Last week I settled a financial dispute with a patient who was threatening litigation. I negotiated a partial refund for services I had rendered and the matter is now closed, but I don’t feel great about the whole situation. I don’t think the patient deserved any money at all but I made a business decsion to not put myself and my office through the legal process. I’ve learned a lot by speaking with the leaders in my local dental society, the attorney for the dental society, and my dental colleagues and now I want to share it with you.
I shouldn’t go into the details of the case so here’s the gist of the story: a patient was nearing the end of treatement when they decided to seek care elsewhere. All treatment had been performed above the standard of care and there was no wrong doing on my part. The patient was unhappy with the cosmetic appearance of the work. It had been well documented on multiple occasions that the patient had refused to have an additional procedure done that would have addressed their cosmetic concern. The patient allowed the new dentist to perform that additional procedure. The patient then called requesting a full refund of money paid toward the treatment.
So the first thing to consider is when to give a refund. My opinion, and the opinion of many dentists I speak with, is that you consider a refund when:
(1) You performed a procedure and there was a complication. Whether the complication is your fault or not, you try to make the patient happy. If the patient is going to stay under my care, I may apply what they’ve paid towards future work rather than write a check.
(2) You performed a procedure without any technical complications but the patient is unhappy anyway. Perhaps you’re concerned that the patient is a little wacky and they will never be happy. You write a full or partial refund to end the doctor-patient relationship as amicably as possible.
In the case of the story I described above, I was advised by some to not refund any money at all because:
(1) The patient refused the procedure that would have addressed the concern. This was documented in the chart.
(2) The patient chose to leave my care before work was completed. The patient ended the doctor-patient relationship.
So no refund, right? Well I still had some colleagues suggest that I write a check out of fear of litigation. Even if I were to win in small claims court, which was very likely, it would cost time and money to defend my position.
Friends, that just didn’t sit well with me. I don’t want to practice in a world where fear and intimidation can be used to bully small business owners. I was ready to go to war. I was ready to pay an attorney twice the disputed amount to defend what’s right. I wasn’t going to give the patient a cent.
Here’s what changed my opinion. First we negotiated a refund that at least covered my lab bill. Second, I made it clear that I was right and the patient was wrong. That mattered a lot to me. I needed someone on their side to acknowledge that I was making a business decision and not admiting any wrong doing. We signed a hold-harmless agreement that stated exactly that in fancy legal jargon.
I don’t feel a sense of relief now. I think I would have felt relief if I had done something wrong or if I hadn’t documented that I was right. I’m glad the situation is over, but part of me wished I had lawyered up and fought this fight. We can’t just lay down for any patient that threatens litigation. But when you write a check and when you lawyer up is a personal decision and a business decision. I realized that I could still sleep at night writing this check and my business would be better off. But the day may come that a patient hints at a lawsuit and I look then in the eyes and say, politely: “Bring it on.”