What we’re missing: An oral pathologist on red flags, referrals, and reality

In this episode, Dr. Bryan Trump discusses why oral pathology is central to clinical practice, not only in recognizing abnormal findings, but in communicating them clearly and responsibly. The conversation explores how hygienists and dentists can describe lesions more effectively, manage patient conversations without escalating fear, document findings thoroughly, and build referral relationships that support both clinical decision-making and patient trust.

What makes this discussion useful is its focus on the moments clinicians actually face in practice: the uncertain finding, the difficult explanation, and the referral that may or may not happen. It is a grounded conversation about how to respond well when instinct tells you something deserves a closer look.

Key Takeaways

• Confidence does not require having the diagnosis immediately; it means recognizing when something is abnormal, communicating that clearly, and using the right referral pathways.
• Photos and radiographs can strengthen both clinical communication and documentation, especially when verbal descriptions alone leave too much open to interpretation.
• When describing a lesion, practical details such as color, borders, base, and overall appearance matter more than using highly technical language perfectly.
• Framing an exam as an extraoral and intraoral evaluation can help clinicians explain what they are doing without unnecessarily escalating anxiety around the word “cancer.”
• Referral systems work better when practices have a defined team of specialists they trust to communicate well and treat patients with the same level of care.
• If a patient declines or delays follow-up, the clinician’s responsibility is to document the recommendation, the reasoning, and the patient’s response clearly.

Continue the conversation

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• When OPAs enter the operatory: threat, workaround, or turning point for dental hygienists?

Episode Transcript

David Torres

Welcome back, listeners, to another episode of A Tale of Two Hygienists, episode 532. My name is David Torres. I am your co-host, and I am here with my amazing co-host, Miss Jessica.

Jessica Atkinson

Hello, welcome back, listeners. And we are joined today with Dr. Bryan Trump.

Meet Dr. Bryan Trump

And listen to this bio. Dr. Bryan Trump is a board-certified oral and maxillofacial pathologist and a full-time professor at the University of Utah School of Dentistry, with adjunct appointments in the departments of pathology and dermatology. Brian grew up in the suburb of Salt Lake City, Utah. He attended Weber State University, where he earned a Bachelor of Science in microbiology.

His DDS is from Virginia Commonwealth University School of Dentistry, and he completed his oral and maxillofacial pathology residency as well as his master's in biomedical sciences at Texas A&M University College of Dentistry. He has established a clinical referral center focused on oral medicine at the dental school and directs Utah's first and only oral pathology biopsy service. His laboratory and clinical practice serves dentists throughout the Intermountain West.

And he is here with us today because I had the opportunity to be on a humanitarian trip with some of his students. And I asked the dental students, so tell me, what's your favorite class? I was hoping they were going to say perio, but that's not what happened. They said, our favorite class is Dr. Trump's class.

And this is Lexi's words. Lexi said, I really love Dr. Trump's oral pathology class because number one, he's really funny. And #2, it's because he tells us that being good at oral pathology is the difference between being a good practitioner and just being a tooth mechanic. So Dr. Trump, please tell us a little bit about what oral pathology has to do with being the best practitioner.

Dr. Bryan Trump

Why oral pathology matters

Okay, well, thank you so much, Dave and Jessica. I was explaining to them that this is my first podcast. And so secretly, I'm both nervous and excited at the same time because I love firsts. And that kind of transitions into that answer.

When I teach the students, the first time I get them is in their cariology course, which is a big part of dentistry, both hygiene and dentistry in general, is the disease that causes teeth to have issues. And pathology really is when you transition from classroom to clinic. Everything you learn in dentistry, there's a lot of things we learn in dentistry that can, a lot of it is learned in the classroom. And then you, of course, you solidify it in the clinic.

But pathology to me is that first step where they get excited about being a practitioner. You get to practice what you're learning through recognition, diagnosis, and treatment, which is what we do throughout our careers. But that's one where I really feel like it hits a, it touches a heartstring with students when we first get to hear that pathology is the practice builder.

All that we do in dentistry, you can do with good hand skills and good diagnostic technique. But the part that I really think is what draws patients to us is our ability to communicate. And pathology is one of those things that we have to communicate regularly, periodontal disease, the need for different restorative procedures, reconstructive phase, disease control. It's communication of the underlying factor is pathology.

So I get to claim that pathology is the reason we have dentistry. And just the fact that I happen to be an oral pathologist might be self-serving, but I really think that it's the one thing where the better we are at recognizing and communicating that, the more patients really see us as their oral healthcare provider and not just another technician that can go through hand motions.

David Torres

Feeling confident when something looks off

Now, I have to ask you, we're very, okay, so yes, we're your first podcasters, but I mean, it's amazing how lucky do we get to have a conversation with you and the listeners to be able to listen to your passion through this interview. But I have to ask you, I mean, obviously you are teaching both dentists and dental hygienists.

And as a hygienist myself, there's a lot of appointments that I have had where I feel extremely confident about a four millimeter pocket that's bleeding and then five and six with bone loss and calling that perio. But as I'm seeing any pathology in my office, I immediately raise my hand, call the doctor, they come in and they also get a little nervous because they remember some of the pathology that they learned in school.

But they're not as assertive as diagnosis as what we do on a day-to-day. What are some of the things that you speak to your students or that you encourage us or communications that we can have with our patients in being confident, but not necessarily scare the patient?

Dr. Bryan Trump

Confidence versus arrogance

Oh, that is an excellent question. I always tell the students, try not to overreact. You don't want to underreact, but you don't want to. I've been in a clinical setting where emotions come out with, oh man, or crap, what's that? And it's like, no. Try not to let the patient know your discomfort, but take a deep breath.

And I always tell them, you can phone a friend. You've got attendings in the dental school and in training, that's what we're there for as faculty, is to have your back and help you feel comfortable so that when you're out on your own. But even when we're out on our own, we've got friends, colleagues that we went to school with or that we build along our career paths. Don't ever forget that you've got help at every corner.

All of my past students know how to get a hold of me. That's just one of the many things I can, that's the least I can do, is that if I taught you, I'm there for you the rest of your lives. I don't just graduate and see you later. It's no, I just love that I get to call you colleague now instead of that student-professor relationship. It's you're my colleague. And I think that's a big key, is to, you know, treat each other as colleagues, not, you know, separately.

Patients can see that. Patients can recognize your comfort with each other as a team. And then when in doubt, refer it out or get a second opinion, take pictures. Pictures are worth 1000 words. I don't know how many times I get dozens of texts or emails a day with hygienists and dentists and doctors and other physicians asking me about pathology.

And the reality is, if they're describing it, I just have to use my imagination, give them a best guess. With pictures, it really does document what you saw, helps me as someone, a specialist who's trying to help you out. But then it's really good to get in the habit of documenting what you saw when you saw it, because patients' pathologies change. And someone who reads your notes, you always want to know and describe what they had when they came to you.

But when you recognize pathology, the key is to recognize what seems normal to you and what seems like a variation of normal. But then once you get into that abnormal, that's when you raise your hand. Whenever it's the you want to phone a friend or raise your hand, that's the something's off. Trust that instinct. Don't ever ignore that because that's a part of your training, even though you've learned all these things and we all forget more than we learn at times.

That is your gut instinct, your mind and your body giving you kind of a visceral response to, I don't know exactly what to call it, but it's making me stop and pause. I can't overemphasize the ability to listen to that stop and pause and not glance over it. It may be that it's nothing, because by the time you contact someone like me that gets to see this more than most people, that doesn't make me better. That just means this is what I chose to do. And I probably couldn't diagnose periodontal disease or beans anymore.

But I absolutely can diagnose pathology, which perio is. But the whole point is, take pictures, document, have that conversation with a patient saying, I'm noticing a change here that looks different than any other time I saw you, but I'm going to reach out to a friend, to a specialist, to Dr. Trump, to Dr. Bruett, to, I mean, there's other people we can, that we can let them know that we've got their back.

Patients want to know that we're confident and we don't have to know answers. As oral healthcare providers, there's a difference between arrogance and confidence. Confidence is, I don't know the answer, I'm going to own up to it, but I'm going to find it. Arrogance is, I know the answer, I'm going to say I know the answer, even though I don't, but it's going to make the patient feel comfortable in the now, but in the long term, it's going to come out.

Your lack of confidence shows at some point. So I always love to teach my students, be careful bordering confidence and arrogance. Arrogance is when you forget your training and forget that gut instinct and just go with what makes the least ripples or is the easiest to just get to the next step, where confidence is saying, I'm not sure, but I know avenues I can go down to find out.

So I hope that answers the question, but that's the part that I think of, is I always want to be a confident provider, but confidence doesn't mean I have to know the answer, but it means I have a good team around me that I can get that answer if needed.

David Torres

What if it is your first time seeing it?

I want to zoom in a bit on that confidence because obviously you have it because you probably have seen patients with a similar scenario. But what about that provider who was like, I'm seeing something for the first time. It's hitting me in the gut. I don't know. Should I say something? Should I not? What do I do? How do I say this? And they have like this breaking into a sweat moment.

How can you, if you were there kind of like watching them, or if they probably went through that this week themselves. What are some of the helpful tools or verbiage or what would you typically coach a provider to say, it's okay, it's your first one. We all go through that, right? Try this, do this.

Dr. Bryan Trump

When you do not know the answer yet

Hey, another excellent question. First, you're not alone. I have those moments where I sweat and I've had moments where I stay up at night. Usually those minutes are really big, like, it is. I have those moments where I don't have the answer. And it's scary to be an oral pathologist that spent all my years in training and I can't tell a patient what's going on.

It's that ability to take a deep breath, to admit and almost own up to the fact that I haven't seen something quite like this, but that doesn't mean we can't figure it out. And it doesn't signify anything right now. But I'm going to take some pictures. I'm going to call a few friends. I'm going to reach out to whoever it is that has your back. And eventually you'll have enough people and enough of a support group to where someone's going to have seen something like it before.

Now, when it comes to hygiene and dentistry, the good news is, one, you don't always have to know because the default is a referral for a biopsy to an oral surgeon or to anyone who does those procedures. There's a lot of specialists who do it. I do the procedures myself as well. To where as long as you have in your pocket a team of people who are listening to you, share your concern with them, they take it from there and, for example, do a biopsy of an unknown process.

The biopsy makes it to an oral pathologist. And then it's our job to communicate all the different things we see under the microscope to help you treat that patient. So even in the worst case scenario of having no clue, there's a way to have a clue. And that's where you have to be willing to tell a patient, I think I'm gonna refer, I'm gonna communicate with, you know, with other colleagues, but the answer might be we need a biopsy to tell us what the disease process or whatever process, it can be physiologic, developmental, inflammatory, infectious, neoplastic, or metabolic.

And it's really the neoplastic side that really worries, you know, all of healthcare. Is this something that's gonna, is this a cancer? Is this a tumor? Infectious and inflammatory, those cause pain and discomfort as well. But really, it's the neoplasms that we're really wanting to make sure we catch as soon as we can.

So trust that instinct of, I've never seen this before. And then part of me wants to say, get excited. Because you're going to learn something new. Like similar to this podcast for me, I now get to have the experience of having a podcast. And I know how fun it was to work with you and Jessica.

And if you find a new pathology, to me, that is a great day because you're going to learn something you didn't know before. That's continuing education. That's lifelong learning that we've all signed up for. We can't stop from, I graduated dental school in 2011. If I had stopped learning in 2011, I would not be who I am now.

And that goes with every one of us. Any hygienist out there and any dentist, if you stop learning and just going through the motions, I mean, again, that's the mechanic. That's the mechanics of dentistry and hygiene. When you're learning, that's the healthcare professional.

Jessica Atkinson

What details should be included in a referral?

So I found something. That's why we're on. We wanted you to talk a lot. So I have found something that's interesting. My gut is telling me to phone a friend. And you are the friend. You're the friend we're going to phone.

How can we make sure, in addition to the photographs that we're taking, that we are giving you a good description of a lesion, size, color, contour, texture? What do you often find that's missing in these descriptions that you're getting from other professionals that you're like, could you have just given me a little more? Like, give us a little, you know, I'm thinking about my students and how I sometimes feel like I'm maybe, I'm like, I'm being nitpicky because I don't want you to miss something.

Dr. Bryan Trump

Yeah. Tell us about that. Is, again, you guys are just excellent questions. I'm grateful for anything.

Jessica Atkinson

We're better than that.

Dr. Bryan Trump

Come on, we're very good. Let's all be better than that because sometimes it's mass on cheek. Okay, that's bare bones. Okay, that could be anything under the sun at this point.

Using what you learned in school, sessile means broad-based, pedunculated means narrow-based and can move around. Pigmented, you would use macule, plaque, is what's the color? Yeah, the most common colors in the mouth are white, red, brown, black, blue, yellow. What? Give it a color. If it's in between, give it a description of the colors.

Jessica Atkinson

And you're not fussy for them to use their $100 words. You're okay if they say blue instead of cyanotic. You're like, are we?

Dr. Bryan Trump

Oh, I'm so okay with that. The fancier people get, the more it melts my heart and I get to call you personally and be like, that was the best description I've ever had.

Jessica Atkinson

We're going to go for that.

Dr. Bryan Trump

But like, you know, there's red and erythematous, there's leukoplakic or white. There's, you know, there's, that's, as you get to hone in your skills of note taking and diagnostics, yeah, we would switch to medical terminology. But in reality, if you're trying to get help, you're in the moment, just take a picture, take a radiograph.

That, I mean, really, I can do a lot with a picture and a radiograph because I know what it looks like. I've seen a lot of this and other oral pathologists or other specialists, you know, anyone, we see things and if you find the right person, they're going to know what's going on. So I would say a picture's worth 1000 words, a radiograph's worth 1000 words.

I rarely get those. I end up calling asking for them. So that's what I ask for the most. Do you have a picture? Because even the descriptors, like you mentioned, people use different terms. They're not necessarily the most correct ones. And so I'm still left with my imagination going, well, is it elevated? Is it flat? Is it blended borders? Is it well-defined borders?

So just a picture saves you a lot, but don't give up on also describing. It's good practice. Take a picture, but then do your best. If someone were to not have your picture, but you were to describe it to them, kind of like playing Pictionary or some type of game, can you give enough terms to where they can envision it and give you a good answer as to what it is? That would be an ideal scenario.

We all have a lot to do. We work, we're busy. And then if, heaven forbid, we get to our charts days or a week later, I'm guilty. There's times where I'm trying to remember what I did a week ago. And the further away you get from it, the more you forget. So that's where a picture for me is a, I know exactly what I saw. I can remember it. I retain it better.

But just realize, I think what I'm trying to get at is figure out who your people are, who is it that you reach out to that's going to help and not judge. Because that's the worst feeling. That's why we transition to arrogance as we're like, well, I have to solve this because I don't have anyone who will have my back. My answer to that is, well, I'm one. Like, let me be one of those people.

But have that team that won't judge you, but will help you. That's what it is to be colleagues is, you know, we're not just acquaintances. To be a colleague and a friend is, I will make time for you, which is when you send something for me to look at on email or text, I stop what I'm doing when I can and I make that time. That's what a friend and a colleague would do. An acquaintance will ignore it.

And again, surround yourself with friends and colleagues. Get that help. Gain that confidence through opening the book. And if you don't know something, go searching for it. Be excited about something new that changed your day instead of being the routine. That's what I see pathology as. Every day I see something that's new because that patient never had it before and they're looking for help and for answers.

Pathology is a practice builder. And the better you are at pathology, the more patients recognize that, they can sense that, they can sense your confidence. And I can almost guarantee that they're the people who want to refer family and friends to you because you did something more than what was required. You went above and beyond. And to me, pathology and your knowledge of pathology is the above and beyond.

Because most people don't remember it because they don't see it all the time. And I totally get that. I get to read the book a couple times a year and teach it throughout the entire year for 12 years now, since I finished residency. Not everyone gets that journey. That's my life, that's my story, and I love it. But I think everyone can at least get some of that passion in terms of I will figure it out and ask.

David Torres

Screening, not diagnosing

So a good referral would be take a photo, be as descriptive as possible, and be proactive. So in other words, what you're saying is like, don't be using the end Gen Z's like, yo, that chick is sus, bro. No live fam, no cap, right? Like, obviously, like, be as thorough as you can.

Dr. Bryan, I have to ask you, as a hygienist, you know, we see a lot of patients, and I think, if my memory serves me correct, in 2025, almost 60, over 59,000 cases were documented of oral cancer. What are some of the things that we can do every day? Because I think we overthink this, right? You mentioned this already.

We are hesitant asking the patient to do an oral cancer screening with the tools that we have at our disposal, whether you have the ViziLite, the VELscope, anything fluorescent that we can see beyond the naked eye and our doctors. But what I find it helpful is understanding that we're doing a screening and not necessarily a diagnosis.

And sometimes conversations that I have with my peers, they're very hesitant because they think that that's true, that they're, if I screen for cancer, I'm going to find it, I'm going to panic and crawl under my dental chair in a fetal position because I don't know what to do, right? But what are some of the verbiage that you think we can kind of use with our patients ourselves in describing a screening or how to go about it?

Because some of the things that I say is, you know, if to myself, I'm like, if I find anything, we'll take it through the proper channels, because screening is better than nothing, right? And like you said, so we're not the ones diagnosing. So it's almost kind of like a cop out, like, okay, like if I find something sus or suspicious, right? Like, it's not really on me. But what verbs do you think will be worth talking to the patients or reassuring them?

Dr. Bryan Trump

Talking to patients about screenings

I, for me, I'm trying to put myself. I see patients all day Wednesdays right now is my day when I'm not teaching and not doing other responsibilities. So when I get into clinic mode, every patient who gets in my chair, it's explaining that I'm doing an extraoral and intraoral exam, that I might use some terms that seem foreign, but by the end of that exam, I will make sure that I define and answer any questions they have.

That kind of lets you have the ability to use leukoplakia, erythroleukoplakia, some terms that we all know what it's going to mean or what we think it is. But then they've already heard us say that we will define it, we will answer it, we're not going to leave them hanging with all these words. Pathology is a foreign language. And for those who speak it, like, you know, I speak it pretty well. I don't sometimes think about what am I using.

I do make a concerted effort when I'm talking to a patient, I change my language and I speak to them and meet them where they are and not, my goal is not to sound smarter. Of course, I went to schooling for a reason, but I don't want to speak up. I want to speak to them and with them. And to do that, to communicate, you have to speak their language.

So get good at transitioning from the medical terms to the everyday layman's terms, but without condescending, but just letting them know, I'm going to say some things for my staff to write down, which I will talk about and make sure I answer all your questions. That opens up the door for you to say whatever word you need to.

I am hesitant to say cancer screening, because then if you find anything, that's where they go. The reality is cancerous, oral cancer is still at the lower end of cancers. In the mouth, squamous cell carcinoma is the most common, but we're talking out of all the hundreds of patients you've seen, how many have really had cancer? For most of us, for me, unfortunately, it's quite common because I'm the referral source. I'm where people go. But for you, it's not likely.

But how grateful is your patient going to be that you're looking? So I like to say I'm doing an extraoral exam where I'm going to look along your lymph node chain and along the skin of your face to just see if there's anything that I can at least recommend you go to a dermatologist. Like you can pass it on, but you're doing above and beyond by doing that extraoral exam. And then you go to intraoral.

And as long as you tell them you're going to use different terms, that almost lets them relax like you told them you'd talk about. Take your notes and then go back and say, here's the list of three things that I saw. One looks like this. One looks like that. The treatment for this one is actually excisional biopsy. The treatment for this is probably anti-inflammatory or scaling root planing. I mean, you get a chance to kind of go through your list of findings.

Patients, more often than not in my experience, are so grateful that you're even communicating and talking to them and looking. They're not often scared about cancer. They want to know. They have the family history of cancer and they want someone to just tell them, is there anything suspicious?

Patients want me to do biopsies. They've, sometimes I'm the 5th, 7th, 12th doctor that they've seen and I'm the first one to say, can I just take a piece? And they're like, please do. And how many times would you expect a patient to say, please cut on me, please numb me up. But the reality is they want those answers. So be confident that they're there and they trust you. That's not a relationship we should ever take for granted.

But also for you, there's plenty of steps you can take. The beginning step is to explain what you're doing and why. That will put them at ease, followed by making sure you define it and bring it up with them. And in my opinion, I don't always say I'm doing a cancer screening. I say I'm doing an intraoral/extraoral exam and I'll share with you whatever I find because, you know, I do think once we say the term cancer, it creates a psychosomatic response and they're going to get emotional in some way.

So just don't use that term at first, but I'm the first one to tell a patient, you know, I've diagnosed a couple in the past couple weeks where I get to be straight up with them and say, in my experience, this is concerning. And I think that this is probably a version of oral cancer. I'm just happy that you're into seeing me now because we get to find the answer to get you to the path to recovery and treatment.

No matter what you find as the healthcare provider, oral healthcare provider, you're the one who finds it. I think that's such a special moment where I've never been more proud than my past hygiene students who are out of state send me texts saying, Dr. Trump, because of what we learned in class. I found this oral cancer in a patient. He totally gives me credit for saving his life.

And part of me knows that chances are he was going to live. But how great is it that relationship began of trust and someone went above and beyond? So, you know, shoot, what was the question?

Jessica Atkinson

Avoid being too vague

You did. I also caution my students not to be over, over cotton candy about it, meaning like oftentimes I'll walk in and they're saying, I'm going to be feeling around just to make sure everything looks really good, just to make sure everything looks normal. And the conversation I have with students is, you're actually doing the opposite. You're going to be looking for anything that is out of the ordinary.

So the verbiage that I suggest is, I'm going to be looking for any lumps or bumps or out of the ordinary and we'll take any information about that and let you know if you need to be seen by anybody else. So I also don't want them to oversimplify and be like, I'm just going to give you a gold star because you came. I want them to recognize that they do have the ability to recognize things that are odd, that they do have that gut instinct that they can then phone a friend.

So I see both ends of that spectrum. But the cancer word can be really scary for people.

Dr. Bryan Trump

Yeah, I really do. I like that take real quick, real quick, and then I'll let you follow up with that, Dave. But it's not being, it's not sugarcoating, but it's also not going straight to like the scary words if we can help it.

But I think I do this, I use the same verbiage, Jessica. I'm looking for lumps, bumps, or things that shouldn't be there. If I find any, we'll talk about it and make sure we have a plan to take care of it. There's my 10 second or less spiel that has the patient going, go for it. I can't wait to see what you find. We're excited now.

David Torres

Communication and patient trust

It's kind of like, you know how like dermatologists, they say, or I had patients tell me like, oh yeah, I'm going for my dermatologist to do a mole patrol. And I was like, okay.

Jessica Atkinson

I've never heard that. That's amazing.

David Torres

Yeah, me neither. So I was like, okay, you know, that's looking for, okay, got it. You know, so listeners, I guess what Dr. Trump is trying to say is like, it's communication, right? It's not essentially what you're saying. It's how you're saying it and how you make the patient feel.

Whatever you do, find your own way, find your verbiage that if you feel empowered, so will the patient. And I have to tell you, somebody who's been practicing for over 13 years, it took me to kind of find my first case to feel even more empowered to continue to do that. And you do really feel like a life-changing experience when you are doing that for the patient that you service and also for the ripple effect that you create for the rest of the patients that you also take care of as well.

What if the patient does not follow through?

I work with my brother, he's a dentist, and I asked him, hey, I'm going to be interviewing Dr. Trump today. What are some of the questions or what questions can you think of that I can ask? And he said, I really would like to know what advice he will have for me when we find cases and we express the importance to going to the specialist to go get the biopsy, to go take a look at it.

How do I manage either having the conversation with the patient or even with myself and my team if the patient didn't go. Is there anything else I could be doing? Because I can't physically put the patient in that chair, right? Like I can't physically, I can try to make the appointment for them, but I don't want to overly, if they didn't go, I don't want to overly stress them out either because it's just feeding onto the anxiety of the patient thinking in their head, oh my gosh, I'm going to get bad news.

What advice do you have for my brother, Dr. Trump.

Dr. Bryan Trump

Referrals, follow-up, and documentation

That's a great one. I would say first off, it's that confidence. Be confident with your patient that you're making a recommendation that's not just the superficial, wishy-washy, maybe there's something there, maybe there's not. You're the first line of defense. There's either something there or there's something not.

And the arrogance is where maybe there's an in-between where phone a friend, just tell them you can take a picture and share it with Dr. Trump or with someone. But let's say the conversation is you found something. The more clear you can be, you found something, it's a variation than what you're used to seeing. I'm recommending you go see Dr. so-and-so, a specialist. I know them. They've got my same chairside manner.

Like I refer to people who I think treat their patients like I do, because by the time a patient's been with me for that 40 minutes or hour, they kind of, I think they, a hygienist and a dentist is like a good pair of shoes. Not all of us fit for all of our patients. We really don't, but they'll search around and we know what patients that we have that we're like, man, I could see them every day and I'd be thrilled.

And then there's patients that.

Jessica Atkinson

Don't let the door hit you on the way out.

Dr. Bryan Trump

Yes. So what you want you from a medical legal standpoint, if you've made the recommendation and you document that it was made, and then the patient, you can even, I would ask them, are you willing to follow up with that? Because then your note can say, patient said they were willing. Your communication was clear. They agreed to it. You can't control whether they show up or not.

What you, the only thing you can control is that you found something, you shared it, you explained why you think it warrants follow-up. You made a referral to an actual place, like not just a good luck, go find an oral someone, go find a specialist. No, have a list of your team. Going back to every office should have your team of specialists that have your back, that you like to communicate with, they communicate with you really well, they take care of your patients the same way you would.

That's the people who I want on my team. Those that will treat the patients like me. And I have to admit, I've adjusted my list of team members over the years after, they're all great people. I really, I adapt well and I care about everybody, but then there's the team of people that will care about my patients the way I want them to.

That's a key, because who, who gets in trouble for a bad referral to an office they didn't have a good experience at? It's not even that office that gave them the bad experience. It's this guy who told them to go there. And so know your team, communicate clearly, and document it.

If they don't go, but you communicated why you recommended it, and if they said yes or no, you can't do much more, so don't let that weigh on you. If there's a patient where I feel like I really want them to go, I'm that clear. I think you have oral cancer. I'm only saying that because I care. We want to know what type it is so that we can get you to the right place for treatment.

The reverse of that is, I'm not sure what it is, but I know this person will help. I trust them. I would go see them. So if you'll go, they will take it from here, and I can't wait to hear back about your experience and what's going on. And it gets that follow-up. You do care enough to where you're not just shoving them out the door, but you want them to come back and tell you, how did that visit go?

And over the years, you're going to learn what visits and what offices really helped you and what offices you might change your list because of patient experience. And that's not that we all can't be perfect. Don't expect perfection. No one is. But effort.

Can you really, even a bad experience from a patient. I've been guilty of a couple bad reviews and they didn't under, the false story wasn't even communicated. And I just have to accept that you can't please everybody. I've had a couple bad student evaluations. I cried over those ones, I have to admit.

Jessica Atkinson

You're not alone.

Dr. Bryan Trump

You're not alone. Yeah, there we go. We're not, there's the answer. You're not alone. Do your best. Document, document, document. And when in doubt, refer it out. My answer to my students is when in doubt, cut it out. If you're going to do the biopsy, do it.

If you're not, that's the referral out is at least there's a paper trail that you tried to get them there. They have every right to say yes or no. They both need to be documented and you're fine. That's all you can do.

Jessica Atkinson

Final takeaway

I love that. I think the takeaways for me today are you're not alone and to use the team, evaluate that team, and remember that we're here for our patients and we want the best for them. So thank you so much for being here with us today, Dr. Trump.

Dr. Bryan Trump

You're welcome. Thank you both.

Jessica Atkinson

You're welcome. That's a wrap on today's episode of A Tale of Two Hygienists podcast. If this conversation made you feel seen, inspired, or even just a little fired up, share it with a fellow hygienist or fellow dental professional.

Share it with your neighbors, your friends, share it with everyone. That is how this community grows.

David Torres

Make sure you subscribe, leave us a review, and connect with us on social media so that we can keep on going with this conversation. Remember, your career, your voice, and your story matter here. We're David.

Jessica Atkinson

And Jessica?

David Torres

And until next time.

Jessica Atkinson

Keep learning, keep laughing, and keep showing up for yourself and for each other.

David Torres

This has been a production of Endeavor Business Media, a division of Endeavor B2B.