As I looked into their faces, I saw the faces of my mother, my aunts, and my uncles. These were older relatives that I loved the most, and the people I would be crushed by the most, if I ever failed them. As I began to treat more and more of these mature, beautiful people, a few other things came into view.

I first realized that there was a shocking void in our profession. It seemed as if we had lost our own souls. And yes, it felt like I had too at times. I had listened to too many "consultants" talk about 'production' and 'targets' instead of hearts and lives. I had gone to too many seminars on "selling" and doing crown preps in four minutes. I attended dental school reunions where classmates brought out pictures of their twin engine airplanes as if they were the most valuable things in their lives. And I thought, 'Is this what it's all about?'

So, I sat and listened as hundreds and hundreds of new patients slowly opened-up and revealed their fears, and a truth that was so stunning that, at first I could barely say it out loud, much less think it.

They knew it all.

They saw right through us when we told them they had an old filling that now needed a crown even though they had no symptoms or decay. We were fooling only ourselves when we talked about "pockets" and deep cleaning when there were 4 and 5mm depths. People have "gut" feelings. And the internet.

They saw our real motivation when we earnestly told them they needed a bridge NOW to replace that missing lower left first molar (it had been gone for 20 years!). They even gave us chances at redemption by asking sensible questions like, "Can't I just have a filling rather than a crown?" Or, "Do I really need this today?"

And then there was the dreaded "Laundry List of Recommendations" (their exact words). We were fooling no one with our comprehensive examinations and long-winded "patient educations", that were really attempts to sell treatment.

Why?

Because they knew.

And so, with that exact phrase, "Adult Dentistry" was born.

"THE PATIENT KNOWS"

Knows what? Everything.

I have seen hundreds of doctors and staff and even patients protest this because they hope it isn't true. Why? Because doctors know they will have to change the way they handle their patient relationships (or in the case of the patient, they will have to take responsibility for both the shape their mouth is in, and also the success of the treatment).

Also, doctors are afraid their income will drop. Not realizing that NOT owning-up to this is WHY their income HAS dropped (or never reached up to prosperous levels in the FIRST place!).

So, I stopped selling, stopped over-explaining and just got down and real with every patient. My new patient interviews became my favorite part of the day. More and more I became known for "telling it straight". I had the pleasure of telling hundreds of second-opinion patients that they did NOT need the 10,000, 15,000 and 20,000 dollars of work "right now". (Then again, many did.) I became skillful at explaining that, no, these other doctors were NOT all crooks. They were just "going by the book they were taught". (Sure, some were pushing it.)

What came next was so simple, so pure, so basic that I still shake my head at how this could have been overlooked for so long.

PATIENTS ARE JUST LOOKING FOR SOMEONE THEY CAN TRUST.

Once I realized this fully, I made this my sacred mission, the Holy Grail, of my practice. (I thought I already was doing this.) So the practice motto became:

Do anything and everything necessary to honor the trust that has been given.

Well first off, that meant NO "SELLING"! Just straight-up conversations about CHOICES.

(I see nationally-known consultants who PREACH "do not give the patient choices, YOU are the doctor, they are in your office to hear what YOU recommend. Giving choices only confuses them...")

Bull crap.

I could write a book on this part alone and maybe I will...in another time and place.

Secondly, DELIVER THE GOODS.

Simply put, there is no substitute for flat-out excellent dentistry. It takes heart AND great clinical DELIVERY to gain and keep trust. So there were the first two pieces of the puzzle:

1) the "HEART" and,

2) the "DELIVER THE GOODS" part of this evolving picture that would become 50+ Adult Dentistry.