The Familiar-Patient Syndrome

Among dentists there is a common belief. They say that when you treat someone you know, the work goes wrong. Strange things happen, complications arise — things you rarely see in everyday practice. They have named it the familiar-patient syndrome. They speak of it as if some kind of bad luck were attached to closeness and acquaintance.

I think the cause and effect are understood backwards

I think the relationship of cause and effect here is understood in reverse. The problem is not acquaintance itself. The problem is that acquaintance pushes you to cross your own red lines so the other person will be satisfied. That unconscious deviation from clinical principles is the prelude to all those strange events. First you set your principles aside, then you see a complication, and in the end you call it a syndrome.

An example: a diagnostic question, or a justification?

A while ago one of my colleagues was asking about the conditions of a familiar patient for a ceramic veneer. From the very questions it was clear the patient was not a suitable candidate for a veneer. But the questions had no diagnostic character. He was looking for a justification to start the treatment. It seemed to me he did not want to be embarrassed in front of that acquaintance and could not bring himself to say no.

I told him that the very "familiar-patient syndrome" people talk about takes shape exactly here. Before any complication, somewhere along the way you have unconsciously compromised your principles to satisfy the familiar patient. The complication is the result of that compromise, not the result of acquaintance.

That is why I think the more accurate name for this phenomenon is not the familiar-patient syndrome. What actually happens is the breaking of principles under the pressure of a relationship. The acquaintance is merely what brings the pressure. If your principles stay in place, the patient being an acquaintance adds no complication at all.

The more accurate name for this phenomenon is not "the familiar-patient syndrome";
it is the breaking of principles under the pressure of a relationship. If your principles stay in place, the patient being an acquaintance adds no complication at all.

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