“BIG, BEARDED, BURLY MAN”: Avoid this Treatment Planning Mistake!

The beat-up pickup truck rolling up to the practice began a day I will never forget…For all the wrong reasons!

My assessment of the driver began as he walked up to the front door: Big, bearded, burly. Not the kind of patient likely to say yes to whatever diagnoses lurk behind that scruffy mug. And there were diagnoses. I was none too pleased when the doctor presented him a 10 thousand dollar treatment plan. What would this do to my case acceptance rate?


When the patient returned to the desk, I found myself in defense mode, as if sympathizing with what I expected to be excuses and hesitancy. In fact my sympathetic conversation amounted to talking him out of the treatment necessary. Clearly I was acting neither in the interest of the patient or the practice. I was guilty of the “J” word…I was judging this man based on his appearance.


I wasn’t prepared for what Big, Bearded, Burly man did next. He told me quite directly:

“Well the doctor said I need to do this, this, this and this. That’s what I want to schedule for…I want to pay you today…BECAUSE I DON’T WANT TO SEE YOU WHEN I COME BACK!”

OUCH! Needless to say, I felt utterly ashamed (and about two inches tall) as he walked out the door with follow-ups scheduled.


I have never made the mistake of pre-judging people since that day. I stick to a specific three-part strategy when discussing treatment and money with patients:

  1. Tell the patient their treatment plan responsibilities.
  2. Clearly explain the consequences of not accepting treatment.
  3. Provide a solution!

That’s it! Remember to listen to the patient. When we feel concerned that a patient can’t pay or won’t accept treatment before we even listen, we are pre-judging that patient. And the damage can be lasting.

That patient got his treatment, but probably also remembers how I made him feel that day. Next time you encounter your own “Big Bearded Burly Man,” begin the conversation with an open ear, and continue as their advocate. Nobody will think less of you for that!