Saint Peter had a terrible cold, so he asked Jesus if he could have the day off to go to the doctor.

Jesus said, “Sure, I’ll watch the Pearly Gates for you.” It was a slow day and at the end of the day an old man with white hair approached the gates.

“May I enter the Kingdom of Heaven?”

Jesus replied, “We’d love to have you, but tell me what you’ve done to earn your space here among the good?”

“I am but a simple carpenter, however my son was very special. I raised him to be a carpenter too, but a miraculous transformation came over him and to this day

all love him.”

Jesus smiled and jumped up, “Father!”

The old man opened his arms, “Pinocchio!”


Never discuss controversial issues. Diversity of thought is not conducive to endearing relationships with your patients. Your position as a doctor provides a soapbox you should avoid mounting. While it may be tempting to proselytize and persuade, you will offend more than you convert.

If a patient asks your opinion on any hot-button issue, tell them you never discuss politics or religion. Even if you know and agree with their political views, a patient in the next room (who’s vehemently opposed to your beliefs) could overhear your conversation and find a new practitioner.

Since most people will not take the advice of the last two paragraphs, they should at least be armed with the proper rules of engagement when they venture into deep waters. While it is best to avoid discussing politics and religion, if you know where and when to discuss such taboo things you can develop some strong bonds with certain patients. The trick to where and when really comes down to with whom and what you should discuss.

There is nothing more binding than to know that the other person embraces your politics or religion. There is also nothing more divisive that knowing you disagree with the other person’s politics or religion. This means you have to know what the other person believes before you speak or you will get into trouble. If you don’t know your patients, don’t get started on controversial issues.

Here is an example of how it works. Whenever you treat law enforcement people, discuss how weak we are on crime, how the cops’ hands are being tied, and how lawyers are screwing up everything. Of course when treating convicts, discuss the excesses of police brutality, how the death penalty is not a deterrent, and how mandatory sentences are just not fair to the criminal class. You get the idea.

Conversation with patients is rarely about politics and religion. More often your patients will enjoy conversation regarding everyday things you may have in common. If you treat many hunters, they will love your hunting stories and feel a particular closeness. Golf conversation is contagious between golfers. If your patient is wearing a Greenpeace button, sure, go ahead and tell them about how you bombed a fishing boat to protect the dolphins; it can’t hurt.

Most small communities are rather homogenous. Quite often, everyone in a small town belongs to the same house of worship and they maintain memberships in the same clubs. This affords you the opportunity to have common beliefs, goals, and aspirations. If you know your people, you can discuss anything as long as you agree with them.


• Ronald (2016/10/29 18:29)
Dr Fleisher, thank you for this wonderful information, I am actually reading your book bedside manner and I agree that patient management is one of the most important disciplines that a dentist needs to learn. Communication skills is the secret for an effective patient satisfaction and obviously we should try to avoid controversial topics, your advice and solution is also interesting \"you have to know what the patient believes BEFORE the dentist speaks about a hot topic\". I highly recommend your book to my other friends. kind regards.
• Anna (2016/10/05 00:05)
Dr. Fleisher, I look forward to this year and thank you for the great instruction which you provide us with. I absolutely agree, we should avoid discussing the issues of politics and religion in a professional setting. Both are sensitive topics, which could potentially lead to conflict and negative feelings between individuals; doctors and patients. As healthcare providers it is our job to remain neutral, focused and to give a patient confidence that we will be objective in our words and actions. It is better to focus on non-divisive issues such as sports, gardening and or fun weekend activities. These are non-threatening topics that could also create a strong bond between the doctor and the patient while avoiding negative impressions and thus possible loss of referrals.
• Antonio (2016/10/04 22:04)
I concur that one should avoid conversations about politics and religion with our patients because it can be a double edge sword. Practicing endodontics with rubber dam also limits the time available to talk to our patients while the can interact or respond comfortably. When meeting a patient for the first time, its always a good idea like mentioned above to look for cues like pins, sports apparel to ask a relative open question. Some thing as simple as a clothing brand like “Quick Silver” or “Burton” can help identify topic that appeals to the patient like surfing or snowboarding. If you don’t have a photographic memory its very wise to make a quick not in the patients chart about them like “pt loves sailing or pt daughter is getting married”. One thing which is also important is having a sense for identifying patients that enjoys chatting from others who prefers to keep to themselves. There is nothing wrong with the patient who chooses to keep matters private but not recognizing it and attempting several times to start a conversation may lead to discomfort on their part. At the end common sense is key. Our patients come to our office for a service which they might be fearful off or in pain. One would not start a conversation with a patient that can’t tolerate not taking sips of ice cold water to calm down the pain after one has diagnosed the involved tooth. Give them the local anesthetic, maintain the tone that you are there for them and watch for signs of relief before attempting to engage them in a conversation. For the fearful patient that comes in with a Phillies hat a conversation directed towards understanding their fears can be in most cases more productive than one about last nights’ game. Robert Green Ingersoll said “It is a thousand times better to have common sense without education than to have education without common sense” but why not have both when we are with our patients.
• Luke (2016/10/02 12:20)
This is a such an important issue, especially right now with the general election approaching! I agree that it\\\'s best just to simply avoid both topics because you never really know what your patients believe about certain political issues or what their spiritual beliefs may be. I think most often outside of work we surround ourselves with friends/family who come from similar backgrounds and have similar belief systems. It can become very problematic if we assume that our patients feel the same even if we\\\'re from the same area and have similar demographics. Whenever a patient brings up religion or politics with me, I just try to switch the topic quickly back to something general like sports, school, patients\\\' travel plans/recreational activities, or even reality TV (depending on the patient).
• Dr Fleisher (2016/09/26 14:11)

I welcome our new residents and our new senior residents to yet another year at Einstein and my blog on bedside manner. I'm sure that we will have a productive year, and by the end, we shall release another two endodontists to conquer the world.

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