Thursday Troubleshooter: How to handle incompetent dentist, who happens to be brother-in-law?

This dental office staff member is married to one of the dentists. The other dentist is her brother-in-law, and his dentistry is not quite up to standard, and patients come back to have the work redone. How does she bring up this problem diplomatically before business plummets?

May 14th, 2015
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QUESTION: I’m the wife of a dentist who’s in practice with his brother. I hear from patients and staff who complain about the brother. He performs incompetent work. Patients often have to come back to have work redone. I once heard one patient, who is a local radio personality, talk about the horrible experience he had as he sat in his dentist’s chair for six hours! (He did not give names on the air.) I cannot sit back and watch this man cause people pain. He’s never done work on me so I cannot say this has happened to me personally. But I see all that’s going on. What can I do to stop the incompetence?

ANSWER FROM DR. LISA KNOWLES, Intentional Dental:
It really matters what your husband has to say about this situation. He should be able to provide a perspective on his brother's dental work. Is your husband willing to find another office and go his separate way, or does he want to stay with his brother despite potentially poor dentistry coming out of the combined office? Is he willing to address this concern with his brother?

To make this situation work for the long term, some facts and data would be helpful when talking to the "incompetent" dentist. How many do-overs are coming back to the office compared to your husband's? How many patients transfer to your husband or another practice after seeing the dentist in question? How does the staff feel about the situation, and can they give specific incidences where this incompetence affected their livelihood and success of the practice?

The reputation of the practice must be taken into consideration. This is a hard discussion to have with someone. Most dentists do not want to recognize their own flaws, and even if they do, they often don’t know who to ask for help. This seems self-serving, but a consultant may be able to facilitate that process and discussion if you’re not comfortable addressing the problems, either alone or in collaboration with your husband.

As a dentist and consultant, I offer feedback when there’s a clinical concern as well as a practice management concern. If you decide to talk with a consultant, look for one with clinical knowhow to help your practice in multiple ways. If you do things on your own, be as gentle as possible and test the water with a meeting between you, your husband, and your brother-in-law. If there is ample evidence to support your concerns and the dentist remains in denial, there is always the consultant route.

There is no easy solution to your concerns. But much growth could occur in the practice if communication remains open.

ANSWER FROM AMY SMITH,Amy Smith Consulting, LLC:
My advice to you depends to a certain extent on what your position is with the practice. Are you employed in any sort of managerial capacity such as office manager? If so, I would start by talking to your brother-in-law in private and voicing your concerns, giving him examples of patients who have complained, etc. Attempt to get to the bottom of his sub-par work with questions like:

• Have you lost your passion for the kind of dentistry you’re doing?
• Do you feel more CE or hands-on training would help?
• Is there something going on we don’t know about that’s contributing to the problem?

The other issue, of course, is your husband’s relationship with his brother. Does he know what’s going on and he’s simply trying to avoid conflict by not addressing it? Is he doing the re-work when patients come back in? Are there hard feelings between the brothers that are not being addressed? How is their financial agreement structured, and does this have anything to do with it?

There are so many unknown variables here it is hard to give you a firm answer, but if there is tension of any kind between the three of you, consider hiring a dental consultant to help you address these issues. If unresolved, this could directly impact not only the profitability and reputation of your practice, but any future sale value as well. And, of course, if the dental work is as bad as you believe it is, the practice is vulnerable to potential lawsuits.

I wish you good luck in dealing with this difficult situation, and urge you — whatever you do, do something to move this issue into the light so it can be discussed and hopefully resolved in a manner that allows everyone to move forward with confidence and support.

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