Another Reason I Hate Seeing the Dentist

I just returned from seeing my dentist and it would be fair to say that I am spitting blood. For the past 30 years this man has been in charge of my mouth and overall I have been relatively happy with him and his services.

Within the past couple of years I have become less and less happy with the things that have been going on in his office. The rates have gone up and they have stopped accepting my insurance. Nevertheless for a variety of reasons I stayed with him.

This past January I went in for a routine cleaning. During my appointment I learned that I had a cracked tooth that might require a crown but that this would not be necessary immediately, if at all.

Today I learned that the tooth snapped and that it will need to be prepared. Strangely enough I haven't felt any pain at all from this.

So I was meeting with the receptionist/assistant/flunky to schedule time to come in for the crown. She told me that it would be $835. Since they have stopped taking my insurance I wasn't sure if I was going to have the work done there, but was understandably reluctant to get involved with someone new for something like this.

I asked if there was a payment plan that could be scheduled and the flunky snootily told me that I could put down 50% today and that I might be able to finance rest if I qualifed for their finance company. She also told me that she thought that I had been a very slow pay and that they have a lot of bills that they have to pay.

She then tried to chastise me about some other work that needs to be done saying that the dentist had found three teeth between January 2004 and 2005 that needed fillings and that I had failed to handle that.

I was completely taken aback by her attitude and told her that at no such time had anyone discussed anything other than the crown with me and for that matter I had a tooth filled in January.

But she insisted on telling me that I was mistaken and that they could not have made a mistake. Her haughty and obnoxious attitude really sent me over the edge and I told her not to worry about scheduling the crown because I was done with them.

I understand that they have bills to pay and I understand that there are challenges, but I aslo know that I come to a rinky dink office that hasn't been updated since 1978, that they do not validate parking and think nothing of engaging in unnecessary conversation about this and that while I sit in the chair and that had they used a nicer manner I probably would have stuck with them.

But not anymore. Goodbye Charlie, see you later Doc I am going to find someone else who has a flunky and no attitude.

14 comments:

dorothy rothschild said...

Um, wow. Really unbelievable. Nothing like good customer service, eh?

You're right to find another. And they should've been lucky to have had you as a client for long since they didn't even take your insurance.

It's a little shocking, this story, Jack.

AbbaGav said...

Looks like the Walmart-ization of dentistry has begun. Good luck with your teeth. I shiver just reading the words "cracked tooth". Uggh.

Anonymous said...

I really think you should let the dentist know about this person that heads up his "customer relations." I am not saying you should go back, but he should know why. If you don't have her name, make sure you make a good description. I'm sure you are not the only person that has received this obnoxious treatment.
Cindra

Lyss said...

I like my dentist and his assitant but hate the front deks pple. I hear from aorund my oral surgeon's office (where I've spent a bit of time in the past year) that I'm not the only one with this problem.

http://no_blog.blogspot.com/2005/03/good-drugs.html

cruisin-mom said...

Jack, since I've enjoyed reading your blog, and my husband is a dentist, I would like to respond to your thoughts:
Please be aware that rates go up in a dental office just like anywhere else. Unfortunately, costs of supplies, rent, salaries, all rise over the years, and must be reflected in the patient's fees. A dental office stops taking certain insurance plans because the insurance companies make it almost impossible for a dentist to provide care, when they are only willing to pay way under what the normal fees are for the service. A dentist cannot have an insurance company dictating fees, and expect him/her to provide the proper care. I imagine that you stayed with him though, because while your insurance covered your care...all seemed pretty good, right? I would thank your lucky stars that your dentist was conservative in his treatment, and willing to wait until you truly needed the crown. Patients have come to my husband's office for a second opinion, because their dentist told them they needed 30 fillings. In reality, the patient needed NOTHING! This has happened several times during his long practice. And, I can tell you from my own experience, that often times teeth snap off without warning and there is no pain involved.
I'm not sure why you would refer to a receptionist as a "flunky", because I know that my husband's office could not run without his valued staff who run his front desk. They probably do not do everything perfectly, but unfortunately they have to carry out the thankless task of explaining to the patient what their fees are. The bad news they usually have to deliver is that there is no payment plan. Unlike the old days, when paying a fee to your doctor or dentist required a handshake and your word, more patients than not have decided that payment for services rendered are not necessary, thereby ruining it for the other honest people who would be willing to make payments in a timely fashion. Therefore, the bad guys have ruined it for the good guys. But that is why dentists offer to take credit cards, checks, cash and insurance, all to help the patient pay his/her fee for service. There probably isn't a dentist in this city who is willing to allow patients to make payments. But if you think about it, why should they? Do you get to leave your favorite stores, Costco or Trader Joes without paying for the items you take out of the store? Why should you be able to leave a dentist's office with services rendered without paying for those services? Would you want your boss to pay you 50% of your paycheck with a promise that the rest will come to you somewhere down the road? Probably not.
You can imagine how frustrating it must be for a dentist who has recommended treatment... the patient does not follow that treatment, and comes in two years later complaining of a toothache (I'm not saying that is you, but this is what goes on). And that complaint very often comes in the form of a phone call to our home at 2:00 a.m. after 3 weeks of pain. So the dentist is blamed for recommending treatment that the patient did not follow...does that make sense? Your dentist engages in unnecessary conversation while you sit in the chair? There is a reason for this...The chairside banter is by design, to help distract the patient from the fact that the dentist is manipulating oral structures with sharp pointed instruments...believe me, chairside banter is a necessary element of good treatment. Try being the dentist pulling a tooth, or performing root canal, while the patient thinks it's okay to answer his/her cell phone. Not to mention the parent's who bring their children into the waiting room only to allow them to climb all over the furniture and pull on the blinds.
And no, dental fees are not cheap, but answer me this? Would you rather have a highly trained dental professional pull your tooth out, who can respond if something goes wrong, or Joe Shmoe off the street? Well, if your answer is the former, than you must expect to pay a fee for his training, his time, and the expenses that he must incur.
Perhaps your dentist's front office person spoke rudely to you, I don't know, but if you approach your new office from the point of view that the front office receptionist is a "flunky", are you perhaps establishing an adversarial relationship from the get go? My husband has kept his fees as low and fair as he can through the years, but don't be surprised if the next dentist wants $1000 for that crown...$865 is a deal by today's standards. I just thought you should have a view from the other side...good luck in your search!
Randi

Jack Steiner said...

Hi Randi,

I understand everything you are saying and it makes sense, but there are some issues here that go both directions.

I stayed with him because I think that he is conscientous and truly interested in providing for his patients.

For the most part I have had few complaints with him, but they have piled up in the last two years.

The initial problem began when he stopped accepting my insurance. It was my choice to stay, but I was quite irked that he raised the rates for a simple cleaning from $55 to $80.

I understand that he was very reasonable and I don't begrudge him the ability to raise his rates, but this is a very substantial increase and there was no mention of this.

They all know that I pay out of my own pocket. I made it clear that I was happy to do so as long as I received quality and value from it.

Instead of making this a long response let me cut to the chase. The problem is with this woman and her poor manners. She unnecessarily abrasive.

I understand that it might be a pain to work with insurance companies, but it is not my problem and I am not interested in listening to her complain to me about how difficult they are. If they are too tough you can drop them, which they apparently they did. (Blue Cross)

I don't like having additional work done on me without asking me first. It is not unreasonable to expect them to check in with me about performing additional procedures.

It takes all of minute to verify that I am willing to pay for the extra X-ray that you think I need.

I don't want to cheap about my health, but I don't want to serve as a cash cow either.

The reality is that there are costs of doing business that both parties need to accept and I don't feel like I have been consulted or listened to. And the reality is that while I expect the professional to provide those services part of that service is communicating and there was a breakdown.

Anyway, I am not angry with you, just irritated with this woman and the lack of concern/care about 30 years.

I haven't ever complained before, and even if I had, after 30 years of seeing me wouldn't it make sense to spend a moment speaking with me, or setting up a brief telephone call.

cruisin-mom said...

Jack, I just wanted to respond to your response, if I may. The reason your dentist probably stopped accepting Blue Cross is because they are notoriously bad at paying proper fees. The going fee for a cleaning (which is not a simple procedure, and must be done with care and skill) is $70-$80. So your dentist was not at all unreasonable to be charging $80. Unfortunately, Blue Cross was probably paying $55 and thus the discrepancy when you no longer had insurance. It is not customary for doctor’s to send out notices regarding fee hikes, just as Unocal does not inform you of an increase in their gas prices (which, I might add takes place on a weekly basis, not after many years!) nor does a restaurant give you fair warning that their menu has changed in price…well you get my point. For some reason, “we” expect doctors and dentists to do their work altruistically. We forget that they have chosen to do what they do because they love it, and feel good about it, but are also trying to make a living and run a business. And, although you may have felt hit between the eyes with the price increase, it is not an unreasonable or unusual thing to happen in dental practice.
Unfortunately, what has happened over several years, is insurance companies have set up an adversarial relationship between the doctor and the patient. There are 3 entities in the treatment room…the dentist, the patient, and the insurance company. Only two of those entities care about your dental health, and it is not the insurance company. Unfortunately the front desk receptionist is the one delivering the news and is the one who gets caught in the fray. And although you may think that insurance companies are not your problem, they, in fact are. Because they make it more and more difficult for doctor’s to be compensated for good treatment, and they dictate the kind of treatment a dentist should give. If your dentist thinks you need a crown, an insurance company may respond back, that all you need is a filling, and that is all they will cover. The dentist (or the messenger, in this case) is blamed by the patient for the insurance company’s neglectful response. And just so you know, there is a movement in dentistry to drop insurance altogether, because an insurance company should never be dictating dental treatment over a doctor’s diagnosis. A dentist takes insurance purely as a service to YOU. Believe me, there is not much gain for the dentist…many of those companies do not pay proper fees, they dictate what kind of services should be rendered rather than allowing the dentist to treat the patient properly, not to mention ethically. Phone calls and letter writing campaigns go back and forth, taking time away from the dentist’s ability to treat patients, and thereby setting up the adversarial relationship between doctor and patient. And that is why dentists end up dropping certain insurance programs. As far as the X-ray…an x-ray is not an “additional” procedure. It is a necessary step to diagnosis and proper treatment. In fact, a dentist could be considered as performing mal-practice if he/she executes a procedure without one. But, all that being said, I understand that if this woman did not treat you respectfully, that is troubling. And the only reason I write all of this back to you is to explain that your dentist was not out of line with the different things you had concerns about…and that you may find things to be quite similar in the next office you go to. I do understand and it is a shame that the front desk receptionist could not have handled it all more tactfully. She does both you and the dentist she works for a huge disservice. But please know, that although she was inappropriate, the front desk employees of a dental office are anything but flunkies. They are an integral part of creating a successful and well-oiled office. Hopefully you will not run into the likes of her in your next office…and I still wish you luck in your search! Thanks for listening Jack, I still enjoy reading your blog…
Randi...and I promise, I won’t open my big mouth on the subject anymore! (no pun intended!)

Stacey said...

After 30 years as a patient, an exception should have been made for you (as far as payments go).

And I bet if the dentist knew that the you asked for a payment plan, he would've obliged. 30 years is a long time of loyal service, esp. after insurance no longer paid.

After 30 years, your goodwill gesture should have been reciprocated.

cruisin-mom said...

okay, I promised I wouldn't open my big mouth! but...Stacey, I agree that it is possible the dentist might have worked with Jack had he been able to talk with him...perhaps the front desk person precluded it,...and again, I reiterate...the "bad" patients (the one who think they are entitled to treatment, and literally walk out the door without paying; and this happens more than you can imagine) have truly messed it up for the "good" patients...that is perhaps where some of the blame needs to lay.

Jack Steiner said...

Hi Randi,

I don't think that I did as good a job explaining the situation as I could have so let me try to do so here.

I don't expect the office to be cold and sterile, but the idle chit chat that I hear grows irritating when I sit unattended for periods of 10 minutes or more.

No one does an effective job of telling me that they need me to wait. They just disappear and then I sit aimlessly while I hear them talk about this and that.

It makes it feel like I am completely unimportant. I don't begrudge them the time to do other things, but I do when I am made to feel like a number.

This is something that a short while ago didn't bother me much, but it has grown to be a problem.

The woman at the front desk began the conversation by telling me how much the crown would be and explaining that they have many bills and they cannot really help me to finance it. She didn't need to act like I was an idiot.

She followed that up by telling me that I needed to have three more fillings done and that I had skipped out on the appointments. I said that I was confused and she told me that the first was diagnosed in January of 2004. That is a 1.5 years ago, why am I hearing about this now.

I explained to her that I didn't have any clue as to what she was talking about and she insisted that the doctor had told me and that I ignored it.

I pointed out that one of the other dates she included was a time in which I did have a filling done. She told me that I was wrong and that it was impossible.

The inconsistency and confusion on her part combined with the poor attitude aggravated me. It makes me wonder about the book keeping. Was this a simple mistake or is it part of a pattern that I have seen from them within the last year.

My prior visit in January was bad, so I made sure to check my records before going in and I really did go in with an open mind.

As I mentioned earlier, I am still happy with the doc's service. I think that he is very professional but the operation around him is a different story.

And as a salesman I am very sensitive to time because time away from the office means that I am not making money. If park in the lot that they do not validate the visit can cost an additional $7.

And if I park on the street I need to be certain to provide enough change for 2 hours.

Am I crazy, but a simple cleaning shouldn't take that long.

Anyway, I despise Blue Cross, but that is a different story.

It is a hard situation but it is a business and it should be run as such.

cruisin-mom said...

Thanks Jack for clarifying what has gone on for you...really sounds like it has been unpleasant, and after 30 years I can really understand your disappointment and disillusion...sometimes even after 30 years, it's time to move on to something new. (I hope my husband won't feel that way after that many years with me! lol)
take care, Randi

Jack Steiner said...

Hi Randi-

All is well. It is almost Friday. :)

Jack Steiner said...

Cindra,

That is a good idea.

Jack Steiner said...

Gavriel,

I don't want to jinx myself, but the tooth hasn't hurt me at all. I was surprised to hear about it.

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