Sickening Mistakes

Every once in a while, hopefully rarely, you get smacked with terribly sickening mistakes. There is a long list of “small mistakes” that practices make that feel less consequential – like incorrectly spelling a patient’s name, communicating the wrong appointment date/time to a patient, or collecting an incorrect amount for treatment rendered. However, this episode focuses on some haunting mistakes that were brought to Dr. Kuba and Bethany’s attention.  In these situations, mistakes were made by team members and associates, leaving the practice owners terribly exposed and at risk. Take your blood pressure medicine, and listen in! 

Previous Episodes Worth Revisiting: 

Details Matter – The Importance of Clinical Documentation

S1: Episode 29 – Thirty Positive Thoughts in Less Than Thirty Minutes 

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Transcript

Are you looking for a podcast where you can hear from real people regarding their real dental drama? If so, then

0:09

you've come to the right place. Join hosts Bethany Penny and Dr. Reena Kuba

0:14

as we dive into the solutions we've created and the mistakes we've made while managing dental drama.

0:22

Let's get started. Hey lady. Hey. Okay, I'm gonna forego all the

0:28

jokes and all of that because we have got a lot to talk about. Yeah, I know. Um, so all this stuff has just kind of

0:35

popped up on yours and my radar. I would say what Thursday is when. Okay.

0:40

Um, so talk about drama and I think both of us are still like

0:47

stomach is churning. So, even talking about this today, I am still like the second I hit record, my stomach

0:53

started hurting again and I've had a sick stomach for like 3 days now. Yeah. So, because um

1:00

you uh three of the examples we're going to talk about today, all three, again, I

1:06

don't know one of them, but I'm assuming I I kind of feel a kinship towards this practitioner because they're a client of

1:12

yours. So, correct me if I'm wrong, but I think the two examples that I know, one of them is uh a client of yours. The

1:19

other one is a colleague of mine. And uh I think all three I view very

1:25

much like it could be me. Oh, yeah. And what I mean by that is sole owner.

1:30

We're not talking corporate conglomerate. We're not talking um we

1:36

just kind of bumble by the seat of our pants and just bumbling along and good practitioners and trying to do good. We try to be

1:43

compliant. We try to follow the rules. We try to tain our train train our staffs. Like so to me, anybody who's a

1:48

client of yours like is a like-minded person, right? Because it is somebody who is like

1:53

willing to say, I want better. I know I can't do it all myself and I want to find somebody who is going to guide me

1:59

properly according to what I want for my practice and um and I'm willing to admit

2:06

that I could use the help. Yes. And utilizing resources we have to us. And that that is a mindset. There's a

2:11

lot of people that are like, "I've got it. I've got it. I don't need that." And so, you know, whatever. Maybe you do.

2:16

But I just feel like again, the the ones that are clients of yours, we're kind of in this like club together cuz we

2:23

clearly like want the best for our practices and we're not afraid to say that

2:28

we need assistance in getting there. Um, and why have it all on us? Anyway,

2:34

all of that to say, like I think the reason I'm honing in on that is I think that's why this is these two days worth

2:41

of information is really hitting me harder because I'm like this absolutely

2:48

could be me in any of these three situations. Like what distinguishes my

2:53

office from theirs? They're not like super bustling cramming 100 patients and

2:59

you know. So anyway, if it could happen to them, I'm just sitting here going, "How the hell do I keep this from

3:06

happening to me?" Um, and so I do want to get to that cuz I think once we get

3:11

past the like I'm going to vomit thinking about this, I do want some silver lining to come and I hope these

3:18

colleagues are going to be okay. Time will tell. We don't know. Um, but I

3:23

think for me, my takeaway is, okay, how am I going to do my damnedest to make sure one of these things doesn't happen

3:29

in my office, right? So to the audience, anybody listening, put your coffee cup down.

3:34

Make sure you've not eaten too heavy a breakfast. I don't want you throwing up on the road on the way.

3:40

No. Yeah. Get ready. It's And I'm glad you tee it up that way cuz if you hear these examples, you might think um you

3:47

know, LZ a fair people that aren't real intelligent or aren't diligent. No,

3:54

these are fantastic people. So, it really can happen to anybody and it's a good opportunity to learn from somebody

4:01

else's calamities. And thankfully, you know, one of the examples we'll talk

4:06

about today, she even said, "Man, this would make a great podcast topic." And so, um,

4:11

well, she even said, "I can't believe y'all don't have this podcast topic yet." And I was like, "Well, we we just

4:17

have never I mean, who wants to talk about this stuff?" Yeah. Um, so anyway, I I just think um

4:25

to to she I think she knows and is okay with us talking about this and um

4:31

which I'm thankful for. So, yes. So, can I jump right in with example one? Okay.

4:37

So, this colleague on Thursday afternoon I get a text and it says, uh, hey,

4:44

what's your quote protocol for the wrong treatment done? And

4:50

already when I read that I like felt like somebody punched me in the stomach. I was like

4:57

and then I thought what does that mean wrong treatment done like we prepped the wrong tooth or we pulled the wrong tooth

5:03

or we like what what are what is the scenario of what we're talking about. So I just said I tried calling she didn't

5:09

answer. Um and she said she was waiting for you to call her back. So then I was like well we'll just call me when you have time so we can talk about cuz I

5:16

kind of wanted to know what exactly she meant. Um, so she calls me and she says

5:21

that ultimately what ended up happening is uh they were there were two siblings

5:29

scheduled for treatment and let's call them I don't know Amy and

5:34

Sarah, right? So Amy and Sarah are Amy's got treatment needs on the right,

5:40

Sarah's got treatment needs at the left. I'm sure you guys can already see where this is going. Apparently assistant

5:46

called for Amy, but apparently Sarah went um and ultimately

5:52

uh I can't remember what I said. Amy needed treatment on the right. So if it's Sarah, Sarah got treatment on the

5:58

right instead of the left side. Instead of the left side. So she got her

6:04

sister's treatment plan. Um which of course I know what y'all are thinking.

6:09

Okay, pediatric dentists hopefully it's a primary. Of course that could not be the luck. Of course it couldn't.

6:16

Young permanent teeth. So like an mod on five and a whatever on what mo on 30 or

6:23

whatever it was. So I think the problem is now Sarah has gotten treatment on the

6:30

right that she didn't need on young virgin teeth, but she also didn't get her treatment that she needs on the

6:36

left. So she's still got active decay on the left side. And then you've got Amy who thank goodness I think they were

6:42

running behind and the parent is like I got to get out of here. Let's res

6:50

double. So luckily Amy goes by but Amy still needs her MMO on five and her deal on 30

6:57

or whatever it is. So I just was like as that was sinking into

7:03

my head I think the things that went through my mind were you know expletative times 10.

7:09

I think first to add to it it wasn't the owner the business owner

7:17

it's her it's the associate that rendered the treatment while the

7:22

business owner was away from the practice. So to add to the harrowing effect of it,

7:27

right, it just makes it more gut gut-wrenching. Although I will say, and I know this is the wrong thing to say, but I think to

7:32

me that was one thing where I was like, "Oh, thank God it wasn't her." Not that I want it to happen to anybody, but like

7:38

at least it's one thing that you weren't even in the building, so your hands are

7:43

clean of it, right? But this associate I guess he um so in kind of going okay

7:50

what what was his um to me that's where I was like okay how did associate handle

7:56

it like what do you say to the parent what do you say to the team

8:02

y what obviously you're not going to bill it

8:07

but just the PR nightmare of all this like anyway so I just was like I don't

8:13

know and then thinking about it from the parents perspective going what the hell

8:19

and then thinking about it from the kids' perspective what the hell

8:24

so just thinking about all those viewpoints all the components all the components and I was like I you

8:30

know and she's asking me what protocol and you know I am not the consultant but

8:36

you know whatever I've learned about consulting I've learned from you so but I'm just like I don't I don't even know

8:41

and I'm sure Bethy's got a treasure trove of things she might recommend in and I said, "But Bethany would probably be really good at giving the PR spin on

8:48

this," which we'll get to later about what you did adise cuz I still don't know what you advised. Um, but my advice

8:54

was call your liability uh your malpractice your malpractice

9:00

like right now. And I think that's when she told me it wasn't her, it was him, her associate

9:06

who um this happened to or that rendered the treatment. And I was like, well, I would have him call like right now. And

9:13

then my friend said, "Well, I probably should call, too, because I'm probably going to get roped into this." And I said, "You're 100% right. You probably

9:19

are as the practice owner. That's one of the risks that we have." And it sucks.

9:24

Y, it sucks. So, to anybody who's trying to be an associate, I know I dogged on y'all associates on the Mega Fish

9:31

episode, and we love you and we need you, but you need us, too. And those of you that are branching out off onto your

9:38

own, I hope you can try to appreciate as an owner doc. We eventually do want help, but this is one area where we

9:45

really push the pause. Mhm. So anyway, that that's what I know of the

9:51

situation, but I could not sleep that whole night. I was just feeling so murky about the whole thing for my friend, for

9:56

the situation, for these parents, for this kid. And then I I checked on her the next day. So I texted her. I said,

10:01

"How are you doing?" So, she calls me, which she's not a super chatty, hey, let's So, the fact that she's calling

10:07

me, I was like, okay, she needs to vent. And she was like, well, um, we, you know, kind of talked and I guess they

10:15

had talked to you by that point. Um, and they had, y'all had a strategy

10:20

of you were going to call the parent. So, they called the parent on Friday saying, "Hey, we need to, you know,

10:26

the parent doesn't know. Parent doesn't know." But cuz they were in a rush to get out of there. And I don't even know that he the doc that he

10:32

even realized at this like I don't know at what point realized or the team

10:37

realized or whatever realized. Um and so I think my friend was saying

10:42

that that uh they called the dad and and said something like let us know we need

10:47

to we need to talk and let us know what times work for you. And the dad calls back and I was like no no no no I need

10:53

to know more details like stop. who is we we call dad and what is like how did y'all and she was like well the doctor

11:01

let's call him Dr. Z, Dr. X, Dr. Y, whatever, right? Dr. X called and said,

11:08

"Hi, Mr. Smith." Um, you know, you brought Amy and Sarah in yesterday and

11:14

needed to tell you about a mishap that occurred and um and then I guess he

11:19

said, "Dr. or so and so, my owner friend, she's also on the line. Um, so

11:24

again, I want to talk to you about that later. Um, because I think a lot of the themes of all three situations that

11:31

we're going to talk about here, you've got kind of I know it's not one sizefits-all, but uh it's going to be

11:37

hopefully in the same vein of advice that you're giving, but um you know um

11:43

this happened and we're so sorry and whatever. And I guess they got lucky

11:48

that Mr. Smith was like, "Oh, okay."

11:54

And then was like, "Okay, so what does that mean for the future?" Like, "What does that" And then they kind of went

12:00

into like, "Oh, the filling should last a while with good home care and blah blah blah," whatever they said. And my

12:07

friend said, she's like, "I think it went as well as it could because the dad started saying, oh yes, we had to rush

12:14

out of there because of something. He had an appointment somewhere and he was

12:20

chatting about that appointment. Yeah. And so he didn't seem to be fixated or dramatic or hyper about the situation.

12:27

And my friend was like the fact that he was willing to talk about something else and have a conversation we took as a

12:32

good sign. And he also went ahead and scheduled uh Sarah to do her left side

12:40

and when Amy's coming back for her right side. So this seemed to put my friend at good ease. I will tell you I was not at

12:47

good ease at all. And I know, friend, I know you're listening to this at some point. Um, and I still was like, "Oh,

12:53

God." Like, that does nothing for me. Like, I'm glad he didn't scream at you in that moment.

12:59

But in my mind, I'm like, he's still processing and he's probably like, you

13:04

know, I think you've got a subset of people who would be acting like raving lunatics, but he's probably one of those

13:10

who's processing. Yeah. So he's babbling about whatever is comfortable to him because he can't

13:15

process what he's just heard. And I was like to friend I was like dude like mom may call like we just have to

13:24

see what h cuz she has oh yeah you know we're lucky that he's going to schedule and I didn't want to burst her bubble cuz she's still on vacay. But I'm like

13:31

are you insane? He hasn't talked to mom yet. He hasn't talked to his kids yet. Like just cuz he scheduled in the moment he's

13:37

just trying to get off the phone and process. We are not safe. And maybe, you know, she's a very practical person, but

13:43

she's she's practical. She's probably going, "Okay, let's just see what happens." And she's very good at that. Me, I'm like

13:51

reeling going into mode of like, "What the f is do I need?"

13:57

All that could still happen. Yes. All that could still happen. And what are we doing about it? And blah

14:02

blah blah. So anyway, hats off to her for having such a cool head, but she's known for having a cool head. Um anyway,

14:09

so for me, I guess that's I think about all of those things. Then I asked her,

14:15

so I kept my mouth shut. I didn't rain on her parade in that regard. But then she was starting to tell me about how he

14:22

now he has been an associate in her practice for four years, 5 years, 3 years, something like that. He's not new

14:27

to the practice and he's a good provider. Like she would not have had him if he was not a good provider. But I

14:34

think what really bothered me hearing about this and again I'll be the first to say I'm hearing it like a game of operator but I guess he um

14:43

when he joined her practice he had been in another practice and when he joined her practice he was always talking bad

14:50

about the previous practice. And when I say always, I don't know. Maybe it was just every now and then when something

14:55

would come up. So, whatever. I'm dramatizing here. But point is, he liked a lot of the way my friend ran her

15:02

practice. But I guess after this incident, he apparently reamed out the

15:07

assistant, which I don't think he's in the wrong necessarily for doing that. I don't know. You're going to give us your advice on that. But basically, what I

15:14

think I don't like about it was almost like it is your fault and my hands are

15:20

okay. And maybe this is his way of coping. Like maybe he hasn't processed yet. But I still find that extremely

15:28

annoying, disappointing, wrong, because at the end of the day, the buck does stop with you. And I feel you. I don't

15:34

know if Dr. Z listens to this podcast or not, but I feel you because I too would be like, "How the hell did this happen?"

15:40

Like, you can't get I pay you assistance. Good freaking money. That is

15:45

your whole job is to get the patient back. But where does my like at the end and

15:52

you know I don't know man I don't know it I could see how it could happen in a

15:57

good practice and to me but at the end of the day it's still me who's responsible. I'm the one who picked up

16:02

the drill and drilled on that too. Yep. Um so I guess he was trying to say to my

16:09

friend like, "Oh yeah, the systems we need to the the system's bad here and whatnot and like we should have a

16:15

timeout and whatever." And my thought was I was like I hope you shut Dr. Z down and well, you know, why can't you

16:23

do a timeout? Who's stopping you, bud? There's nobody stopping. There's nobody stopping you. So, you can

16:29

have protocols from here. That's why I've been kind of a, you know, Texas a couple year back, they had their

16:35

sedation rehaul and they're doing inspections. And I'm like, I do not

16:40

agree with this because those of us that follow the rules will continue to follow the rules and the others that don't want to. I'm pretty sure even for in Texas to

16:48

get your state your level two permit. I guarantee I would pay money, good money

16:54

to put a bet down. I guarantee a lot of these people that get their level two permits that you have to have that you

16:59

if you don't didn't go through a residency and you have to submit 10 cases. I guarantee they all share the same 10 cases. I would not be at all

17:06

surprised if at least half those practitioners that have a level two license haven't shared cases, changed

17:11

names, change a couple things a case. Like, so people who are going to cut corners and and do that are going to do that

17:18

regardless. So to me, my point in saying that though is if Dr. Z, if you're like, well,

17:23

we should have a timeout or we do have a timeout, but we don't do it right. Really, because you've been in that practice 5 years

17:29

and suddenly the system's not working. So much autonomy in that practice. That's what's great about this owner doc

17:37

is that she lets those her associate she lets him run it the way he wants to run

17:43

it. So well and so do I for the most part like so do I'm not hounding somebody's treatment plans. I'm not until I see

17:50

some funny stuff then I get in there and I always give the doc the benefit of the doubt but um you know if it can't be

17:57

explained properly and you know for 5 years this has never happened. So, don't don't go throwing my owner my friend

18:04

your owner duck under the bus. Don't do that. Um, which again, my my owner friend is

18:10

not super emotional, so I think she kind of let him rattle on and and you know, let it let him get it out of his system.

18:17

Um, so who's to know what kind of come to Jesus moment he's going to have with himself.

18:22

Hopefully. Hopefully. Hopefully. Yeah. But I guess apparently the assistant

18:28

even called owner doc and was like um you know I understand if I need to be

18:34

fired over this and whatever. So that was another question I had for you. So if we could talk about that in a moment

18:40

like what do what do you do? The ripple effect. Um I'm just babbling away here. Sorry I

18:46

got to get all this out of my system here. You're getting all the details out though which is important. Um well so so

18:52

where it's left standing now owner doc was still on her vacation trying to enjoy her time at the beach with her kids which God bless how you did that. I

19:00

think Dr. Z god bless whatever you're having to do to get yourself off the edge of the cliff but hopefully you are

19:07

landing on your feet going this was on me because it was. That's not to say

19:12

that the team doesn't need a good swift kick in the pants to go what are y'all doing? Yep.

19:18

How is this not going to happen again? I even went that next morning to my team and I I'm usually late to huddle if I

19:24

make huddle at all a lot of times. I made sure I was at huddle and I was like guys I hate to rain on our parade. We have a very busy day today but

19:33

the we we it does not matter how busy we are. It does not matter that people's kids are out of school cuz in Texas this

19:39

is a long weekend for most school districts. It doesn't matter. Every kid deserves better and we need to slow

19:48

down. Yes. Um, and pay attention. So, um, I think

19:53

even just talking about it and going, "This could happen to any one of us. What are we doing to help protect and prevent?" And yes, this is I'm sure the

19:59

assistants in the meeting were going, "Well, that's the doctor's fault. That's not my fault." And docs in our minds were going, "Well, that we pay you to

20:06

and we've got to decide like to me it's like somewhere in the middle. We're all responsible here." Yes. And we all now

20:11

to be the one person who wasn't responsible was owner doc. And I was like, I sure hope you don't think this is on you cuz there's you weren't even

20:17

in the freaking building. Yeah. So, um I don't I don't know what to say about all of that. Then on um the other

20:25

night, Friday night, I was driving my girls to my mom's. We was got spent some time with grandma over the weekend,

20:31

whatever. And I, you know, I'm driving and I just pushed pause on the on their

20:36

radio and I said, "Can I talk to y'all about something? Like something's still weighing heavy on me." And they're like,

20:42

"Yeah, what's going on?" And I and they're like, "What did we do?" I'm like, "No, no, no, it wasn't y'all. It's a it's a work thing." And I said, so I

20:48

kind of summed it up. I said, I've got a colleague who's a friend of mine who they got and and apparently colleague

20:54

told me on Friday on on our second call together, um that these Amy and Sarah

20:59

are like really close in age. Yeah. And um so why Sarah sat down when they

21:06

called for Amy, I don't know who, you know, I don't know. But my girls are

21:12

very close in age. They're pretty not quite Irish twins, but almost. They're about the same size. They both names

21:18

start with S. They're not common names. Like, so it would be easy for somebody to switch them,

21:24

right? So, I just asked them. I said, "If that happened to you, what like if you know,

21:30

Sonica, if you sat down and they ended up drilling on your right side, cuz that's a side Syra needed, what would

21:35

you do?" And she just turns her head and looks at me like, "That could even happen." And I'm like,

21:42

"Yeah, that can happen." And she's like, "So, these are my teeth that have been

21:48

drilled on where I didn't need drilling." I said, "Yeah." And she's like, "Yeah, that's not okay." And I

21:53

said, "Well, would you go back to that office to get your left side done?" She's like, "No, no, I would not go back

22:00

to that office." I'm like, "Sarah, what about you?" Sarah's like, "No." I'm like, "Okay, but what do you do? What What would you do? What if that was me?

22:06

What if I was Dr. Z? What if I had done this on somebody? It was a true mistake. There was no well that's still not okay.

22:14

And they didn't really have an answer beyond that for me. Um and I said, "Well, what do you think should happen?" "Well, they should get sued."

22:20

Wow. So, both my girls were like, "They should get sued." I'm like, "Su?" But it was an honest mistake. Yeah. But the but

22:27

now if it was me and I had the wrong tooth drilled, Yeah. I need to be compensated for that.

22:33

Wow. And I was like, "Okay, welcome to this society now." like they, you know, and I

22:41

said, "Well, they're not going to get charged for their work." Yeah, but they still did the wrong teeth and I'm not

22:47

going back to that office. Wow. Like, okay. Yeah. So, um anyway, I the

22:54

whole thing just makes me want to vomit. And I I'm just kind of going through this, but I'm not giving you an opportunity to say what you shared. Do

23:01

you have anything like what you advised? Do you have any other thoughts on this before you give advice or do you want to

23:08

give advice? I'm making you wait, but if you want to just give it now. No, I feel like you hit on all of

23:15

the main things and no, I I don't want to add more cuz once I start talking about it, I just it makes I literally am

23:23

sick sitting here again just hearing you recount all the details. I haven't been able to stop thinking about it. So, no,

23:29

I feel like you hit all of the main details. Um,

23:35

yeah. No, I won't add anything else. I feel like you've covered it. Okay. So, perhaps I've just been very

23:41

lucky that this has not happened to me. And I hate to use the word yet, but that's how I feel like before you get

23:47

sued or right like we're all all told that shit's going to happen and we will have a reckoning at some point in our

23:53

careers. So, um, so if this has happened to you and you have good advice that you want to message to us for us to share in

24:00

another podcast with with listeners, like we'd be happy to pass along any advice you have. Of course, Bethy's

24:06

going to get to her advice in a minute, but um, do you want me to move on to I mean, I feel like the the second

24:12

example, the colleague that you were talking to is a good it's another it's similar

24:18

similar. So, maybe share that one. So this again is when I um this was

24:25

Thursday and I had lunch with a colleague. Uh so I you know finished up my conversation with owner doc and was

24:31

just like bless you like I'm so I don't have any words like just call your liability good luck you know whatever.

24:38

And so I get to lunch and I guess I still just had a look on my face that my colleague at lunch was like you okay?

24:44

And I'm like I'm okay but I'm just reeling. And maybe it's because it's

24:49

like it's a really good friend of mine, but I also think like our practices are run very similar. So it it didn't happen

24:55

to me, but it very Yes, it very well could. Um because I've got associates just like she does and I've So anyway, um

25:04

and and my team, too. Like I, you know, I love my team. Do we have to catch a

25:10

ridiculous amount of mistakes? Yes. But that's part of running a business in whatever field you're in. It can be

25:16

ridiculously exhausting. And it can also be like, I just didn't think,

25:21

yes, I'm catching their mistakes, but that could go down to this level of mistake. Kind of like we said in the podcast a couple of podcasts ago where

25:29

as an owner, you don't know how many hands there are to slap you. Like there are so many stupid things your staff can

25:34

do or that you can do, but you didn't really think this was one of them. putting the wrong sister in the chair

25:40

and and then you not catching it and you like that's just really not on somebody's radar of the normal things

25:46

that you know we're thinking like I don't know you forgot the edge like

25:52

you didn't order the 330 burs like something like that or a dental office with no toothpaste like that's what we get you know most

25:59

this is in a the next league I guess anyway so colleague that I'm having

26:04

lunch with was like oh well I've got a similar situation and he's like this was

26:12

um a so um I guess colleague I was

26:17

having lunch with was an orthodontist. Yeah. And he sent a extraction request

26:24

to you know a provider and and I know this provider and this provider he's fantastic. I've referred patients to him

26:32

in the past like he same thing small very small very I don't even know that

26:39

he has associates. Yeah. Um but in his practice an orthodontist

26:44

friend referred uh for or requested extraction of a on like a teenager like

26:51

a 13 14 12 whatever how old your old patient because the patient doesn't have number four. Yeah. Well, apparently this dentist

27:01

extracted three. And so we all talk about like extracting

27:07

the wrong tooth and it's never ideal and it's it always like you know would make you want to throw up but for the most

27:13

part scenario right and I guess to me my um experience

27:18

is like preolar extractions. So even if you got the wrong preolar usually the orthodontist can make that work from

27:25

what I have heard. Um, but this is a whole different

27:30

enchilada cuz it's tooth number three that you were hoping to move forward into the space of four counting on two.

27:38

Well, now how do you as the orthodontist, how do you treatment plan that like what because now do you keep a

27:44

cuz that was probably part of the discussion anyway. Like is it better to leave three alone and keep a and then

27:49

plan for an implant, right? And then you decided you did have enough space and it would be worth it to remove a move three, but now you've

27:57

removed three. So now you're going to move two into the spot of A. Like so that the whole thing you were trying to avoid is back, you're literally back to

28:04

square one here. And so um to add to the fun of that, I guess

28:09

the general dentist panicked, called the oral surgeon in the building next door.

28:15

Oral surgeon is like, I don't know, we could try to reimplant it and see what happens.

28:21

So he tried. So now I'm like, was that a good thing or a bad thing? Cuz at least

28:26

if you didn't, then at least you've narrowed your window of could we, should we,

28:31

right? But now you reimplanted three and it may take and it may not. And if it does take, it's probably going to need endo

28:38

and then it's might ankyos. So then what's your timing on all this? So, do we wait for three to settle down? And

28:43

then if that doesn't work out, then we talk about a like what the beep should we do with this enchilada now? And I

28:51

just wanted to throw up times two with this because what a bleeping mess. And

29:01

again, then you go to this dentist. I guess the dentist is like, I don't think I can ever extract a tooth ever again.

29:07

Like I think I'm done. like dentist is traumatized. Yeah. Um

29:13

what do you say to the parent? What And I guess to me too for optic

29:18

sake like even for Dr. Z in the first scenario like to come to work every day

29:26

and the whole team knows you prepped the wrong teeth. Yeah. Like that's just embarrassing on a whole

29:32

another level. It's I I can't imagine. Um,

29:37

and then front desk and like how we talk about optics and keeping your mouth shut and then like if if a staff member is

29:44

already like upset at you and you fire somebody, are they going to be the ones to call the state board on you saying

29:51

you you know maybe dad didn't, maybe you stayed out of that boat there, but what if it's somebody else that calls on you

29:56

or what? Like like that's where my brain goes. This is an endless Yeah.

30:01

Yeah. How long are you going to suffer with this decision? So, and but even showing up to work going, "Hey guys, I'm

30:08

the doctor that I ask you to trust behind me and to do all this and yep, I'm the one who how." And so, for this

30:16

other doc now, how is he supposed to be like, "Hey guys, yeah, prepped the wrong or pulled the wrong tooth. Hey, orthodontist that you refer

30:23

me patients and I refer to you." And now orthodontist whole team is going to know that I pulled the wrong tooth. And then

30:30

mom, like think of the Google reviews, the lawsuits, the like I just want to

30:37

put my head deep in the sand. I'm telling you, if this happens to me, I am like putting up my drill. This is going

30:43

to be the thing that's going to push me over the edge. I am done. Yeah. And I'm going to go figure out how to grow peppers in my backyard and sell

30:50

them at the farmers market. Like, I'm done. Like, this this is too rich for me. This because my brain runs down this path.

30:57

So, for those of you that your brain doesn't run down this path and you're like, "Well, it is what it is. It happens to everybody." Then I wish I had

31:03

a little bit of that in me. I think that would make me far more of a sane person than I am. Um, saved me a lot in

31:09

therapy. Um, but I I just I think that's where I would turn to you and go, "Okay,

31:16

how am I showing up the next day? What conversation am I having with the staff? What conversation am I having with the

31:21

orthodontist?" because I'm already dealing with the parent and the, you know, whatever dynamic they have. Maybe

31:27

mom's cool with it, but maybe dad's not. Maybe there's a stepdad in the picture and he's like, "Let's sue." Well, dad wants to sue, too. Like, it could go any

31:34

which way. Um, so I guess that is to me going, where does this stinky onion stop

31:40

blooming? Like, what do we do here? Um, and then I guess orthodontist said that

31:46

the kid even was like traumatized. Like then I think about it from the kids standpoint and my girls too. Like if

31:52

this happened to one of them, they're old enough, 12, 13. Are these kids going to be the ones to

31:58

be like every time they go to a doctor, every time they go to a dentist, every time they go to the chiropractor,

32:04

whoever, has this lost trust for the entire medical field and I am to blame

32:09

for this? Right. Right. It's happened on my watch. And again, there are a lot of people who are not going to

32:14

think twice about that. that y'all's personalities don't uh dwell don't dwell on that. So again, I I I

32:21

hope that's you. Um for those of you that are like me, Bethany, what do we do? Cuz I think I think my colleague in

32:27

situation one is more like not as emotional and she would be like, "Look,

32:33

it's unfortunate. I feel bad for those girls and their experience. There's nothing I can do about it. I will hope

32:39

that they are okay and that yeah, you know, it's teeth and hopefully it's

32:45

okay. I don't know. But I I I lose sleep over stuff like that. Like I Anyway,

32:52

yucky. Terrible. Like terribly yucky. Any um

32:58

Yeah. commentary on that? I know that one's not your client and you don't No. to me that one cuz you shared that

33:04

example with me um before we met today and

33:09

both are terrible but even in that I was like oh my gosh that's even worse

33:14

because it's so such a permanent longterm

33:19

decision not just impacting the orthodontic care but then also it's like

33:25

even if they re-implanted three and got it to stick how do you you now can't move that tooth you can't be moving that

33:31

around. Can you I don't know. Right. So, um I am with you on that that

33:38

I just feel like it's one of those situations that is awful.

33:44

I mean terrible in my mind extra because it is an endless path of like we got to

33:52

wait till this kid's now 18, 21. Like this is going to linger in our memories. You know what I mean? Like same with the

33:58

the fillings on the permanent teeth. I I guess to me that's why I'm a pediatric dentist. Like my mistakes aren't that

34:03

big. You know what I mean? Like that's what I hope for. Um but to me this is one that for the rest of and I don't

34:10

know how the Well, that probably would be like could this kid turn around and sue when she's 18,

34:16

right? I know. I don't think so. It's been settled, but who knows what the rules and laws are at

34:21

that time. I know. I know. Those are my thoughts. Exact. And I'm glad that you point out

34:26

that it's multi-layered because we do have multiple things to think about here. What is the liability on the

34:32

practice owner in the first example? What about the team members? Not the not

34:39

only the one that got chewed out that didn't realize the wrong uh patient was

34:46

in the chair, but also systemically for the whole team. What are we communicating? How are we talking about

34:52

this? What are what what is our protocol going forward? Well, we had a protocol

34:58

in place, but that seemed to fail us here, why? So, there's so much

35:04

training and talking and all of that that needs to occur afterwards. So, you've got the team side of it. You've

35:10

got how in the heck do I deal with this associate? You know, is he owning it?

35:18

Is he going to try to blame shift here?

35:24

to save his own hide. I think there's a risk there. Oh, a thousand%.

35:30

He already is. He already is making a few comments here and there. And I think my colleague's giving him the benefit of

35:35

the doubt that, okay, this just happened and you're processing. Yeah, but you worry about that. Of

35:41

course, you worry about the parent interaction. How do I deal with these parents? What do I say? What do I not

35:47

say? The example where the extra the wrong tooth is extracted. There's

35:52

conversations that need to happen with the patient, even though the patient's a minor. There's conversations that need

35:58

to happen with the parent. I There's malpractice conversations that

36:03

you're having. I mean, this is a this is a mushroom cloud of stuff that you're

36:09

really having to deal with, and you've got to be diligent in all of those. It's a big deal.

36:14

It's a it's a huge deal. And I think to me what what's um you know I I look at

36:20

and I kind of what I said to my team that morning when I got to huddle and I was like look like this is I'm not

36:26

trying to say you know the team sucks and y'all better not suck and y'all better do your jobs like that that's not

36:32

what I'm trying to say here. What I'm trying to say is things can happen. doctors can be

36:38

distracted or you know I was like this is why I don't like parents back in the operatory because a lot of them chat and

36:44

chat and chat and those are always the ones that I get back to write the note and I'm like shoot I was supposed to give an ortho referral or I was supposed

36:50

to check on that bump that we saw last time on the lip and I forgot to check cuz that mom wouldn't stop talking.

36:56

Yeah. And so you know but at the end of the day it's still on me. And so what I was

37:02

telling the team though, I said, "But I mean it was an assistant that called the wrong kid and put up the wrong x-rays

37:07

and put up the wrong treatment plan." Um, and for the assistant that was

37:12

sitting with the doc that was meant to extract a and extracted three, like were you just like sitting there staring off

37:19

at a space? Like you why were your eyeballs not in that mouth? And I'm on my assistance all the time about that.

37:25

I'm like, you are sitting there entering notes when you need to be looking at the airway of this kid and you need to be

37:31

know what I'm you need to know what I'm doing in the mouth here. Yeah. Um and I think there's so many assistants that just kind of check out

37:36

and go on autopilot. Yeah. And I'm like that is your job to be my second set of eyes and I y'all all have

37:44

full authority to stop the doc and say, "Hey Mhm.

37:49

what let's Yeah. Y'all need to advocate for this patient, too." Yeah. Um, the other thing like you said

37:55

where I'm kind of thinking like this puts a whole another onion layer on does your team like you because if your staff

38:02

doesn't really like you, are they going to advocate for you if a parent comes at you or if if you know this mom is now

38:09

talking to her mommy group and you're part of mommy group and they're like that Dr. Kuba is so terrible. she, you

38:15

know, on my kid and now it's this rumor mill and if like my team member is like,

38:21

"Yeah, yeah, I know I work there, but yeah, she has been pretty scattered lately. She's just opened another

38:26

practice, so that's probably why she didn't pay attention." You know what I mean? Like, if your team doesn't like you, are they going to advocate for you? And same

38:33

with this associate. Is this associate now going to throw owner under the bus and be like, "Uh uh uh, it was her staff, her this, her that." Although, I

38:39

don't think he has a leg to stand on cuz he's been there long enough. and um you know had it's not like it's a corporate

38:46

you have to do even even for corporate well they make me do this well they make us do it doesn't stand at the state

38:52

board. No. Um but I just uh there's there's too many onion layers on this. Okay. So

39:00

can I tee up the third one? Yes. Yeah. So y'all are going to really hate me for this and Bethany for this. But the third

39:06

one is another sucker punch to the stomach. I'm going to throw up. Uh but

39:11

in a in a different vein, I think the the common thread here is it wasn't the doctor, it was a team member. However,

39:19

all of the brunt is coming on that doctor. Yet again, another spot that leaves us practice owners very

39:25

vulnerable. And I think my resounding theme throughout the history of this podcast has been we cannot do everything

39:32

ourselves. Yeah, we can't. And we can all we can do is train and try and train and try and at

39:40

the end of the day like stuff like this is going to happen. And again, for those of you that are, you

39:45

know, have very strong lack of emotional uh trigger, maybe this isn't going to

39:51

hit you as much, but at least even it's still going to hurt. Maybe not hurt in an emotional sense, but it's going to

39:56

hurt in the headache that you now have to deal with. Um, and it is it is making

40:02

me go, you know what, again, staff, you want to dictate your hours. You want to dictate your days. You want to dictate

40:07

your pay, and I this, and I do this, and I do this, and then like something like this happens, and you're like, oh yeah,

40:12

are you that great? You're that great. You put the wrong kid in the chair, or you did what this staff member did. Um,

40:18

so in order to protect this practice and just to be annoying, we are going to

40:24

save this scenario for uh our subscribers. So, it's a bonus episode.

40:29

Um, so if you want to hear what happened in this practice and then all of the tips of what do we do with everything

40:36

you just summed up with all of these onion layers, what is our advice that we can try to what would we do if we were

40:43

in the situation? Um, and I know even my colleague, she had one good thing that she mentioned about malpractice. I'll

40:50

share that in the um in the bonus episode, but that's going to be all you for how do we handle all of these

40:56

things, the parent, the team, the all of the optics, all of the malpractice, all of that. And stay tuned.

41:02

Thanks for joining the conversation today. We hope that you are comforted in knowing that you are not alone, but we

41:09

also hope that you're walking away with some really great tips and tricks to try in your practice.

41:16

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41:37

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