Food for thought. ðŸ’🤔
Once, a patient was sitting in the chair and suddenly demanded, "Get me my old files." It might have been a total misunderstanding in communication, but it's common for patients to question whether the work was done well or if it should be free when not liable, especially after the standard post-care period of 15 days. This is often a result of human error, the learning curve, or practice with time—an aspect that’s a shared responsibility between the practitioner and the scientists who deliver the technology, with the patient therefore called to follow post-care instructions. Whether it’s complex procedures like implants or simple silver fillings—despite concerns about toxicity—what matters is the longer durability gained from experience. After investing time, effort, and money into learning, and with the patient's trust in the procedure, this needs to be understood. If you trust your doctor, go back to them. I am sure their intentions are to do their best within their abilities. Don’t undermine either your own choice or their efforts in a trusting society that works in harmony and efficiency. In the mouth, there are many variable factors that could lead to failure—from the practitioner's technique to unknowingly biting on something while eating, or even missing a canal or a broken file during a root canal. These issues are often only realized after the standard 15-day post-care period or during the procedure, respectively, which is generally understood. The "do no harm" principle, as previously mentioned, is always followed. However, we have extended this post care period to two months, with the understanding that sometimes things happen, and we might be able to help you without affecting our family's ability to put food on the table by doing endless free work. Fillings, root canals, crowns, bridges, and sometimes even implants inevitably fail over time. Implants have a 5% failure rate, so even after spending lakhs, we've seen cases where they go down the drain for both our patients and others. Yet, it's still about hope—hope that with proper care, time, and effort, the result will be successful. So, preventive care and better case selection are key, while leaving the rest to God.
Our goal is to provide safety and peace of mind for our patients, ensuring a good night's sleep after a well-done job. We do not aim to do free work to retain a patient's trust, but rather to acknowledge that the learning curve in dentistry can take decades, and every day offers something new to learn. Blaming the doctor, the scientist, the technology, or the idea doesn't solve the problem, nor do excuses from either the patient or the doctor. Instead, adopting a gentlemanly or lady-like approach helps, and I hope and pray that this leads to a better understanding. The patient may be curious to learn and understand, which is why we introduced the D warranty—to align healthcare and business practices, clear any misunderstandings, and reach a solution. Can you go to a hospital and ask them for a free surgery after a failed surgery, again? Sometimes, all the fees taken by a dental surgeon is a smile. Most dentists have gone through the journey of thanking patients for allowing them to practice during their examinations, and later in life, this gratitude extends to retreatments. More often than not, a smile remains the only fee—along with the wisdom gained and healthcare business administration alignment strategies. This ultimately benefits everyone: families, patients, new technology, the dental industry, the country's GDP, and a better world.
Since it's a service, we do not offer refunds, but we are willing to provide some leeway within the specified timeframe as stated in the D warranty. Ultimately, we emphasize the shared responsibility of preventive care between doctor and patient. Do you demand your mother for food on the table like a crying baby, or have you grown up—with teeth—to enjoy the meal and serve yourself? So, strive for oral healthcare and other awareness. I try to, at times, focus on it—preferably before or after the post-care of treatment. We initially started a decade ago with paper files, which I categorized and carried in a briefcase, keeping them alphabetically ordered in my clinic and contact list in phone Google account. Now, backed up furthermore, on an excel for annual reminders. As our patient volumes increased in the limited space of Dr. Dhruv Dental Care at GG Hospital, we had specially designed wooden shelves built by their carpenter. Nowadays, easier access and solutions to call with Urban Company.
Eventually, my mentor suggested that for future clinics, stainless steel cabinets would be more hygienic and ergonomic, eliminating the need to bend for files. At that time, we used both wooden and granite hygienic surfaces for storage, ensuring cleanliness. Later, we expanded to bigger cupboards with tiled surface in the waiting area to manage files systematically. However, due to the misbehavior or misunderstanding with one patient, we realized it was better to follow the mandate of the D warranty and keep files for only five years. Much before this incident, we had already transitioned. Respecting the loyalty of our initial patients who trusted us during our early days, my dental assistants personally scanned each paper file and uploaded them onto a hard drive. We then further transitioned to an electronic system using written Doxper prescriptions after trying platforms like Lybrate, Practo, and others, which we found inconvenient, tedious, and highly time-consuming. These platforms required extensive data entry, which could ultimately be lost when transferring to another provider's similar system. In contrast, I feel safer with a doctor-patient-centric approach that prioritizes privacy and direct record management. Spending an hour after patient consultations to input data proved inefficient, especially after a long day of treatment. The Doxper system allowed us to maintain systematic records for old patients while enabling more efficient and streamlined service, supported by a helpful owner and excellent customer service. It also offers the possibility of fostering a long-term relationship without incurring excessive costs that patients might otherwise have to bear, especially with the increasing costs each year, based on my one-year experience using their software and the annual renewal dental maintenance. Now, patients are encouraged to save their prescriptions and bring their own files. For legal purposes, we electronically archive prescriptions, but we no longer retrieve old files. In some rare cases, we may personally retrieve dental patient files, or our dental assistants may be politely asked to do so—either to verify or access information, such as addressing false claims of treatment due to a patient’s forgetfulness, claims of additional unpaid work (which is typically noted down with side notes accessible to you), or to review medical history for preventive measures that need to be taken. We have now tick-marked these medical details in our updated form image below, and we kindly request that you verbally inform us and carry your updated medical prescriptions, along with all relevant current or past medical history when visiting. This may also include removing old files or transferring them to other dental clinics or panel practitioners during cases or after the mandatory retention period, all done with mutual understanding as an additional service offered 'for you.' This is considered a privilege stemming from a hopefully long-term relationship—whether the file is needed for a case, has been misplaced or forgotten, or is required by another dental practitioner. However, we do not actively encourage this practice. Patients must take responsibility for their health—they’re not children. Other than their children, they are responsible for bringing them to our clinic to be served. This approach helps save time, space, and money for both us and the patients, while ensuring their data is securely managed and their privacy concerns are duly addressed. Though uploading to servers does take time and may involve occasional technical errors, I am sure the team is working on upgrades to improve the system while data reassured safe.
To simplify the process and ensure all parties are happy, a new D warranty prescription will be filled each time you visit, unless you're undergoing ongoing treatment. In that case, it's advisable to bring the previous prescription along. This helps ensure clarity for payments and prevents errors in work delivery for both parties. Keeping communication clear—between patient and doctor, and within the doctor and team—is essential. Whether or not the helpful D warranty prescription is included, it's important to have the treatment plan, other relevant information, and post-care medications clearly outlined. You can access post-care details and FAQs via the website link on the QR code.
Similarly, you need to take care of your nutrition. If you keep losing teeth, how will you digest your food? The process of mastication and salivary enzymes plays a vital role in initial digestion. Prescriptions give us a case history, and maintaining each tooth is crucial for continuous healthcare. Enjoy that yum 😋 McDonald’s meal, or any other but remember the importance of preventive care—or opt for something healthy yet tasty, like my mother's carrot cake from my recent birthday.
On Digital Records and Patient Responsibility
In the past, patients or clinics or hospitals hoarded X-rays and files at with them or at home, creating a pile of unnecessary clutter. Now, you can scan your X-ray or take photos with so much storage use AI tools, such as CRM Aident, for self-assessment. We retain only the OPG (Orthopantomogram) images sent by Raddon Diagnostic Centre to our email address at care@drdhruv.com. Alternatively, you can save these images as they are typically sent systematically to us via WhatsApp as well. Thorough checkups and timely follow-ups prevent cavities and ensure better outcomes. IOPAs on the Kodak system are categorized with the prescription date as the key reference for when the X-ray was taken. Please ensure you write today’s date along with the patient’s name in bold letters and your mobile number clearly. Share this information with us whenever you wish for us to provide the X-ray, or take a photo under the direction and guidance of the doctor after treatment for your records.
For privacy, the X-ray unit is not connected to the internet, and the data remains on the system until it crashes. Meanwhile, we continue to cover the cost of the maintenance personnel to ensure its upkeep.
On Capitalism and Collaboration
Preventive care dental packages are the future, whether you like it or not. Asking dentists for warranties, guarantees, or free services isn’t sustainable. Trust that we’ve worked tirelessly for years, and our dental profession deserves recognition for the sacrifices made to ensure patients' health. Dentists shouldn’t have to bear the burden of servicing implants or managing spare parts indefinitely, especially with the advent of new technologies such as regenerative tooth growth in Japan or systems like D warranty, which, at least in my framework, is not feasible for osseointegrated implants in the U.S. Preventive care empowers patients to avoid costly interventions, such as basal implants—which we do not recommend due to their one-piece design, making crown repairs challenging once attached. Instead, screw-based implants, preferably Nobel Biocare Active implants, are recommended, given their trusted international lifetime warranty. This warranty remains valid as long as the patient retains their sticker and collaborates with any dental practitioner. However, we are not liable for these warranties, leaving it to the patient's discretion to assess the risks of older, tried-and-tested technologies with some failure rates versus waiting for new advancements. Also, avoiding complex jaw surgeries, such as those needed for patients who have not undergone pre-orthodontics or cancer treatments requiring GA (general anesthesia) like Manipal hospitals facilities, further highlights the importance of early maintenance and proactive dental health. Let’s aim for a collaborative approach—patients, dentists, and corporations working together for the greater good. It’s time for egos, like those of Musk (the richest man) and Trump (the most powerful man), to unite for impactful initiatives on platforms like Twitter and beyond—such as Mission Mars—and not just a DOGE retrieving files to make memes, but with loyalty and a smile! 😊 Health is wealth, and your family, prosperity, and community form the backbone of a healthier, happier world.
A Message of Gratitude
Javali and Associates assisted in drafting the RPID (D Warranty, updated brief details at the bottom of the image below: legally and scientifically understood prescription) and auditing our accounts. Thank you to my parents, patients, team, wife, family members, and our humble dental community for your support. Together, we continue to grow, innovate, and serve. God bless you all.
*Healthy fats, not just yummy French fries: Omega-3 sources include fish, nuts, etc. Financial results? Fiduciary duty: profits and loyalty to shareholders or owner.
How are patients benefiting? In healthcare, patient trust and the duty of care are higher for the sake of the practice's reputation, as well as adherence to ethical and legal codes and the well-being of the individual.
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