{ tooth & nail } 

Ashton’s Bracelet W

e can learn a lot about our- selves from our children. Sometimes, we can even learn something about

ourselves as professionals in the business of dentistry. A recent event with one of my kids caused me to reflect on how I charge pa- tients. My seven year old, James, had a school fundraiser known as “The Marketplace.” The premise is kids bring in items from home and sell them at “The Marketplace” to other kids and the money spent is donated to a cause of some sort. This event stirred up kids into entrepreneurship, and my son was involved in a sale on the side. James bought a brace- let for a dollar from a young student I am naming Ashton. James was very proud of this deal, as similar bracelets had been selling for two or even three dollars! I was upset that money was spent outside “The Marketplace.” Nonetheless, James was proud of his haggling skills.

The next day at school, Ashton approached James and informed him he had not meant to sell him the bracelet and he needed it back. My trusting boy returned the bracelet on the promise of the return of his dollar. Ashton replied that he did not have the dollar with him and would give it to James later. James waited until toward the end of the school day and requested his dollar from Ashton. Ashton said he did not have it. James, seeing the error of his deal, demanded the bracelet back until Ashton could give him his dollar. Ashton apologized and informed James that he could not give him the bracelet because he had thrown it away, but promised the return of the dollar tomorrow.

Distraught, James relayed the story to me. Halfway through the story I knew what I would tell my little guy. I informed him that he was probably never going to see his dollar. It was likely Ashton had lied and not thrown away the bracelet. Maybe I was wrong, and

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honorable Ashton would come through, but he should have never trusted Ashton to do what he promised. Weeks have passed. No dollar.

The day after Ashton sold his bracelet, I had a patient in who was the mother of an irregular, but established, patient. She had an abscess and needed a tooth extracted. I told the patient how much she owed for the exam and how much she would owe to extract the tooth. The patient replied she did not have enough money to take out the tooth, but still wanted it done today if possible. I told her as long as she paid something, even $10, I would take out the tooth and she could pay the rest later. To which the patient apologized and informed me she no money at all. However, she promised to return later that day or first thing tomorrow and pay something towards her balance. Me, trusting dentist, extracted the tooth on the promise of payment of at least some of the balance.

Distraught, I relay the story to you. Halfway through the story you knew what you would tell me. You would inform me I was prob- ably never going to get anything or see that balance paid off. It was likely the patient lied and had no intention of returning with a partial payment. Maybe you’d be wrong, and the honorable patient would come through. Weeks have passed. No payment. Like father, like son?

I try to practice dentistry using the Golden Rule: treat others as you would want to be treated. If I had a toothache and needed an extraction, but did not have the money and told someone I would pay them tomorrow, I would want them to help me today. So why then did I advise James that he should behave differently when Ashton promised him something? Was I telling my son not to trust someone’s promise in a financial deal, but

then I always trust people at my office? That would make me a hypocrite. So, how should we approach agreements with people? There are several options.

The first dentist to own my family’s practice was Dr. Elzie Miller. Dr. Miller did not like to charge or bill patients on the day of service. He always dismissed them and sent them a bill in a week or two. He did not want his patients to associate the bill with the dental work. Some dentists require payment ahead of doing the dental work. Some dentists split the difference, asking patients to pay their outstanding bill minus expected insurance or credits at the end of the appointment. Still, other dentists wait until the insurance com- pany has paid and send a final bill. Yet, what should you do when somebody promises to pay you Tuesday for a hamburger today?

The moral dilemma faced here is one we face in all aspects of practice and life. When somebody tells you something should you trust them? We want to believe that at their core most people are honest and good, yet