It is often said that "The customer is always right". Particularly early on in their career I feel that this mentality may mean dentists feel under pressure to react to a patient's every whim. Agreeing to do work which they deep down know isn't going to work as well. Either because the treatment modality just isn't suitable in this case, or because they are not experienced enough to do a good job here, or because the patient wants something done quickly when really more time is needed.
In these circumstances, learning to say "no" and how to do it well is a great skill to master.
Let me refer just briefly to the GDC Standards section 7 which says:
"You must only carry out a task or a type of treatment if
you are appropriately trained, competent, confident.....
If you are not confident to provide treatment, you must refer the patient to an appropriately trained colleague....
You must only work within your mental and physical capabilities."
So If you feel you are not confident or capable of performing a task, not only is it right to say so to a patient, but not doing so puts you at risk of bigger problems.
But saying no often leaves both parties feeling very negative. I have recently been learning to deliver "positive nos". It sounds a bit counter intuitive but go with me.
A "positive no" follows these steps:
1) say something positive
2) your no
3) your yes (the reason why you are saying no)
4) if possible providing an alternative solution
So for instance when a patient asks at their check-up:
"Can you do that crown prep today?"
Rather than just saying "No I need more time". Try taking a few more seconds to say:
"Its great that you are keen to fix this tooth, but it wont be possible to do the work today. As you are aware I always aim to provide the best possible treatment and that just wouldn't be possible in the time available today. Would you like me to smooth any sharp edges for you today?"
While you are still delivering the same message, the second version is much more positive and helps to reinforce your ethos and also provides an alternative solution the pt can accept today if they wish. If you want to find out more about this technique I would strongly recommend reading or listening to "How to have a good day" by Caroline Webb. Here is my review of that book:
How do you think you can put positive nos to good use?
Dr Chris Harper