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Professional Courtesy: Recommendations Reflect You by Thomas Giacobbi, DDS, FAGD

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by Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

As a full-time general dentist I cultivate relationships with three groups of people: patients, staff and specialists. I very much respect specialists and what they do, but I love that I can choose among a larger variety of procedures. I like the freedom of that. The procedures that don't light my fire can be referred to a trusted specialist. Let's look more closely at this relationship.

First, let's acknowledge the challenges specialists face. They interact with many dental practices on a daily basis and they must have the ability to connect with a variety of distinct personalities. Sometimes, patients are referred after treatment is started and the specialist has to recover the case and hopefully save the patient's relationship with the referring dentist.

Specialists must also communicate patient treatment and challenges in a timely manner since the general dentist never wants to be caught off guard by a patient calling ready to proceed with the next phase of their treatment.

Beyond the basics, a specialist can deepen the relationship by becoming a resource for the general dentist who performs some of the same procedures, or in some cases, referring patients to the general dentist. The latter often happens with orthodontists and pediatric dentists who frequently see patients from direct referrals.

The needs and responsibilities of the referring dentist represent the other side of this discussion. Whenever I have a need to refer a patient to a specialist, I make an effort to match the patient to the right specialist—this may include everything from matching personalities to taking care of patients who will only see someone in their insurance network.

I also take the time to contact the specialist in advance of a patient's visit when there are special circumstances, so the patient is not burdened with remembering details and so the specialist has a proper perspective on the clinical needs of the patient and their treatment plan.

I also monitor the care my patients receive not only from clinical reports, but also from patient feedback. This is critical and often overlooked.

In our practice, we give the patient a comment card to fill out the next time they're in the office. The card has the name of the specialist and the card is self addressed to come back to our office. If the written or verbal feedback was less than positive, we can work to improve the relationship or we seek a new specialist for future referrals. It's no secret that the treatment our patients receive while in the care of a specialist is a reflection on our practice.

On the whole, the feedback our patients provide is very positive but no relationship is perfect, and one or two patients with a negative opinion should not permanently sever an otherwise good relationship.

    These are some of the challenges I've seen over the years:
  • Staff members at a specialty office do not process insurance claims in a timely manner, leaving our team with inaccurate benefits information as we continue treatment.
  • Multiple reports from patients indicating a specialist with poor bedside manner (failure to communicate well with the patient, aloof attitude, or lack of comfort
    • during procedure).
  • An endodontist who wanted to charge a patient all over again to retreat a root canal performed in his office six months prior.
  • Letters from specialists frequently received after the patient has returned to our office for the next step in their treatment.

    The following is my advice as you continue to cultivate your relationships with specialists.
  • If possible, you should work with more than one specialist.
  • You should visit the dentists to whom you refer and see if the office and the people working there meet your standards.
  • Keep an open line of communication via telephone or email to discuss a case with your specialists. Great communication is critical for any relationship to be successful.
  • Take advantage of Dentaltown.com's private groups which allow you to set up your own private forum with all of the specialists in your referral network. This would allow discussion and coordination of cases among multiple specialists. I outlined this great feature in detail in the April 2013 issue of Dentaltown Magazine, which is available online.
Feel free to share this column with your specialists or referring dentists. I'm available by email for your questions: tom@dentaltown.com or on Twitter @ddsTom.

Dentaltown Magazine
September 2025
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