So today I had a cash patient of 7 years walk out. He has not seen the hygienist in 18 months, when he was just under the state requirement of an exam in 12 months. It has been 2.5 years since his last full exam or x-rays. I have only seen him for limited exams in the last 18 months, specifically for broken teeth, which he did not want fixed.

His complaint today was he did not want to pay for an exam or x-rays. I nicely had to tell him legally there was nothing I could do without them.

Now, occasionally I might comp x-rays for a great patient or extenuating circumstances. However, this patient has 2 broken teeth that have needed crowns for 2 and 7 years. In the total 7 years I have seen him, he has only had 2 fillings done, 6 years ago. He has not referred anyone. He is a nice guy, and did not cause a scene leaving, but there is nothing that makes me feel value in doing things for free for him. No judgement of course, we never know what may be going on in the life of any individual.  

Am I sad to see a patient walk out? Sure.  He clearly needs dental care.
Do I care from a business perspective that this patient left? Nope

You want to make sure to avoid giving away too much time and mental energy on the patients who will never reciprocate it.  Some people can be energy vampires or black holes.  They are unhappy at life and the only way they have found to cope is to bring everyone around them down as well.  Not only are there legal liabilities, but they can bring the team down and prevent you from taking great care of everyone else.

Instead, devote that energy and effort into taking better care of the patients who value you, your team, and the services you provide.  We can do our best for every patient, but not every patient will accept, and that is okay.