We all know what PITA means and so do our team members. When a challenging patient walks in the door we orthodontists believe that they are easy to recognize and label. Traditionally the way we orthodontists deal with those patients who demand extra time and attention is to increase the fee we charge them to make up for the additional resource allocation (I’ve talked about this before) but is that the best thing for these patients and for the practice? It is fair for sure – those who will take up more of our time should pay for it. However, Bridget and I were discussing this the other day and realized that the act of labeling these patients PITAs is a self fulfilling prophecy that dooms us to having a tumultuous relationship with the patient. By labeling the patient a PITA we guarantee that they will be treated as such by the front desk, by the TC, by the chair side assistants and by the doctor. And when someone is treated this way, their natural reaction is to live it!

We all have bad days – doctors and patients and parents and team members – and making a snap judgement about a patient or anyone else is a bad idea based on limited interaction… though this is what we all have traditionally done. Now that we realize the error of our ways, Bridget and I plan to reschedule patients we suspect of being “difficult” so we can talk to them again before making a decision and/or starting treatment. If our suspicions are confirmed we will decline treatment rather than offering to do it for a higher fee because it’s generally just not worth it to us. If, however, the patient was having a bad day during our first encounter (or perhaps we were) then we can start fresh and foster a great relationship that will last the course of treatment and into retention. We think this is a much better way of approaching things but it will take self control and an open mind! Nothing worthwhile is easy.

7 thoughts on “Orthodontists and the PITA Principle

  1. Ben – so if you decline treatment, how exactly do you like to phrase that?
    Thanks!

  2. 1) I don’t think this office is a good fit for you.
    2) if they argue I say “I don’t have the skills required to treat your case” because that is very very hard to argue with.

  3. I’m slow Jamie! It took me a while to figure this out. 🙂

  4. I like it! We had a PITA mom who was abusive, angry. We had a no holds barred meeting and told her we can’t treat her son. She admitted to have a bad day, cried, apologized. Fast forward, this week we took his braces off and the entire 1 1/2 she was smiles and pleasant.

  5. 99 % of problems from 1 %. An added fee does not compensate for the heart tissue and stomach lining lost. So as with Jamie, 1,000% agree!

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