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A Confrontation With a Patient Ends With a Bad Online Review

By April 12, 2019September 13th, 2020Dental Practice Fixers, Podcast Episodes
man sitting at table typing on computer or leaving an online review

A doctor asks what he should do about a bad online review he received from a pissed off patient. It appears as thought the patient did not want radiographs and there ended up being a communication breakdown. After hearing the story, there were definitely some steps that Rich and Dave would have recommended that likely could have mitigated this bad situation. Then of course we do the call of the week. What happens when a potential new patient calls a dental office with a bad tooth to see if it better to have it saved with a root canal or extracted? Not too tough of a question, right? Let’s see how this was handled! If you have a question that you would like answered on our podcast, please send it in to We will do our best to get yours answered!

A Confrontation With A Patient Ends With A Bad Online Review

 Voice Recording: The Dental Practice Fixers Podcast is brought to you by the Madow Center for Dental Practice Success. To find out how we can help increase the success of your practice, check out or call us at 1-800-258-0060.
[Music Playing]
Dr. Richard Madow: What happens when a new patient comes in, it’s a little bit of a confrontation or disagreement with the dentist that winds up threatening to put a bad review on Yelp. We’re going to find out that exact situation today or Season 2, Episode 8 of the Dental Practice Fixers Podcast. Hey, I’m Dr. Richard Madow: here with my co-host Dr. David Madow. How is it going today Dave?
Dr. David Madow: I’m Dr. David Madow. It feels great man. For once in a while we’re in – a lot of times it’s split screen, but I can touch him. We’re in the same room.
Dr. Richard Madow: Mom he touched me. He started it.
Dr. David Madow: We’re in the same room. Believe it.
Dr. Richard Madow: I’m a little bit uncomfortable actually. We’re very close today. We’ll it is fun being back in the home studio today. Welcome everybody for Season 2, Episode 8. So we’ve got a fantastic listener question today about a really odd situation, but I think it’s the kind of thing that could absolutely happen to any of our listeners out there if it hasn’t yet.
Dr. David Madow: I think we’re going to make a really great phone call at the end like we usually do. Our weekly phone call, this is going to be awesome today.
Dr. Richard Madow: We don’t have a time. It’s going to be awesome. It’s amazing.
Dr. David Madow: When we ask a question like this, it’s going to be awesome. I promise.
Dr. Richard Madow: Yeah. Alright, so I can’t remember what’s been happening since our last episode of the Dental Practice Fixers but what do you say let’s get ready down to it. It’s a really interesting question from the listener and I know we’re going to have fun. Some great comments for us. So Dave why don’t you take it away. I think you got this on some kind of a messaging service. What’s App, I don’t know what it was.
Dr. David Madow: One of our followers, subscribers, messaged us and then also he made it very clear and you’ll see why I withhold the name and so if you ever have a question, if you want something answered on our show and you want to keep it totally confidential, private message us and make sure you make it clear and we can probably tell to withhold your name. We’ll make it confidential.
Dr. Richard Madow: I think there’s a better chance if it’s a really good question if somebody wants their name withheld.
Dr. David Madow: I agree. Totally agree.
Dr. Richard Madow: Well you know, I’ll tell you when they give their names, that might be fake names.
Dr. David Madow: I will warn you though, this question is a little bit messy but I’ve got to read the whole thing because you’re going to see what happens in this – this is a crazy situation. Okay here we go. I’m going to read it slow though so please, well you have to hear every single word of this. It’s amazing. Dear Madow Brothers, I just had a new patient come in to my office. He wanted a cleaning, so we said great. Let’s get some x-rays so we can do an exam. He said, I don’t want x-rays.
Dr. Richard Madow: A little sound effect when he doesn’t want x-rays.
Dr. David Madow: So I gave him a long explanation of why we need them and how we use the most advanced technology to reduce radiation. He said okay so we get four bite wings, and as we’re going over to the panoramic area he said I don’t want to do this anymore. Well you can’t make this stuff up.
Dr. Richard Madow: I quit.
Dr. David Madow: So we haven’t talked about how I can get sued for malpractice if I do a comprehensive exam without either a full mouth series or a pan. He then threats me with a bad online review for making him get x-rays he didn’t need. Then I said, I didn’t hold you down.
Dr. Richard Madow: He actually said that.
Dr. David Madow: I didn’t hold you down. I didn’t bind and gag you. I wasn’t part of it. I explained why I need them and that you elected to get them. You could have left whenever you wanted and I know what you’re trying to do. You’re trying to blackmail me with a bad review. Then he tries to rationalize the bad review saying: So I can’t tell people my experience and I said, are you going to put in the review about how you’re trying to blackmail me with said review to commit malpractice. And he replied, this never happens in California. What? He left and he left a bad review. What can I do? Name withhold by request.
Dr. Richard Madow: They need to be addressed.  Would start with one. When you’re reading that whole convoluted situation.
Dr. David Madow: I know exactly what you think.
Dr. Richard Madow: Whisper to me. You point to it.
Dr. David Madow: Okay I’ll tell you right now. It starts right here.
Dr. Richard Madow: Exactly. I’ll tell you what it is. Those of you watching the video. Why in the hell would a dentist ever utter the word malpractice? When you’re talking to a patient, if I don’t do this, you can sue me for malpractice. That just paints the worst picture. Puts ideas in their head, brings up things that never should be brought up. Why would you ever, ever use the word malpractice or insinuate that you’re doing anything that’s wrong or unethical or could be doing anything that – because you agreed, because you point it to her right away to it.
Dr. David Madow: That’s the thing. There’s so many bad things in the question, but that’s the thing. Why would you ever bring up so you can sue me for malpractice. Yeah put the idea right in there.
Dr. Richard Madow: Why don’t you tell someone to get some cheap ass crazy lawyer that has a billboard on the I10 since we’re in California.
Dr. David Madow: I guess this patient moved somewhere from California so this never had to…
Dr. Richard Madow: Why put any kind of idea like that, you know, patients that – ridiculous. That’s the one thing I want to point out.
Dr. David Madow: The overall total of this, the whole scenario. What’s your thoughts?
Dr. Richard Madow: You know what’s interesting. I think the dentist sent this in trying to get like a sympathetic ear from us, but I think that dentist did so many things wrong. I think they were kind of asking for it. Agreed?
Dr. David Madow: I think the dentist was kind of confrontational – the patient might have been an asshole. There’s no question. I’m getting from this, the dentist was kind of new and inexperienced because I think an experienced dentist would not have done half of these things. First of all, he said he went through a long explanation of why we need it or how we use them. You’re pretty much – let’s make sure it’s simple.
Dr. Richard Madow: There could be interproximal carries that the radiographs…
Dr. David Madow: That’s your dental voice.
Dr. Richard Madow: You heard it before.
Dr. David Madow: There’s so many things. I explained why I need them.
Dr. Richard Madow: Let’s get back to a more basic question maybe. And then we’ll talk a whole bit…
Dr. David Madow: Okay let’s do that.
Dr. Richard Madow: What do you do when a patient refuses x-rays? I think this dentist almost coerced or twisted the patient’s arm into doing something they weren’t comfortable with and it’s never good when you twist the patient’s arm into doing something they’re not comfortable with.
Dr. David Madow: Right. But that opens up a whole another question. We as dentists feel that we need radiographs to make a proper diagnosis, and forget even the malpractice. But we just feel like not doing radiographs, you’re not getting the whole picture. Do we want to see a patient that’s refusing radiographs?
Dr. Richard Madow: I say no. Tell them to walk. Can you imagine if you went to your physician and they said we want to do this image. No. I refuse that. Then you’re out of here. Done. I cannot treat you ethically and in good conscience without a proper diagnosis. I can’t do that without x-rays. I think maybe you should find a dental practice that’s more suited to your philosophy. You don’t have to treat every patient that walks through the door especially one that’s telling you what to do.
Dr. David Madow: Yeah because chances are, a patient is already telling you what to do. I don’t like x-rays, I don’t believe in x-rays. Let’s face it, they’re going to be a kook. All the things that happen, they don’t want this, they don’t want that or questioning every step in a way. Like you just said, you don’t have to treat every patient. Make your life enjoyable. Make your profession enjoyable. Treat the patients that are aligned with you.
Dr. Richard Madow: And then what happens? Patient goes, leave a bad review on Yelp. Now this patient probably would have done the same if you’d kicked them out, but at least you have some ground to stand on that. Could you imagine if your car was like spewing smoke out the back and you took it into the mechanic and they sort of, okay we need to hook it up to this machine and sort of figure it out. [cross talking - 0:09:02.3].
Dr. David Madow: My car is not getting hooked up on that machine. I don’t believe in that machine.
Dr. Richard Madow: I’m telling you to walk, drive, run or be towed the heck out of there.
Dr. David Madow: [inaudible - 0:09:10.4] some of the language.
Dr. Richard Madow: It’s possible.
Dr. David Madow: There’s so many problems with this thing. So let’s talk about for a second. So then he got a bad review on Yelp and this dentist could have prevented it by doing some things differently and from your occasion with this patient, the patient might have been a wacko. I don’t know. But okay, so he got a bad review on Yelp. Now what, what do you do?
Dr. Richard Madow: Well again, speaking of [inaudible - 0:09:36.4], it’s never really you’ll get wacko patients. It’s inevitable that you get a bad review on Yelp or Google or whatever site people are [inaudible - 0:09:43.5]. As we know, the thing you don’t want to do is get into some back and forth with the crazy patient on Yelp. We discussed this before. Some of the strategies going and just kind of in a really nice non-confrontational way, tell your side of the story and say you love to welcome the chance to bring them back to the practice. This person you probably don’t want to come back to the practice.
Dr. David Madow: But say even if you don’t want it. Say it anyway on that to make it look good. And if they call, say I’m going to come back and say no…
Dr. Richard Madow: [inaudible - 0:10:15.1] I’m going back or they don’t want you back and [inaudible - 0:10:18.3].
Dr. David Madow: Yeah. But never get confrontational on Yelp or…
Dr. Richard Madow: Never say this patient was a jerk or anything like that.
Dr. David Madow: And also a lot things lately like whether it’s an automotive service place or hotel or restaurant that gets a bad review. The good ones have somebody that’s – you can tell there’s somebody in charge of it. Always come on and say we’re so sorry you did not have a positive experience then you have to say a few more words and say you’re always welcome back or always trying to make our service better. It’s the best way to go.
Dr. Richard Madow: I don’t know if you use TripAdvisor a lot. I don’t use TripAdvisor.
Dr. David Madow: I’m only a Yelp guy.
Dr. Richard Madow: Yeah. Well I use it for hotels. And no matter how great a hotel is, they screw up, they get bad reviews. And as you said, they’re really well-managed. It’s almost like a script which is fine. The manager of the hotel goes, we’re so sorry you had this experience. They don’t blame it on the hotel guest. They say things like this helps us to improve and we want to have you back to show you what kind of five star experience we can offer. Something on those lines.
Dr. David Madow: If you’re looking for a hotel and you’ll see you zeroed in on a hotel on TripAdvisor and you’ll see two or three bad ones like that, but you see 500 great reviews, you’re probably going to stay there. Right?
Dr. Richard Madow: I think that two or three were probably crackpots.
Dr. David Madow: Yes. But if you go on to a hotel site and you see 50 good reviews but 38 horrible reviews. You’re probably not going to stay there. So our advice to this dentist that wrote in and anybody else that’s listening or watching, hopefully watching us now on YouTube. You’ve got to really make sure your communication skills are up to – I think this dentist needs a little practice and with experience he or she will get better. But if this happens again and again and you continue to get bad reviews on Yelp, that’s going to definitely impact your practice for sure.
Dr. Richard Madow: I didn’t hold you down. You could have left whenever you wanted. I wanted to give this dentist a bad review too. What a jerky think to say.
Dr. David Madow: Well it’s horrible language, I didn’t hold you down. Why ever talk like that? Your communication skills need some improvement. You’re going to continue to get more reviews like this. I hate to say.
Dr. Richard Madow: And possibly soon. So we really appreciate that you wrote in and we don’t, it’s not our goal to start saying that docs who write in are doing all these things incorrectly but hopefully this will be a good learning experience. You please, doc use this as a learning experience. Don’t get confrontational with your patients. You don’t have to treat somebody that’s telling you what to do, but always be kind and gentle when you communicate with patients. There’s no need to use this kind of language, and certainly don’t bring up anything like malpractice.
Dr. David Madow: You and I had practices for a long time. We practiced separately, we both made tons of mistakes, but you learn from it. We’re not knocking you personally. You wrote this in. We’re not making fun of you, but you got to learn from your mistakes. Don’t let this happen again. Make sure your communication skills are getting better every time.
Dr. Richard Madow: Absolutely. Great, great. Thanks so much for writing in. We hope we didn’t skewer you too badly and just stick with us on the Dental Practice Fixers and hopefully you’ll learn.
Dr. David Madow: Should we do the call of the week?
Dr. Richard Madow: Let’s do the call of the week, but before we do the call of the week, I just want to mention I got the most amazing – I think we both got it actually, the dentist, they said they listen to Dental Practice Fixers, they took our advice, they got Fattmerchant for credit card processing in their practice, and they said, it was just like you said, completely seamless. I’m not being charged an overage percentage and I’m saving money each and every month. The patients don’t know the difference. Nobody knows who you’re using for credit card processing. Fattmerchant is the best, and if you’re a friend of ours, they’ll give you a free terminal. So just make it brief, find out why Fattmerchant is the best in credit card processing, why you’ll save money very single month and they’ll give you the free terminal if you’re an FOM. A friend of Madow.
Dr. David Madow: FOM, I like that.
Dr. Richard Madow: Bitly’s B I T. L Y/FATTMAD. Check out Fattmerchant for incredible credit card processing. BIT.LY/FATTMAD and you’ll see us on there wearing much nicer clothes and a little more made up and looking better than this too. That’s your extra bonus.
Dr. David Madow: Yeah on the website we look better.
Dr. Richard Madow: Well they think you look better. I know I’m kind of look back up but maybe a little bit.
Dr. David Madow: I can see it. Like a little face lift.
Dr. Richard Madow: Exactly. Exactly like that.
Dr. David Madow: While we’re helping you with your practice, every episode of the Dental Practice Fixers, we’re trying to – we have a topic, we have somebody that writes in, we try to give the best advice possible, but let’s face it, as great as this is and it’s pretty darn good though. We think it’s probably one of the top podcasts in dentistry these days.
Dr. Richard Madow: It’s in the top 500.
Dr. David Madow: Absolutely in the top 500. But if you really want to crank up in your practice, you want to reach a level of success, you just haven’t been able to do on your own. We recommend checking out our Masterclass for dentists. It’s a full day, we bring you in – generally we bring you into Baltimore where we like to hang, and occasionally we travel a little bit but don’t count on that at all. But it’s a full day of talking, discussing. We have our coaches there and it’s a pretty intense day, and we share with you what it’s actually like and how we can help you by working with one of our coaches. And so, if you want to increase your practice, you just can’t do it on your own. And let’s face it, most dentists can’t do it on their own. We want to share with you how we can help you predictably get to that level that you just haven’t been able to achieve. So, if you want to know more, go to Check us out. We’d love to have you. We keep Masterclasses very intimate. Somewhere between 8 and 12 docs only. We don’t let these get too big and you do need to own a practice to be able to come to the Masterclass. You’ve got to be a doctor, actually a practice owner.
Dr. Richard Madow: It’s so cool how so many people that have attended have told us it was one of the best days they ever spent in dentistry and really was the day that turned things around for them and upped them on the graph. So yeah, we’d love to see you in Masterclass. Cool, let’s do our call of the week. What do you say?
Dr. David Madow: Let’s get into it. Alright.
[phone ringing]
Female Voice: Thank you for choosing [inaudible - 0:16:36.0] How can I help you?
Dr. David Madow: Hi I’ve got a question for you. I’m kind of new in the area. I’ve got a tooth that is pretty bad. Do you all generally recommend like a root canal or extrapolating the tooth. What is the recommended treatment?
Female Speaker: It’s hard to say what the recommended treatment is, based on the fact that we really don’t know and we don’t have a diagnosis from the doctor. If the tooth is bothering you in a sense that is keeping you up at night, if it’s constantly just dull throbbing pain, that usually is indicative of needing a root canal. However, if it’s just a deep cavity or some decay that has affected the nerve of the tooth, that also could indicate a root canal. It depends on how severe it is, it could also be probably be an extraction. Just depending on how severe, if it’s like a chipped or broken or fractured tooth. Sometimes we can save it with a root canal and crown, sometimes it would need to be extracted.
Dr. David Madow: Do root canals hurt? I’ve heard bad things about them.
Female Speaker: Root canal is used to be kind of traumatic but dentistry honest to god has come so far with just managing all of that. It’s a lot better experience now than it was with say maybe even 10 years ago. Dr. [inaudible - 0:17:58.2] uses the most up to date technology, and honestly, you can even go back to work right after. It’s not a stronger thing.
Dr. David Madow: Gotta find a job. That’s a bad joke. Well thank you. You were really really helpful. I really appreciate that. Thank you so much.
Female speaker: Of course, my pleasure, no problem. Thank you.
Dr. David Madow: Thank you, bye.
Dr. Richard Madow: Wow good call. What do you think?
Dr. David Madow: Well let me tell you something. I was ready to give her an A plus. She was pleasant. I thought she answered the questions great. Yeah, I asked her if root canal hurts, and she didn’t even laugh when I asked her about extrapolation. She’s well with the flow, which is good. I asked her if it hurts, she gave a great explanation how they used to but now with modern technology and the doctor is so great.
Dr. Richard Madow: Doctor who?
Dr. David Madow: Edit that out. But the only problem is – the huge problem is at the very end, she didn’t ask for the appointment. She did everything perfectly.
Dr. Richard Madow: Well I’m not sure I agree with that. Yeah I agree that not asking the appointment is the killer.
Dr. David Madow: What did she do?
Dr. Richard Madow: I thought she went into way… She used the word “indicative” which I didn’t like. I think she wanted to give way too much clinical detail. I mean she was very knowledgeable. She spoke on the level that anybody could understand and that’s really great. So often we see people speak way over the patient’s head. So she did that very well but I think she give way too much information. I think she should have said – she said we can’t tell without the doctor taking a look and giving a diagnosis. So at that point, why not say, why don’t you come on in here for a free consultation. She went into so many – it’s this, it’s that, and the patient is going to remember. You said that if it keeps them up at night… Again, she was really good with the information, but I think you’ve kind go down the rabbit hole and start giving too much information. I think she should have gone for the close much earlier by saying. We really can’t tell what it needs over the phone. Why don’t you come right in for a consultation? But the things she said were great. She was very knowledgeable, very pleasant, spoke on a good patient understanding level. All those were…
Dr. David Madow: Would you agree with thing Rich, would you agree that even though she might have gotten a little too clinical, would you agree if in the end she would have said, we’d love to get you in to take a look at this. I have Monday afternoon at 4:00 or Tuesday morning at 10:00. Would you give her the A?
Dr. Richard Madow: A minus.
Dr. David Madow: A minus. Okay that’s pretty good because most people get an F. I want to share something with you guys. You guys that are listening or watching. If your front desk person simply made it a point to ask every single caller for an appointment and offer 2 good options, basically you’d be getting As.
Dr. Richard Madow: And more new patients.
Dr. David Madow: That’s right. Even if only 20% of that came out with some excuse and the other ones wouldn’t appoint. But 20% by you saying would you like to make an appointment. I have such and such time or such and such time. You’d be so far ahead of the game. It’s not even funny.
Dr. Richard Madow: In this call it’s like, you said I don’t know if it needs an extrapolation or root canal. If at that very point, she would have said, well I’ll tell you what, let’s bring you in to find out.
Dr. David Madow: That would have been best.
Dr. Richard Madow: I mean she was very well-spoken but that would have been best.
Dr. David Madow: She was well-spoken.
Dr. Richard Madow: That would have been better. We’d love to see you as our new patient.
Dr. David Madow: Ask her, boom appointment. Ask for the appointment. How many episodes and how many seasons do we have to do…
Dr. Richard Madow: By the time we get to season 10, every dental practice in the country is going to be asking. That’s our goal. We’re not going to quit until it happens.
Dr. David Madow: And then we have to go on Canada and Mexico. And we’re going to take over the world. Every office in the world is going to ask for an appointment. We’re going to have to know every language.
Dr. Richard Madow: You mean like an office in Papua New Guinea?
Dr. David Madow: Absolutely. No question.
Dr. Richard Madow: Guam?
Dr. David Madow: Oh definitely Guam. Guam is part of the US.
Dr. Richard Madow: My good buddy from dental school, Dr. Andrew [inaudible - 0:22:10.1] practices in Guam. I don’t know if he listens to the Dental Practice Fixers from there but if he does…
Dr. David Madow: Yeah he will be. We’re going to send him this episode.
Dr. Richard Madow: As far as you can get from where we are in the East Coast and in US. I wonder if they recommend … in Guam for their patients.
Dr. David Madow: Oh man I think that wraps episode 8. Thanks for being with us. By the way if you have a question, comment, you know how to get us. Well, that’s one easy way. Facebook, you’ll find us, communicate with us. YouTube now is even easier. You just comment on the actual episode. We want to hear from you with The Dental Practice Fixers. We’ll see you next time.
Dr. Richard Madow: Thumbs up on YouTube, good review on ITunes. We really appreciate it. Thanks everyone.
[music playing]





If you enjoyed this podcast, check out our previous podcast, A Prosthodontist is Humiliating and Degrading the General Dentists in the Community

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