There was a recent thread on CERECDOCTORS.COM that really hit home with me. I am all about patients taking responsibility for their own situations. When a patient starts looking to put blame for their condition on someone else, that really bothers me and sends up a red flag. Some comments that we all have heard are:

- My past dentist drilled too much and that why my teeth are breaking,
- My mother never made me drink milk as a child,
- My wife buys the cheapest toothpaste she can find,
- I never received a recall card from you and that's why I am two years overdue for a checkup,
- And a slew of others.

I want to say "Come on, you're an adult; don't blame anyone for your problems but yourself." These are patients who must be educated by you. Not your team - you. They need to be responsible for their own problems before you begin treatment. If they do not have this epiphany, the first issue that arises during treatment is your fault and no one else's. I move slowly with these patients and document my discussions very well.

My ultimate goal is to have a patient understand that I am there to help them and my main goal is just that. To that end, I am a big fan of co-diagnosis. I use a two-pronged approach to achieve this goal. I print out a good digital photo and show it to them right away. I draw and make notes directly on this photo as I explain what happened, what needs to be done and how we can achieve it. I know I have done a good job when the patient begins to finish my sentences. We have arrived at the same conclusions, at the same time in an 'A-HA' type of moment. We have co-diagnosed.

I then start a conversation on how to prevent this problem in other areas and what THEY need to do to make that happen. This photo becomes a part of their patient record and is dated and noted that this was part of a discussion regarding pending treatment.

It doesn't end there, though. I make the patient a part of some of the treatment decisions as we move through the case. Nothing technical, just input on how they would like this area designed, usually while adjusting the proposal on the CEREC screen. Also, when staining a crown, I give them a mirror and ask questions along the way so they have input. This makes them proud of the result, as they have had a role in the fabrication. In essence, at various times during the treatment process, I let them "Drive the Bus."

Through these techniques, we can make the patient understand that their problems are indeed THEIR problems, that they can help in the diagnosis and therefore understand the etiology and prevention, and have a role in the final say of how their restoration is designed and how it will look. By making them a part of the process you will make them happier, because who isn't happy Driving the Bus?