Patient Communication
What doctors can learn about patient trust from the dental chair
An Australian dentist with four generations of patients explains why protected time, honest risk talk and real care keep people coming back.
Four Generations of Trust: Lessons from an Australian Dentist on Building Lifelong Patient Loyalty
Video from Doctors Making A Difference.
Generated from the canonical interview transcript and validated against source data by Guests on Air.
How can doctors and dentists build patient trust that lasts?
Protect time with each patient, especially at the first visit, and explain options and risks before any treatment starts. Dr. Sasha Rutnam spends at least an hour with every new patient, never starts treatment on the day of the consult, and treats an angry patient as an anxious one who can be won over.
Dr. Sasha Rutnam has practised general dentistry in Sydney for more than 30 years, and she now treats a fourth generation of some families. Some patients travel five hours to see her, even though plenty of other dentists work nearby. On the Doctors Making a Difference podcast, she explained what physicians can take from that record.
Her answer is not a technique or a script. It is time. She argues that trust is built in the first appointment, protected by how a practice schedules its day, and tested when something goes wrong. Each of those moments depends on whether the clinician slowed down enough to explain what was happening and why.
The lesson reaches beyond dentistry. Dentists work on patients who are awake, anxious and sometimes in pain, which makes the dental chair a hard place to earn confidence. What works there, she suggests, also works in a surgeon's rooms or a family practice, where patients decide whether to return, refer friends and follow through.
Key takeaways
- Spend at least an hour with a new patient, mostly talking, because the first visit is where trust is built.
- Treat booked patient time as protected, with emergency slots and associates absorbing interruptions.
- Explain risks and failure rates before treatment, and never start major work on the day of the consult.
- Referrals follow care rather than low prices, so time spent building trust grows a private practice.
1. Trust starts at the first appointment
Her first rule for young dentists and doctors is simple: allocate enough time. When clinicians are rushed, she says, they communicate poorly and assume patients know what is in their heads. That is when misunderstandings start and relationships go downhill. Explaining things well also helps a practice avoid the complaints and legal trouble that follow a poorly understood procedure.
In her own practice, a new patient never gets less than an hour. Only part of that is clinical work. She estimates that 30 to 40 minutes go on talking, learning about the person and explaining what she sees. She calls that first appointment the place where trust is really built, and the extra time makes a lasting difference.
That investment pays back over decades. Patients come to a clinician about their health and their body, and she believes the connection has to be made from day one. In a busy suburb full of dentists, retention depends on that bond. Patients who trust their dentist stay, and patients who stay bring their children and, eventually, their grandchildren.
2. Protect the time and explain the risks
Finding that time in a crowded schedule is a job for the whole team. Her staff build emergency spots into the day, and associate dentists can see urgent cases. Nobody walks into her room to talk about what is happening outside. When a patient is in the chair, she says, that time belongs to them, and they can tell when a clinician is distracted.
Delays still happen, and she does not pretend otherwise. What matters is acknowledging them. She apologises when she runs late and offers to reschedule if the patient has somewhere else to be. One patient told her they wanted to keep seeing her and nobody else, because another dentist had kept them waiting without an apology. The courtesy costs little and earns loyalty.
The same honesty applies to clinical risk. A root canal on an upper molar may succeed only 65 to 70 percent of the time, she says, and patients need to hear that before they book. She never starts treatment on the day of the consult. Patients get written consent, verbal information and time to think, just as they would before surgery.
3. Why care is a business strategy
Some clinicians see relationship building as a soft skill that only a quiet private practice can afford. She disagrees. In private practice, she argues, growth comes from referrals, and referrals come from reputation. Patients tell friends that a dentist was gentle, caring and got them out of pain. Nobody recommends a dentist for being the cheapest option in town.
Her own practice grew so large on that reputation that she eventually sold it to a dental group because she could no longer manage it. Trust also changes what patients accept. After an hour of explanation, a recommended implant feels like care. After five minutes, the same advice sounds like upselling, and patients who are not in pain will simply put it off.
She has set out these lessons in her book Dental Patient Communication Made Simple: A Practical Guide to Explaining Treatment, Handling Objections and Improving Case Acceptance, which works through scenarios such as anxious patients and complications. Her view is that angry patients are usually anxious ones, and many become her most loyal patients once they are won over.
