Dental Practice Heroes

Owners Only: What To Do When Things Get Weird

• Dr. Paul Etchison • Episode 634

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Sex questions, angry patients, and a staff meeting joke gone wrong — welcome to dentistry.

In this episode, the DPH coaches share the weird, unexpected, and straight up awkward moments that have tested their leadership and their staff. Their stories highlight how you can respectfully handle uncomfortable situations in your practice and continue to lead even when things get messy.

Topics discussed:

  • Henry’s awkward break room moment
  • How to handle explicit questions from patients
  • The joke that taught Paul a lesson
  • How to talk to employees about co-workers’ complaints
  • Running into former employees outside the practice
  • What to do when a patient gets out of control
  • The “nice to doctor, rude to staff” patient
  • Holiday party chaos and how to control it

This episode was produced by Podcast Boutique https://www.podcastboutique.com

Take Control of Your Practice and Your Life

We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.


Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.

Paul Etchison:

If you ever walked out of conversation in your practice thinking, why did I just say that? Or how did I end up in that situation? Well, this episode is for you because as your practice grows, you will deal with a bigger team. You'll see more patients, you'll have more personalities, more moving parts, and those uncomfortable moments, those embarrassing things that happen, those sticky situations. They aren't an if, they are definitely a when. Awkward staff stuff, weird patient questions, unexpected conflict, it all comes with the territory of being a practice owner. And if you're not ready for it, those moments can rattle your confidence and make leadership feel heavier than it needs to be. Well, today on this episode, we're gonna have some fun with it. The DPH coaches and I are gonna be pulling real lessons out of real situations that we've had, how to handle those awkward moments as the owner, how you can protect your team and your culture, and how to lead without letting all that weird stuff and unexpected things throw you off. Now, you were listening to the Dental Practice Heroes podcast, where we help dentists cut clinical days, increase their profits, and build practices that run on strong teams and solid systems, not on constant owner adrenaline. I am your host, Dr. Paul Etchison, the author of two books on dental practice management, a dental coach, and the owner of a large six-doctor practice in the south suburbs of Chicago. And today I am once again joined by my two DPH coaches, Dr. Henry Ernst and Dr. Steve Markowitz. Now, Dr. Henry, owner of an 18-hour practice in the Carolinas, and Dr. Steve, the owner of six practices in the Boston area, each of them just practicing dentistry minimally. And these are the guys who live the DPH style, teach the framework, and have helped dozens of dentists do the same. And today we're talking about some sticky situations. Are you ready? Let's go. Hello there. Welcome to the Dental Practice Heroes Podcast. You're listening to myself, Dr. Paul Edgison, and we're here with the coaches, Dr. Henry Ernst and Dr. Steve Markowitz. And we're taking apart situations that we think are important to practice owners to help you be the best practice owner possible. And, you know, we were talking a little bit before this, and it turned into, we're like, let's do an episode on it. We're talking about some uncomfortable situations. And I'm sure if you're a practice owner, you've got yourself into some uncomfortable situations where you look back on it and you're like, how did I let that happen? Why did that come out of my mouth? What the heck was I thinking? And I thought it'd be fun just to go through some different situations because these are random as hell, but I think there's something to be learned from each one of these. So I'm going to pass it to you, Henry. What is, when I say like, can you think of a really uncomfortable situation you got yourself into? What comes to mind?

SPEAKER_00:

Thanks for passing me the rock first on this one. So, first off, I'll go with one that's a fresh in my head. And this is just a random thing. And this can happen when you're having a bigger practice that's got more people, more touch points in dentistry. So recently I was walking around a potential new office manager in the office, and our break room is huge. So we have at least 10 people in there at lunchtime sometimes. So I walked a potential new practice manager in there, and all of a sudden she looked at one of our team members and says, You look familiar. The team member looked straight at her and said, Yeah, you fired me at my last job. So dead silence. Dead silence. And I didn't, I was just like, okay. And I just kept walking. And then granted, when I sat down with this person, she's very mature. And she said, I was in such a bad situation when I took this manager job in another office. The first day they told me to terminate this person. So she asked for permission to talk to her one-on-one. So it was actually good. They got the thing out. But that was one that came to mind. Another one, this is one that's more lighthearted. This is a patient one. Patient's in the chair. I removed all of his teeth, wasn't sedated. I removed all his teeth, placed dentures in his mouth, and the patient looked at me and he did that little. I don't know if you guys have seen this before. Before the patient's going to talk to you, the patient looks to the side and see if the other's an assistant there. Whenever they do that, you know something interesting is coming out. And he saw there was a female dental assistant there, but he still went anyways. He goes, I just got to know, doc. What about oral sex? And I said, What about it? And he said, You want some? He said, Can I have oral sex like with these dentures? And I said, Well, and he basically was asking, could he perform oral sex? And I looked at him and I said, You know what? Put some fix it in there, go for it.

Paul Etchison:

See, I would I would have gone the other way to make him feel weird. I'd be like, Well, I guess you could put the dentures in like a mannequin head. I what do you mean?

SPEAKER_00:

Like I took it this way and I said, Well, look at it this way. I'm glad that you're confident that you got your new smile and you've got that much confidence. Go for it.

Paul Etchison:

Oh, yeah. You know, that's actually a success story. You should probably use that in some marketing of some sort. You know, what bums in my mind, actually, going back to your first story, Henry, what's a good thing is that that uncomfortable situation happened and that your employee said you fired me. It's good that it came out. Like, I think like some of us as practice owners, like our goal as a leader is to draw out these conversations and get them out into the open because otherwise there would have been all this resentment. And nobody knows why. No way, why does this person, I swear this person hates me. I don't know what I did to this person. And then you're like, oh, that happened.

SPEAKER_00:

It was dead quiet. There was so much quiet between in a room with 15 people. And I just put my put my arm on the shoulder of the okay, let's let's see the rest of the office.

Paul Etchison:

So I I'm gonna share a good quiet story where I, you know, I one thing I'm good at is I'm pretty good at dentistry. I'm good at leading people, but I'm good at sucking all the air out of a room every now and then. So we were doing a meeting, maybe 30, 35 people on my team at the time. And we've got somebody on our team that just very talkative, you know, great employee. She's not there anymore, but she was a great employee. She was somebody, if you asked her to do something, she'd do it right away. Smile on her face, patients loved her, but she would just get distracted, just talking, just always want to talk. And something came up, like somebody asked a question. She asked a question during the meeting, and it was something like I don't even remember what she asked me, but like my joke was like, Corey, let's get real. You're just gonna be in the back room talking all day anyway. And I said this in a room full of people as it is a funny joke. But when you say that in front of a room full of people, it's not funny. And it got really quiet, and then she cried and ran out of the room, which was rather embarrassing, which leads me to the conclusion is that funny jokes are sometimes funny when it's just one-on-one, but nothing is funny when you call it out in front of a whole room, front of your whole team. So if you have to give somebody feedback in the same regard, don't do it in front of a whole team. My other thing that comes up is we did these anonymous surveys and we had one employee and she was a hygienist, and it came up on a few of her surveys. It was like, what should somebody do less of? What do they do more of? Much like your thing that you always recommend doing with like publicly, like Henry recommends doing this with your whole team. Like asking everybody, what should we do more of? What should we do less of? But I cited her, I said, Hey, I'm just gonna go Susan. Susan, I'm gonna say something that has come up on a number of surveys, and I just want you to acknowledge it, and we're just gonna move on from it. And we're not gonna ask questions and we're just gonna go. And she's like, Okay, what is this? Like, I don't even know what this is. I said, A number of people at the front desk say you walk up to the front desk, you fart, and you walk away, and it smells after you're gone. And she goes, What? I said, We're just gonna move on. She goes, No, who's I'm like, we're just gonna move on. I don't know. It came up on multiple surveys. Anyway, moving on. And um, I kind of like that way of handling it.

SPEAKER_01:

Are you, are you, Susan?

Paul Etchison:

No, no. If I'm gonna do it, I'm gonna announce it and everyone's gonna know it was me. Yeah, no, yeah. You're proud of it. I gotta say, like, it was an uncomfortable situation. But after that, I was like, I'm pretty happy with how that went because I can't imagine doing that any differently. Like, hey, I gotta talk to you about something. It's come up quite a bit. Like it was a nice, lighthearted way of doing it. So, Steve, what what pops in your brain? Uncomfortable stuff.

SPEAKER_01:

I'm really awkward, dude. So there isn't a lot of stuff that makes me uncomfortable. But Henry's first story did remind me. So this was probably four years ago at one of those regional dental conferences. There's one in Boston every January. And like I'm in between what I'm taking some courses or something, and I'm in between, I'm sitting at one of those tables just with like random people. And I'm just I'll talk to literally anyone. So I grabbed my drinking water, I turn to the next person sitting next to me, and I was like, Oh, where you know, where are you from? Where do you practice? She had like two seconds. She started looking at me angrily, and I was like, This is weird. I actually forget her name, but she was like, I worked for you for two years. And I was like, Oh my goodness. She works with you currently? No, no, no, no, no. She left, she left. Oh she used to. I worked for you for two years. And I was like, Oh my goodness, you look so great. And I like stood up and gave her a hug, and and then I went back to my seat, like put my face in my sandwich, and I was like, I cannot wait to tell that story to people on my team. So, why didn't you remember her? It was like right back from COVID, people wearing masks. Like, yeah, I wasn't really working with her that closely. Like, I probably saw her maybe once a week. And then, like, out of context, I never would have thought that I would have seen that woman ever again. I wish I knew her better. Uh, I don't know if that's the lesson, but we were trying to come up with uncomfortable stories. Like, there's it takes a lot for me to get uncomfortable, but as soon as Henry talked about his first story, I was like, Oh, I remember.

SPEAKER_00:

Would the denture patient story make you uncomfortable?

SPEAKER_01:

Or no, no, I I get that. I I mean people bring that up, not all the time, of course, but I do hear that stuff.

SPEAKER_00:

I wasn't uncomfortable with me and the patient. I was uncomfortable because the assistant was there, the female assistant.

SPEAKER_01:

I think for me, it's more like this is gonna be a good story. So let's see where this goes. And then we can we can bond as a team over this person's either boldness to ask things, because they could have said, like, I like to drink through straws, and sometimes they're bigger than others, and that could have got the same point across. Oh, Paul, what are you looking at? I'm so confused. And first Henry's second story or whatever, I don't know. Oh tell me more about the straws, like what? It's the same thing.

Paul Etchison:

Oh, just random.

SPEAKER_00:

Same ocean. Okay. Okay. So I gotta so here you can grade these, so you see if these would make you uncomfortable. And I will say that I'll preface this by saying I feel like a lot of these things happen. And I heard the term, once you start growing your practice and you start having associates, your practice is never the same. I feel like a lot of these things happened once we grew to that kind of sort of mega practice level. So one day, one of our hygiene team leads came up to me, and we always hate to hear this line. I gotta talk to you about something. So she came up to me and told me that when one of the associate doctors goes to the bathroom, he always leaves pee on the seat. And Henry, you have to talk to him about it. So I had to talk to an adult male about peeing on the seat and leaving the seat up. So he explained it to me where he didn't put the seat up, but he doesn't pee on the seat. But the splash from the water hits, lifts up and hits though. He's not peeing on the seat, but it's like the water.

Paul Etchison:

So he says, My aim is good, but my power is stronger. My stream is stronger.

SPEAKER_00:

What do we think about that one, Steve? Is that uncomfortable?

SPEAKER_01:

No, it's not uncomfortable. It's okay, I would just be genuinely curious of the power of this stream that would come. Or, or maybe just in your practice, you your water level is super high.

SPEAKER_00:

Maybe it's the only guy who does that, I guess. I don't know. One more that this is more of like uh a more serious one, I guess, is we had a patient one time that got a tooth removed, and he we've all had this patient. He legitimately had some soreness afterward, but he kept asking for meds, kept asking for meds, kept asking for meds, and he got to the point where he was just really, really rude to the staff and cursing them. And so I had to be the bouncer. And I came up to him and I said, Listen, we did talk, but not here, we need to go outside. So I took him outside, we're talking, and my staff, one of my older staff members that knows baseball, he was he said that I was like Earl Weaver. If you know that analogy, the old Baltimore Orioles, I had my finger in his face and I was basically saying, You cannot do this, you will not be here anymore, you cannot be here anymore. You need to leave. Respectfully need to leave. And so the cool thing was when that happened in the moment, your heart rate's up. And I didn't know if this guy was gonna swing at me, but I was kind of ready in my head. But my staff looked at me like I was Superman. Like I took control of the situation. I didn't accept that they were getting belittled and you know, bad words to them. I put my arm around, I said, we need to talk outside. And I know that's something different, but that's still uncomfortable.

SPEAKER_01:

No, it is definitely uncomfortable.

Paul Etchison:

No, I think that's great. You go to Bath for your team. I had a patient that it was just like every time she came in, we're like, oh, because she was just such a pain. She was like kind of like passive aggressive rude. But she wasn't like almost like it's like outwardly kind of rude, but not so obnoxious that you're like, hold on a second, but it just like keeps wearing at you every little thing. So I finally had to talk to her and I said, Hey, I gotta talk to you about something. Like a lot of people on the team, they say, like, you're kind of rude to her, and you're always really nice to me, but like she's like, Oh no, I know it's she's like, I sometimes I do that, I'm working on it. I have a like thing with the way I grew up. Like, I'm always trying to assert myself, trying to be more assertive. I think it comes off too assertive. And she was super apologetic. Like, I didn't think she was gonna be that way, but it was really hard for me to have the conversation. Yet I had it. My team was really happy I had it. Now she walks up with the hygienist right after this conversation. She walks up with the hygienist at the front desk and she looks at the hygienist. She goes, Don't check me out with that girl. I can't stand her voice. You know, we're like, hey, you know what? She obviously doesn't think there's anything wrong with this. Let's just brush it off and be okay. I mean, she's not being aggressive, but we don't love seeing her. She's still a patient.

SPEAKER_01:

So to piggyback on on like the difficult patients, I see that a lot too, where patients uh behave differently with me than with other people in the office. What is your line for when it is like when you try to insert yourself to be the hero? Not to like have a conversation like Henry did, but like to fix it and be like, oh, just take the patient versus just dismiss them. Is there a line for you on when you differentiate between how you're gonna react to how the patient's behavior?

Paul Etchison:

Well, yeah, I think a dismissal often makes the problem worse, in my experience. Dismissals are not cut and dry, at least not in my practice. When we've dismissed people, they want to come talk about it. Oh, let's talk about it. I won't talk about it. This is bullshit. You know, you gotta weigh the thing, is like dealing with this person worse than a dismissal. And I remember we had we talked about this a long time ago, and I said I was gonna dismiss a point a patient that week. I did. Yeah, that's that's a tough one, man.

SPEAKER_00:

Henry, what do you say? I'll give you an example that just happened recently. I had a patient who's the nicest patient. She's so sweet. We did overdentures for her, and we finished the case. And we there was one visit where we were a little bit, it was when I was gone for like a week or two, and I was really busy one day, and I fell behind like a half hour. And so the husband calls, and the husband hasn't been in the office for two years. He calls and he's cursing out the person on the phone. You guys are stupid. Why'd you guys make her wait in a half hour? This is bullshit. And he was just rude. And he had done this once before, and I called him out on it. But this time I called and we sent him a letter, and I told her, I said, Listen, your husband, he's not allowed here anymore. I love to have you here. You're good, and we, you know, don't look at anything upon you, but he's not allowed to be here anymore. And I won't, and if he walks into this office, I'm gonna call the police. And that was it. Done, haven't heard from him since.

SPEAKER_01:

So is he still a patient?

SPEAKER_00:

Yes. And I would say once it gets to the point where your staff is feeling uncomfortable, and maybe it comes innately to me because I'm a father of four daughters. When my staff starts feeling uncomfortable or they may feel unsafe, then that's a big issue, right? And that you have to draw the line. And it's not trying to be a hero, but it's protecting your team.

Paul Etchison:

Yeah, I hate those people that they can be so rude to females, but then like when we walk in the room, there it's like they can't. I mean, I'm not trying to out-alpha them, but it bothers me.

SPEAKER_00:

I'm trying so hard. I want Steve to give me some uncomfortable shit. So I'm gonna try to take this another direction. How about we all have big organizations? How about it's I just put up our Christmas tree against my will. My nine-year-old made me.

SPEAKER_01:

Against your will. Right, in your house? Yeah, it's like you're supposed to put the Christmas tree up after Thanksgiving.

Paul Etchison:

Oh, I feel like that changed. I feel like it's November now.

SPEAKER_01:

It goes up. We go the Friday after Thanksgiving to go into Christmas party.

SPEAKER_00:

That's acceptable. So, anyways, it's about Christmas time. We all have Christmas parties, I'm sure. There has to be some sort of interesting Christmas stuff that happens at the Christmas party. Do we have alcohol at our Christmas party? I mean, I mean, I've got some stories, but I'm trying to pull some stuff out of Steve over there.

SPEAKER_01:

Yeah, I mean, we've had all that. Like, there was a time where it's like we tried to limit alcohol, as much as alcohol at our Christmas party because we do, like you, Henry, we try to have one full organization bashed, and there could be 200 people at that thing, maybe more. And a couple of years ago, there was people drinking on the dance floor, and a couple glasses broke, and then someone stepped on the glass, and then they had to go to the hospital because there was they got glass in their foot. Like, but that's not doesn't make me uncomfortable. I'm like, oh shit, we need to do something different because you guys are a bunch of fools, and now we can't have as much fun. So a humbug. But I don't know if if it makes me uncomfortable.

SPEAKER_00:

We have fun. I mean, my major rule is no everybody Ubers, you know, no drinking and driving. But I mean, I have a laundry list, team members hooking up. Uh, we've had throwing up on the outside, we've had lots of stuff, lots of stuff. And the old adage is like, have fun, guys, there's no judgments. But I'm not, I'm usually the last one to hear about stuff months later.

Paul Etchison:

You ever have one of those ones where like and maybe this doesn't happen to you? I know this has happened to my hygienist a few times, but where they're going to take the bib off the patient and the patient thinks you're going for a hug. Yeah.

SPEAKER_01:

That actually, sorry, Henry, that would make me a little uncomfortable. And then we would have a long embrace. I there you go. My goddamn, if they're coming in for a hug and I wasn't expecting it, we're just gonna do we're gonna do a really weird bro hug for like way a little too long where everyone is uncomfortable. So you're a hugger. Oh, yeah, you know that.

Paul Etchison:

Dude, I have this patient, Anne, that loves me, loves me, loves me, loves me. This patient named Anne, and she loves me and she always wants to hug me and give me a long embrace. She's very sweet. She went for like a she started kissing me on the cheek. And then the one time she grabbed my chin and she got me on the lips. Nice. Yeah? Yeah. How old is Anne? Uh, 60, maybe. That's too young for you, Paul. What do you mean? She wasn't wearing a nice blouse. She wasn't blouse age.

SPEAKER_01:

This was, I was helping out just doing some exams when I was sobbing by one of her office the other day. This 83-year-old woman, I walked in, and she's like, You are too young to be a doctor. And I was like, that's amazing. I've been doing this for 18 years. That's the nicest thing anyone's ever said to me. But not young enough to be my lover. She walked out into the hallway and was like, Dr. Markowitz is gonna go call his mommy for a ride. And just like, literally, yeah, making like I never met this woman. And I'm like, this does not make me uncomfortable, Henry. But I just need you to know that 80 plus year old women, that's my key demo.

Paul Etchison:

That's mine too. I do well with that as well. Why is that?

SPEAKER_01:

This was actually last week. I had a woman for the first patient. She literally asked the assistant for my autograph. So she lost a crown. She brought it one of those like Sunday, Monday, Tuesday, Wednesday, Thursday medicine date holders, and it was a Thursday, and she put it on Friday. And I was I came in and I was like, Did you lose this crown last Friday? And she said no. I was like, Well, today is Thursday. Why did you put it on Friday? Oh, it's messing my whole week up. I didn't think that was going to be funny. She literally lost, she thought it was the funniest thing that's she's ever heard in her life. That when I walked out, she asked for my autograph.

SPEAKER_00:

We have it with the older ladies. I mean, I had one this week. Last week I put four implants on a patient. She's probably like 70-ish. And I ran to the grocery store next door just to get some rotisserie chicken or stuff. And I saw her at the Will wine counter where they have there was a lady giving out free cheese samples. And she was talking to the lady at the wine, and she was doing this. She was showing, lifting and showing her implants to the lady at the counter. And she made eye contact with me and called me over. She goes, Look at this. This is Dr. Ernst. He's the one who did this. You should do this too, because you have no teeth on the bottom. And look how handsome he is, too. Handsome young man. I was just like, oh my gosh.

SPEAKER_01:

Little Henry finally getting his.

Paul Etchison:

So, Steve, when when she said you got to call your mommy for a ride home, were you like deep down, like somewhat offended?

SPEAKER_01:

You're like, oh, I'm a big boy. I'm a big boy. Not only my mommy. I was offended. And then this is gonna come off like I'm such a jerk, but I don't really care.

Paul Etchison:

Oh, I can't wait for this. This is gonna be great.

SPEAKER_01:

This is gonna be good. My mother just had her 70th birthday, and I got three boys. They wanted to go, they were coming to her 70th birthday party, and it was uh like a costume party she wanted. So they were practicing on how to talk to older people at the party. We went into Google Translator, and it was like how to talk to old people. And Jacob was saying, like, what do what do I say? And Google Translator, what I put in was, It's so nice to see you. Good job, not dying. And like those were the types of things that I was that we were sharing with my uh with my three boys on how to talk to different types of of people. And um, we went over really, really well.

Paul Etchison:

It's awesome. I love it. You know, just wrapping things up. You know, I think what we learned from this episode is that Steve gets in uncomfortable situations, but doesn't get uncomfortable. Yeah. Unless it's an airplane.

SPEAKER_01:

If it's an airplane, Steve's very uncomfortable. Oh shit, man. I think the lesson is that we have the same stuff as everybody else in these practices. We see the same stuff and deal with the public as art. And as long as we can still laugh about it, we're gonna be in a good place.

Paul Etchison:

That's right. I like that. And just to leave the listeners with something fun, if you want to do uh an interesting thing, go into Google Translate and ask it how to say this in French. A seal pushed me yesterday. Ask it how to say a seal pushed me yesterday in French. You'll you'll very much enjoy that. That's what that translation sounds like. All right. Thank you so much for listening. Uh, dentalpracticeheroes.com. You can get a free strategy call. Go to the website and sign up, and we'll talk to you and talk you through what it'll be to have better practice, more freedom in your life, more money, more time off, more associate driven practice, whatever you like, whatever your heart desires, whatever your goals are, we will help you do that. Thank you so much for listening. Take care.

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Dr. Paul Etchison

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