Trust Takes a Lifetime to Build

I have heard it said that trust takes a lifetime to build, and a second to lose.

Last week I was working with a patient. She had an existing crown with a cavity that had penetrated into the tooth underneath it, making it necessary to remove the crown, clean out the cavity, and make a new crown for the tooth. After I had taken off the existing crown, I got a better view of the adjacent tooth. It also had a crown on it, and with my new and improved view, I could see that there was a cavity underneath this crown as well and that this tooth would also need a new crown for an appropriate repair.

I stopped what I was doing and let my patient know what I was seeing and what the recommended treatment would be. Notwithstanding her displeasure at needing more work than she had planned on, she looked at me and said simply, “OK.”

I was struck by this person’s trust in me and in my team. As most know, a crown is a significant investment. And here I was, asking this patient a “spur of the moment” question that involved a considerable expense. I felt grateful for the amount of trust she placed in us and I also felt a great sense of responsibility to honor that trust – to always exercise honesty and transparency in everything I do.

Now, I am not perfect. In fact, I have been called a “snake oil salesman”, a “carpet bagger”, and other less appropriate names. But notwithstanding my imperfections and the ways that others perceive those imperfections, I know that my goal is to be perfectly honest in all things. That is what I strive for because I believe it is right. I also believe it is difficult to trust someone that is not perfectly honest in all things. One would wonder, “What might this person not be honest in?”

And herein lies the dilemma: I may have the goal to be perfectly honest. The intent and desire of my heart may be to be perfectly honest. But the fact of life is that I am human and not omnipotent. As a human, I am imperfect and subject to making mistakes. As a less than omnipotent being, there may be forces at work that are beyond my control that foil my best efforts at providing a successful service.

Let’s say that, despite our best efforts, there is a scheduling error – for some reason (it was input incorrectly, the save button wasn’t clicked, something took our attention for a moment, etc.) a patient’s appointment was not properly recorded on the schedule and when that patient arrived for her appointment the schedule showed she did not have one and there was not a way to fit her in. Our intent is always five-star customer service. However, because of our error, she may perceive that we do not care about our patients, become upset, and maybe even yell at us (yes, it has happened :^).

An example of something out of my control would be a vertically fractured root. These are often undetectable, difficult to diagnose, and cause a lot of grief. A tooth with a vertical root fracture is hopeless and must be removed. However, the symptoms are identical to those of a tooth with an abscess and needing a root canal. Even if the root canal is performed perfectly, the tooth will continue to have symptoms and deteriorate. This is typically when an undetectable fracture is diagnosed – when all other options have been ruled out. It is also when patients are tired of dealing with discomfort and pain and get easily frustrated because they haven’t yet achieved the positive results they were hoping for. And this is when some perceive that I am trying to profit from their misfortune, simply because their desired outcome was not achieved and their problem has not been resolved, despite my best efforts and factors beyond my power to control.

I am deeply grateful for patients (and employees) who, in spite of my imperfections, trust me; grateful for those who understand that intention does not always equal outcome and who continue to trust our office with the immense privilege of providing their dental care.

Thank you all!

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Dr. James Burneson

Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.

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