It is your job to educate the patient and give them a realistic understanding of the procedures. Explain things clearly and use terms that are understandable. Try to present your explanations with the proper balance between what is expected and what could go wrong. You must warn the patient about the very worst-case scenario without scaring them away from the preferred treatment:

• Begin by explaining that the procedure is not usually a worrisome event if that is the case.
• With risky procedures that have many problems associated with them, be forthright.
• Explain any and all adverse possibilities that could occur. Even if the occurrence is one in a thousand, the complication is one hundred percent when it happens to your patient.

Here is an example of a thorough explanation with an element of humor. It can help you formulate a script for all of the procedures you perform:

DOCTOR

“Root canal therapy is not usually a big deal. As a matter of fact most of my patients tell me it’s the greatest thing they ever experienced.”

Pause:

The patient will usually smile, laugh, or make comment. You smile back and continue.

DOCTOR

“Of course I’m just kidding. The reality is that you could have some discomfort or pain afterward and this is completely normal. A small percent of the cases could experience pain for a few days. It’s usually handled well with some Tylenol or Advil and it settles down. In rare cases you could have a flare-up, whereby you have pain and swelling that could get so bad you’d want the tooth pulled.

This is rare and almost never happens.”

If this patient has a severe flare-up, they have been forewarned and are less likely to assume the practitioner did something wrong.

I saw a minor male patient for a postoperative complication of pain and swelling. As soon as I entered the room, the mother was on attack mode. “In all my experience with root canals, I never saw anything like this,” she asserted. I asked her, “How much is all your experience?” She told me that she had two root canals. I almost laughed, but refrained and just let a friendly smile show. “It’s interesting that in all your experience you may not have seen anything like this, but I’ve treated around a thousand cases each year for the past thirty years, and I’ve seen this a few times.”

I looked into my notes and saw the specific entry warning the possibility of a flare-up notated because this particular case was the type that has an increased chance of complications. I looked up from the chart and said, “Mrs. Smith, I see a note here that indicates we discussed the possibility that this tooth could flare-up. Do you remember that discussion?” She went on to apologize for attacking me, and I told her I’m sure I’d react the same way (you have to lie sometimes). I, again, explained how the dormant infection could act up, that the antibiotic wasn’t doing the trick, that we would increase the dose, and, if necessary, switch to something stronger. I took all the time necessary to explain and answer the mother’s questions while knowing the next patient was probably getting annoyed waiting for me as I went further behind schedule. That’s bedside manner. That’s avoiding lawsuits when things go wrong.

Even the best-loved doctor may get sued if the damages are large enough. A death after a routine procedure will surely see some legal discovery to determine if the doctor could be at fault. By arming yourself with all the proper documentation, and by being there for the patient and family in times of trouble, you provide the comfort your patients deserve, and keep yourself safe.