The binding resolution

Oct. 1, 2009
“Doctor, Mrs. Johnson wants to visit with you, in private.

by Duane A. Schmidt, DDS

For more on this topic, go to and search using the following key words: binding resolution, arbitration, patient relationships, Dr. Duane A. Schmidt.

“Doctor, Mrs. Johnson wants to visit with you, in private.”

If you wonder why Mrs. Johnson wants to visit, the word “private” is your first clue. Most likely she has a grievance over some aspect of your services. While this scenario is played out daily in thousands of dental offices across the nation, how to deal with a patient complaint receives short shrift in the literature.

The first few minutes with this patient may lead to satisfaction and restored confidence, or to a shattered relationship. The problem stems not from Mrs. Johnson, but from the dentist ... because entrepreneurs can be feisty and an easy first reaction is to defend office protocol, at all costs.

Early in my career, I often went to extremes to prove my patients were wrong. Sometimes I won. But what had I won? Over the decades I learned to defuse difficult situations with greater finesse. I have since learned that an unhappy patient seeks one of three responses: recognition, reparation, or retribution.

Recognition starts with a simple question: “Mrs. Johnson, what is the problem and what would you like me to do about it?”

Surprisingly, this disarming approach often yields the fact that the patient wants only an apology or wants you to be aware of what he or she perceives as a problem. Your apology, if needed, and your promise to study the matter and take appropriate steps are usually enough to satisfy someone.

The patient seeking reparations wants some corrective measure from your office, such as a repair, a remake, or a referral to another dentist. Failing to offer, provide, or pay for a remake can be a costly mistake that elevates reparation to a demand for retribution. Sooner or later we all learn that appeasement is a far simpler path to success than confrontation.

A patient who wants retribution seeks recompense for real or perceived damages. These patients often bypass the personal confrontation and go directly to their attorney, who is delighted to send a couple of letters and receive a sizeable settlement from your liability carrier.

To avoid a costly lawsuit, insurers often agree to throw a few thousand dollars at the problem to make it go away. However, that fix leaves a stain on your record and you may find your liability rates escalating needlessly.

There is another solution that we learned of in the mid–1990s when we hired a national moving company to ship a pricey antique organ cross–country for us. Wouldn't you know they lost the bench, a beautiful, hand–carved keepsake. Their solution was to offer us a figure we thought was way too low, or go to “binding arbitration.”

We learned that this legal maneuver was employed by hundreds of thousands of businesses, banks and moving companies among them. When we signed the contract for the move, we had also agreed that in the event of a dispute about the service, we would go to binding arbitration.

In checking with the American Arbitration Association (AAA), we discovered that binding arbitration requires both parties to pay a few hundred dollars up–front to hire an arbitrator, who listens to both sides and makes a binding decision. There is no attendant publicity, the disputants may hire an attorney or represent themselves, and the process is quick and easy.

The AAA told me that no dental office had tried this technique, but that it was legal in all 50 states. Working with them, we fashioned a binding arbitration clause for two uses in our practice — one, in the health history which new patients sign, and two, in the Informed Consent Agreement which patients sign after they view our informed consent videos.

Since we took that somewhat bold step, tens of thousands of new patients have signed without a question. And, importantly, hundreds of thousands of patients who signed informed consents for surgery, crown and bridge, dentures, and root canal fillings have done so willingly.

If we cannot placate or appease a patient and he or she wants to learn more about arbitration, we present the patient with our Customer Satisfaction Brochure. In more than 10 years, only one patient has sought binding arbitration, and the arbitrator found in favor of the office. (For free downloads of a binding arbitration agreement, a health history, and a copy of the Customer Satisfaction Brochure, visit

Over the past few years, in a practice seeing right at 300 patients daily, 17 attorneys have sent our office a letter demanding all records, X–rays, and patient care documents. We comply and add the script for the informed consent DVD, plus a copy of the patient's signature on the binding arbitration agreement. None of the attorneys were heard from again.

In the language of the law, res ipsa loquitur — the thing speaks for itself.

Duane A. Schmidt, DDS, is a Fellow in the American Academy of Pediatric Dentistry, an adjunct professor at the University of Iowa College of Dentistry, and a published author. With a staff of 55, he led the creation of a 34–chair dental practice in Cedar Rapids, Iowa. Reach him at [email protected].

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Whitepaper: The Blueprint for Practice Growth

With just a few changes, you can significantly boost revenue and grow your practice. In this white paper, Dr. Katz covers: Establishing consistent diagnosis protocols, Addressing...