To refund or not refund, that is the question!

“Patient Y needed a crown placed after a previous trauma to tooth 21 had resulted in root canal therapy being performed. It was explained and documented that the existing dark halo would be evident. Patient Y, a 20 year old, gave consent to cementation of the crown and was happy with the result. Her mother was not. They demanded a refund.”

“Patient Z came in wanting to improve the appearance of her lower anteriors. Porcelain veneers were decided to be the best option. Patient Z was quite specific about what she wanted in terms of the aesthetic result so I brought the ceramist to be involved in the consultations. We delivered exactly what she wanted and she initially happy after cementation. A month went by and then she turned up demanding a refund because her unhappiness with the veneers was causing her depression to worsen.”

Patients demanding a refund. It is unfortunate but most dentists will be faced with such situations during their careers. The above examples detail two occasions this happened in my practice.

To refund or not refund, that is the question!

It has been my experience that one of the strongest issues raised when a patient asks for a refund is the dentist’s reaction. Many dentists see a refund as an admission that they were somehow negligent. Even though I understand and honour the ‘insult’ to the dentists’ sense of professionalism and commitment to patient care, acting with such a mindset will hamper your attempts to resolve the situation.

My general rule in almost all such cases has been ‘Refund and Refer’. That is, refund the money the patient paid for the treatment in question, and refer them to a specialist for further management.

The refund resolves the patient’s upset and the referral to a specialist ensures you are maintaining your professional duty to that patient.

Some may consider this a weak and possibly an unnecessary strategy. But I have good reasons.

Let’s look at the benefits and drawbacks when refusing to refund an unhappy patient.


  • You get to keep the patient payment for the treatment you performed
  • You have the personal victory of being ‘right’


  • You will spend ALOT of personal time and energy contemplating and worrying over what the patient claims and how best to manage the situation
  • If it goes further and you must defend your case, your practice will also have to take their focus away from your happy, satisfied patients to gather and supply evidence
  • The cost of a legal battle will likely be far above that of any refund that was asked of you
  • In the past, unhappy patients have told only close friends and family about their negative experience. However, social media now means that there is a high chance that hundreds and even thousands learn of what happened. And remember, they will be getting the patient’s version only.

It is my observation that the drawbacks of refusing refunds outweigh the benefits. Holding onto and giving life to situations of this nature will often increase the damage to you and your practice. It is better to manage them in a manner that minimise their impact, not magnify it.

My philosophy is that you only charge patients for treatment they are happy with. Refund their fee stating that the reason you agree to give their money back is not because of any particular fault on your part, but simply because they are unhappy.

Obviously, ensure that you and the practice implement the proper systems to avoid unhappiness and continue developing your communication skills to better engage and discuss treatments with your patients.

If the question is to refund or not refund, I say the answer is to REFUND! And REFER!