Perception vs Realty

PERCEPTION VS REALITY

We live in an age where perception may become totally disconnected from reality. We see this every day in our dental offices. We may pride ourselves on being the best and most caring general dentist, periodontist, endodontist, orthodontist, or other dental specialist and yet our patients may believe that the care that was given to be less than ideal based on perceptions unrelated to the actual delivery of care. Our websites universally show a happy staff, all smiling, with their arms around each other, and a very happy doctor in the middle. They portray an up to date and modern practice with only the very best of equipment, staff, supplies training, and using only the latest technologies in order to provide the very best of care. Your patient sees this and this is what they expect when they come to the office. What they may find when they enter, is that the parking lot is too crowded, because tenants from the new apartment building next door are now occupying too many spaces, the carpet in the reception area has a new coffee stain compliments of yesterday’s patient, the receptionist just found out that her husband has cancer and is justifiably inattentive, and the necessary paperwork and check-in process is onerous. You are also running behind schedule and they have to wait an extra 45 minutes to be seen. To top that off they find out that they have already used most of their insurance benefits for the year but they still need additional restorative and endodontic treatments to relieve their pain and correct functional and esthetic concerns. The patient is still seen of course and appropriate and attentive treatment was given. The reality is that the quality of care was not affected by any of the above factors and yet the patient may leave the office with the perception that because the parking lot was too full, you were too busy to give them the appropriate amount of time and this was of course confirmed by the fact that they had to wait an additional 45 minutes to be seen. The coffee stain on the waiting room carpet confirms to their mind that appropriate cleanliness and sterility of the office is now in question and they’re wondering if you even have an autoclave. The discourteous reception confirms to your patient that your office staff only cares about themselves and not the patients. Now they have to go fill a prescription for an antibiotic but no prescription for pain medicine was given and they’re worried that they may have to endure significant pain and discomfort as well. Again the reality is that the care that was given to the patient by the doctor was excellent and no prescription for pain medication was indicated but the perception is entirely different.

We see this on many other issues as well. Several years ago I saw many patients for extractions of teeth with irreversible pulpitis. This all began because they wanted all of the “poisonous” mercury fillings removed and replaced with composite restorations. There is no scientific evidence to support this practice. Yet these patients insisted on the removal of the amalgam restorations which ultimately resulted in the loss of the tooth.

Community water fluoridation is another perception versus reality issue. In spite of the American Dental Association’s support for appropriate community water fluoridation and a long proven benefit, there is the perception by many in the community that fluoridation of the water is poisonous and provides no benefits.

Vaccination use is another area where perception versus reality clashes. (I will not go into Covid vaccinations at this point.) One of my neighbors refused to vaccinate his own children against common childhood and adult diseases and yet provided vaccination for his dog (Dogs don’t get autism). As expected his children came down with pertussis, and although treated successfully with antibiotics, this was totally unnecessary. There is the perception that childhood vaccinations are related to autism and autoimmune disorders when there is no scientific evidence to support this. The truth is that the recent outbreak of measles, a potentially deadly disease, at Disneyland could have been avoided by simple vaccination that is readily available.

We live in a world where perception is just as important as reality. Many of our patients make decisions based on their perception of what reality is and not based on what is actually true. Professor Thomas Sowell, an economist at Stanford University stated, “Truth is often not complicated. What gets complicated is evading the truth.”

Truth and reality always prevail in the end but it is our duty as healthcare providers to try and to keep the cost that is paid by society and individuals to a minimum by always upholding what is true versus what is the perceived reality. The cost that is counted not just in dollars but in sorrow, pain, lost opportunity, illness, disease, and even loss of life that easily could have been avoided by making decisions based on truth and not just perception. We do this by educating our patients and letting them know what is in their best interest is in fact in our best interest as well.

Dr Ken Baldwin ADA Delegate