment to the new dentist and there might be no notes.
  • They could have had extra work done by a third dentist while they were on holiday, that the patient is not disclosing.
  • The mediocre dentistry that you were critical of might look admirable on a patient who was suffering from some temporary combination of dental phobia, inflamed tongue, ocean of saliva, a severe gag reflex, a small budget or vertigo whenever the chair goes back.

2. The patients and the staff may not believe you.

A practice’s long-standing patients and staff will often have a deep sense of loyalty to the previous dentist and trust their clinical judgement and ability over yours (after all, they just met you!). Patients and staff in this category may doubt your credentials and motivations for criticising the previous work done by their beloved long-standing dentist. There is a high risk of losing this patient or staff member (and their network) if you start criticising their trusted dentist.

3. They may believe you…but it makes you and your practice look bad

Let’s say that you tell a long-standing patient of your new practice that they have previously paid for subpar dentistry in the practice and they believe you. You may feel that you’ve spoken the truth, but this doesn’t mean that they will thank you for it. A more than likely outcome is that the patient will be justifiably upset and possibly angry at what has happened. What you may not realise is that this upset and anger won’t just be directed at the previous dentist, but:

  • At themselves for being duped by an unethical or incompetent dentist.
  • At the practice (your practice) as a whole, for having had them pay for poor dentistry.
  • A patient who feels duped once by a dentist will be doubly cautious going forward with any diagnosis given by any dentist. They won’t easily accept the remedy or any future treatment that you are suggesting.
  • There is a high risk of this patient leaving the practice and telling people what happened there.

4. You would compromise goodwill transfer from the previous dentist.

Comments that you that you make to long-standing patients or staff, who you feel the previous dentist did poor work on, have a good chance of being passed on to that previous owner and ruining your relationship with them.

That relationship is vital and needs to be maintained, in order to maximise the chances of goodwill transfer and minimise patient attrition.

For years post sale, everyone will be asking the previous owner what they think of the dentist who bought their practice. You don’t want to compromise your chances of getting a strong endorsement by giving avoidable criticism about their dentistry to a third party.

So… with the stakes so high, if you see subpar dentistry that was previously done in your new practice, what do you do?

How you deal with this scenario will depend greatly upon the severity of the clinical compromises made by the previous dentist:

1. If the work isn’t up to your clinical standards, but is adequate, and the patient has no functional or cosmetic complaints, then it is probably best to let it go and ‘let sleeping dogs lie’.

2. If the work isn’t up to your clinical standards and needs to be fixed or replaced:

a. Try to do so at a financial discount (or free) and
b. Try to point out things that were done right by the previous dentist, to reinforce the patient’s relationship with the practice.
c. Don’t implicate wrong-doing on the part of the previous dentist.  Say things like:

  • “It looks like the dentist did everything they could to make this perfect. I’m sure the other dentist did the best job that they could at the time. Like medical treatment, dental treatment doesn’t always go as planned and sometimes there are complications and hurdles that appear along the way…especially with big cases."
  • “ These things happen. They happen to me every now and then, too. What’s important is that we turn this around before it becomes a problem.”
  • “It looks like your previous dentist has done some heroic work trying to save this tooth and was putting fillings on your fillings on your fillings in order to keep the tooth there. It seems that there is now next to no tooth left, and I’m afraid we are going to have to put something here that will give this tooth some extra strength. Something made outside the mouth that won’t rely on the tooth for anything except a foundation. If you want, I can take an X-ray and check if there is a reasonable foundation."
  • “We've learned an awful lot in dentistry in the last few years, and I've been doing a lot of post-graduate study, and we know a lot more now than we did even a year ago. Best thinking on how to approach this treatment has changed. Dr X has tried the traditional way to get a result here, but now I think we need to take advantage of what we now know to be best treatment."

There is no need to lie about previous work that has been done… but there is no need to tell patients and staff that that you think the dental work they had done is poor either. The real truth of the matter is that there is nothing for you to really gain by publicly criticising the work of the previous owner of the practice, and much to lose.  There are much more diplomatic ways of dealing with these issues, which don’t expose you and the practice to possible goodwill loss.