Dentist refused me service!

[care bear]

I have a question for you dentists. Is it common practice to refuse service to a patient b/c (s)he 'second-guesses' you or basically asks too many questions?
I just had that happen and I was floored!!

I had made an appointment for fillings and a possible root canal next week, and I was talking to the receptionist today about financial stuff. on the phone with her, I remembered a question I wanted to ask the dentist. she said 'oh i can help you with that' . . .anyway, in the process of getting to my real question, I asked if any healthy tooth structure is removed when a crown is placed. my understanding was that yes, that is the case. we went on for about 20 minutes, b/c the receptionist kept telling me that a crown is 'just a big filling' and she seemed pretty irritable. when I asked if she could check with someone else, she had the office manager call me back. . .and refuse me service, cancelling my appointment!

can you guys answer for me: 1. is any healthy tooth structure removed to place a crown on a tooth that has a large cavity? and, my next question was going to be: 2. how much is removed? ie. what is left of the tooth?
and finally 3.- is refusing service something that dentists regularly do?? as a medical student, I am taken aback. the only time I have known MDs that I have worked with to drop patients is if they just don't pay. anyway, i am looking forward to hearing your responses. take care!

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[eddiescott]

I have a question for you dentists. Is it common practice to refuse service to a patient b/c (s)he 'second-guesses' you or basically asks too many questions?
I just had that happen and I was floored!!

I had made an appointment for fillings and a possible root canal next week, and I was talking to the receptionist today about financial stuff. on the phone with her, I remembered a question I wanted to ask the dentist. she said 'oh i can help you with that' . . .anyway, in the process of getting to my real question, I asked if any healthy tooth structure is removed when a crown is placed. my understanding was that yes, that is the case. we went on for about 20 minutes, b/c the receptionist kept telling me that a crown is 'just a big filling' and she seemed pretty irritable. when I asked if she could check with someone else, she had the office manager call me back. . .and refuse me service, cancelling my appointment!

can you guys answer for me: 1. is any healthy tooth structure removed to place a crown on a tooth that has a large cavity? and, my next question was going to be: 2. how much is removed? ie. what is left of the tooth?
and finally 3.- is refusing service something that dentists regularly do?? as a medical student, I am taken aback. the only time I have known MDs that I have worked with to drop patients is if they just don't pay. anyway, i am looking forward to hearing your responses. take care!

ALL I CAN SAY IS WOW.......

 

[Dr.BadVibes]

You seem annoying so I'd probably refuse you service as well 😀

 

[care bear]

You seem annoying so I'd probably refuse you service as well 😀

why annoying?

honestly, i'm curious.

i have been a medical receptionist, before med school. there's no way I'm more annoying than some of those patients I used to work with!

the thing that gets me is that this dentist seems to let his office staff have *way* too much power. i really wonder if the dentist even knew of my being dropped- he definitely couldn't know all the details, b/c the manager called me back pretty quickly.

and do you think there is a prejudice against patients who are in the medical field??

before choosing this dentist I went to consultations w/4 diff. dentists so I could make an informed decision. . .and at one of the consultations the dental assistant was joking with me and saying something like 'i can tell when someone's in medicine. . you guys are always so controlling'. . .is that a widespread prejudice? could that have contributed to the situation today?

 

[delicious]

before choosing this dentist I went to consultations w/4 diff. dentists so I could make an informed decision. .

You consulted with four different dentists?! For a root canal and a crown. You're a pretty annoying person I'd say. As for the receptionist, maybe it was the dentist's wife.

 

[SeaBass]

Regarding preparation for a crown, a relatively thin layer is removed circumferentially and from the biting surface (i.e. from all of the tooth exposed in the mouth). Depending on what material is chosen to make the crown with (metal, porcelain, or a combination), this reduction ranges from about .5-1.5mm). Most often some healthy tooth structure IS removed in this process and the amount depends on how much of this outer surface is already restorative material from your existing filling. The trade off is, the tooth structure that still remains is better protected from fracture than if a large filling were left in place.

Out of curiosity, for what did you seek 4 different opinions about?

 

[DrIsh]

Informed decision?

You seem to be bordering paranoia. Most of the questions you have asked can easily be answered via a google search.

Do not get me wrong, you are very correct in trying to make an informed decision but there are limits.

Good luck,
Ish

 

[dWiz]

You seem annoying so I'd probably refuse you service as well 😀

second that motion

 

[delicious]

It's official... care bear is a bi -polar bear. A nut-ball if you will.

 

[lnn2]

can you guys answer for me: 1. is any healthy tooth structure removed to place a crown on a tooth that has a large cavity? and, my next question was going to be: 2. how much is removed? ie. what is left of the tooth?
and finally 3.- is refusing service something that dentists regularly do?? as a medical student, I am taken aback. the only time I have known MDs that I have worked with to drop patients is if they just don't pay. anyway, i am looking forward to hearing your responses. take care!

1&2. Some healthy tooth structure must be removed in order to place a crown. Usually 1mm all around and 2mm from the top surface of the tooth. What left of the tooth is the healthy tooth structure, free of decays.
3. Dentists do not "regularly" refuse services but they sometimes refuse service to patients with "red flags"

The reason for putting a crown on the tooth is for protecting it from being fractured due to bitting forces. The tooth either has a big filling or it's dead (Root canal treated) Root canal treated teeth become fragile, dry and brittle.

and do you think there is a prejudice against patients who are in the medical field??

That's nonsense!

Why annoying?
The receptionist was nice enough to spend more than 20minutes on the phone explaining things to you even though she's not the right person to talk to. Since you think that she's pretty irritable, same thing might had happened on the other end! I wouldn't let my receptionist talk more than 20minutes with any patient over the phone. Have any questions, schedule an appointment to come in.

The dentist didn't let his staff have "way too much power"! believe it or not, they work together as a team, and he definetely knew about the details one way or another. The manager called you back quickly because they have policy, protocol to deal those situations or it had happened before.

It's very good that you wanted to make an informed decision. It's good to have second maybe third opinion but anymore than that, you're just looking for an answer that you already have in mind or you just don't trust dentists!

Depends on the context, it's not bad, (as a matter of fact, it's good) to ask many questions if you have any doubts, concerns...There're no stupid questions, just inquisitive idiots! For me, if I sense that the patient doesn't believe in my ability, disrespectful to me or the staff then I would show them the door, pronto!

the dentist refused you service maybe due to his first impressions of:
1. Your distrust in dentists.
2. You will not be happy with the result no matter what I do.
3. You seem to be unpleasant to deal with

IMO, patients who don't give a **** about their teeth, oral health, "whatever" attitude patients, patients who want to play dentists...are the worst kind of patients!

Don't take it personal because the dentist refused you his service. It's for the mutual benefits!

 

[12YearOldKid]

Inn2 covered it pretty good already, but I'll chime in anyway.

Questions 1 and 2: Yes, healthy tooth structure is almost always removed during a dental procedure. Whether it's a crown prep or just a little tiny filling. It's not uncommon to remove gum tissue for crowns as well. There is just no way around that.

What you have to realize is that while the tissue may be healthy right now, it's not going to stay that way for very long unless the dentist does something about it. You have to admit it's better than letting your teeth rot out of your head. 😉

Here is a picture that will show you about how much tooth structure is removed for a typical crown. The half of the tooth closest to you shows a "prepped" tooth in relation to the whole tooth.

While that may look like a lot of removed structure on this photo, remember that this picture is about 8 times the size of an actual tooth. It really is just a matter of a millimeter or so. Millions of people have this done every year with no problems. You'll be OK. 🙂

 

[12YearOldKid]

As for the dentist refusing you treatment... well that's just CYA. I don't want to hurt your feelings, but your behavior probably came across as either very controlling or very untrusting --- neither of which makes a good patient. By weeding out people with those personality traits, a dentist can for the most part avoid two of the biggest stressors in dentistry: patients who don't pay because they are unhappy with their work and patients who hire lawyers.

Now it's very possible that you are simply scared and just need a little more reassurance than the average patient. If that is the case, it will probably help to admit that to yourself and tell the dentist openly that you are nervous or frightened. He can then take some extra time to be especially gentle and explain things to you in more detail. And if that still isn't enough to allay your fears, nitrous oxide is cheap. 😀

Feel free to PM me if you have any other questions but don't want to submit yourself to the public abuse that some of the other posters have so freely bestowed upon you. I can abuse you privately. 😉 Just kidding; I would be more than happy to help you if you want.

 

[aphistis]

Inn2 covered it pretty good already, but I'll chime in anyway.

Questions 1 and 2: Yes, healthy tooth structure is almost always removed during a dental procedure. Whether it's a crown prep or just a little tiny filling. It's not uncommon to remove gum tissue for crowns as well. There is just no way around that.

What you have to realize is that while the tissue may be healthy right now, it's not going to stay that way for very long unless the dentist does something about it. You have to admit it's better than letting your teeth rot out of your head. 😉

Here is a picture that will show you about how much tooth structure is removed for a typical crown. The half of the tooth closest to you shows a "prepped" tooth in relation to the whole tooth.

While that may look like a lot of removed structure on this photo, remember that this picture is about 8 times the size of an actual tooth. It really is just a matter of a millimeter or so. Millions of people have this done every year with no problems. You'll be OK. 🙂

GREAT post, 12yearold. 😀 👍

 

[datu]

why annoying?

honestly, i'm curious.

i have been a medical receptionist, before med school. there's no way I'm more annoying than some of those patients I used to work with!

the thing that gets me is that this dentist seems to let his office staff have *way* too much power. i really wonder if the dentist even knew of my being dropped- he definitely couldn't know all the details, b/c the manager called me back pretty quickly.

and do you think there is a prejudice against patients who are in the medical field??

before choosing this dentist I went to consultations w/4 diff. dentists so I could make an informed decision. . .and at one of the consultations the dental assistant was joking with me and saying something like 'i can tell when someone's in medicine. . you guys are always so controlling'. . .is that a widespread prejudice? could that have contributed to the situation today?

You asked a very good question and no, you're not annoying. Yes, healthy tooth structure is, as a rule, removed during a crown preparation. And depending on the tooth, it can be a good deal more than .5-1.5 mm (come on guys, if the shoulder's already 1 mm on, say #19, you're going to be removing more than 2 mm from the lingual areas of that tooth).

OTOH, if the assistant was joking, I'd just leave it at that--he/she was joking. There aren't many things left these days that people can poke fun at without getting into trouble.

 

[SPBest]

Boy, if I had a patient that asked those many questions it would be great, I'd know they care. But if they didn't accept an answer or kept hounding me I'd be thinking this is a law suit waiting to happen. See Ya!!!

 

[Sweeti8286]

I thought that it's illegal to refuse service- the only valid excuse really is that you don't accept their insurance policy.....

 

[care bear]

wow, well i certainly got a lot of responses. . .thanks for everyone who has chimed in, even if only to call me a nutball. 🙄

i'm not easily offended, don't worry.

the reason i went to so many dentists was not mostly to get opinions about what I needed done; it was largely financial. . .and I'm glad I did! you might be surprised how differently denstists in the same town will price the exact same services! I was looking for the best, most talented dentist for the best possible price.


and after all that, i thought I had found him, and that's why this news threw me off so badly.

to answer a few things people have said:

1. 'everything i was concerned about could be answered with a google search.'
believe me, i have spent countless hours on the internet, online dental journals, etc in the last few weeks trying to better understand what the dentist was going to do. the problem is that not all sources affirm each other! and the official word from every dentist's office of course does not line up with every bit of information out there. that is why i get confused.

2. 'the receptionist was nice enough to spend 20 min explaining things. . .'
I didn't want to be talking to the receptionist! I wanted to talk to the dental assistant or the dentist, but the receptionist insisted that she could help me, and kept insisting that what she was saying was correct even though she was saying that a crown is 'just a big filling'. IMO that is no way to run a health care office. when i was a receptionist i certainly did not try to answer specific questions, especially if the pt. was disagreeing with me. it's not too hard to say 'the Dr. will call you back'. . .unless that dentist just does not want to be bothered with patients! which i now realize is the case.

i have no desire to 'play dentist'. if i wanted to be a dentist, i'd be in dental school right now! however, what I DO want is someone who will be patient with me and willing to explain things, not leaving the receptionist to give incorrect info. and then labeling me as bothersome and dropping me from the practice!

thank you SO much to everyone who chimed in about crown prep. that really helps. it wasn't as if i was not going to get the crown b/c tooth structure is removed, i just wanted to KNOW.

and to answer one other point, yes I am really afraid of having all this work done. i have a lot of fear and I was/am actually arranging for sedation while the work is done. this probably sounds silly. . but the needle coming toward my mouth while i can't see it just drives me crazy!! i can get shots anywhere else w/o a problem; i think as long as i can see what's going on i'm ok. might sound weird, but I know i will need some sort of sedation to handle the dental stuff.

anyway. . .i gotta run. this was really informative, thanks to all of you again!
take care.

 

[hockeydentist]

Boy, if I had a patient that asked those many questions it would be great, I'd know they care. But if they didn't accept an answer or kept hounding me I'd be thinking this is a law suit waiting to happen. See Ya!!!

I was thinking the samething. "no crown for you" we reserve the right to serve.

Questioning someone for knowledge is one thing, but repeated questioning over competency is another.

 

[KY2007]

Wow I can't believe you guys. Making fun of someone because they had questions to ask. Have you heard of informed consent? I am ashamed that you guys are fellow colleagues. If you don't want to "DEAL" with patients questions or concerns then I suggest you drop out of dental school and become lab techs. If that doesn't sound like the right option for you then grow up and act like the doctors you're supposed to be.

 

[ehop24]

okay, i agree that carebear might have been a little over the top with all the questioning. MIGHT have been.

but the fact is that nobody ever took the time to educate carebear about the procedure. this is our duty as dentists. i'm sorry, but the patient has the right to truly understand everything we are doing to them.

nonetheless, if it came across to the receptionist as though carebear was acting in a pre-litigious manner, then by all means it is acceptable to refuse the treatment.

however, the office systems failed on several occasions well before that phone call. "do you have any questions about the crown treatment that we are planning to perform?" "do you understand why it is important that you receive this crown and not another type of treatment?" it's called informed consent. it's one of the reasons that dentists get their pants sued off.

and i know it might have been a pain in the rear, but if carebear wanted to speak with someone that could describe a crown as more than a "big filling", then somebody should have found a way.

what about when that dentist is having back pain and the doc says "we're just going to take out that kidney." "why?" "becuase your kidney is sick." i sure would expect a little better education prior to going under the knife.

i cannot know the true specifics of carebear's situation, but i do know that our duty as dentists is not to just tell patients what they need and kick out anybody that starts to ask questions.

 

[delicious]

okay, i agree that carebear might have been a little over the top with all the questioning. MIGHT have been.

but the fact is that nobody ever took the time to educate carebear about the procedure. this is our duty as dentists. i'm sorry, but the patient has the right to truly understand everything we are doing to them.

nonetheless, if it came across to the receptionist as though carebear was acting in a pre-litigious manner, then by all means it is acceptable to refuse the treatment.

however, the office systems failed on several occasions well before that phone call. "do you have any questions about the crown treatment that we are planning to perform?" "do you understand why it is important that you receive this crown and not another type of treatment?" it's called informed consent. it's one of the reasons that dentists get their pants sued off.

and i know it might have been a pain in the rear, but if carebear wanted to speak with someone that could describe a crown as more than a "big filling", then somebody should have found a way.

what about when that dentist is having back pain and the doc says "we're just going to take out that kidney." "why?" "becuase your kidney is sick." i sure would expect a little better education prior to going under the knife.

i cannot know the true specifics of carebear's situation, but i do know that our duty as dentists is not to just tell patients what they need and kick out anybody that starts to ask questions.

This person had visited four dentists, and still had a burning enough question to ask a receptionist. Carebear says the visits to the dentists were more financial than research about the procedure: well, that's pretty dumb - four visits and you couldn't get around to asking about a crown!! Sure, part of the duty of dentists is to educate; but it's not our job to eternally hold a person's hand and tolerate indecisiveness. Reading this story makes me think of an annoying little kid who asks a question, and then responds why to the answer, and then responds why to the answer to that question. Eternal whys.

 

[HuyetKiem]

.

but the fact is that nobody ever took the time to educate carebear about the procedure. this is our duty as dentists. i'm sorry, but the patient has the right to truly understand everything we are doing to them.



however, the office systems failed on several occasions well before that phone call. "do you have any questions about the crown treatment that we are planning to perform?" "do you understand why it is important that you receive this crown and not another type of treatment?" it's called informed consent. it's one of the reasons that dentists get their pants sued off.

.

Nobody could educate him about the procedure or answer million of his questions over the fone. He hasn't examed by the dentist, and no Xray has taken. Informed consent for an unknown person over the fone ? How could it be ?

 

[EHA DDS]

The real question Care Bear is why do you have a quote from Corinthians in your post?

 

[care bear]

wow, EHA, you really know how to cut to the core.
i suppose the tone of my posts probably did seem unloving. i assure you that i have no personal feelings of ill-will (ok, i'm inclined to, but i'm working through them!) towards either the dentist or the office staff. i am not trying to slander this particular dentist. i was just taken aback by what seemed to me to be an unprofessional response, and i wanted to get the anonymous advice of dentists. now thanks to your responses i realize that it is not SO unusual or out of the ordinary for a dentist to not give a patient service (the whole 'pre-litigious' thing ) and that actually makes me feel better. my problem with the dentist was not personal but professional, and i guess i didn't think it was sinful to be surprised by the way you are treated in a professional context.

to others: i was examined by this dentist previously;and i had another appointment all lined up. i will give some more details so that you all will not think i am crazy (or maybe you will).

yesterday, since i was planning to have sedation for my fillings next week, the office called me to set up a sedation appointment (info, and giving me some meds). they said it should take 10 min. i said that i know i tend to have a lot of questions, so could they set aside 20 min. for the sedation appointment so I could feel free to ask more questions. that is when the receptionist said that SHE could answer my questions right then instead of me asking the dentist at the appointment.

i started off by asking her about financial issues. my tooth (#13) has a large cavity near the pulp, but in the Xray it doesn't appear to be touching the pulp yet.
so, the office had worked up several possible treatment plans, one including a root canal if neccesary. i was asking the receptionist which of the plans i would have to pay for up front. she said the one without the root canal, but that the doctor still wanted to do the crown even if root canal wasn't neccesary. i hadn't realized that until that minute (i was thinking he was only going to do the crown if i had to get the root canal) and so i had questions about the crown. after she described it as 'a big filling' I said, 'you know, would you mind checking with someone else? or you know what, could you just have some info on crowns ready for me when i come for the sedation appointment?' and she said , 'well, didn't you watch the video on crowns when you were here for the initial consultation?" and i said 'i remember watching the one on root canals but not the one on crowns. could you just ask someone else or get some info for me'? it went on and on. she insisted that she knew what a crown was and didn't need to check with anyone else. finally she said she would have the office manager call me back. . .and the mgr. called me back and dropped me.



prior to yesterday, i had had a consultation, watched some videos, discussed some questions with the dental assistant, (i.e. what about a direct pulp cap; is that something the Dr. could do in my case? or what about inlays/onlays, what are those?) Then I said i needed some time to think about it because I was very hesitant about getting a root canal and crown, but I would call back if i decided to make an appointment.

Last week (after consulting with other dentists ) i called back, made an appointment, everything was great, they called my primary care doc to get permission for sedation, I was all set to go until yesterday on the phone.

so that's really the fullest story i can give. just for your collective information.
thanks again for all the advice- and even for the criticism. i guess i just have to find a dental office that can work with my style.

take care!

 

[care bear]

Sure, part of the duty of dentists is to educate; but it's not our job to eternally hold a person's hand and tolerate indecisiveness. Reading this story makes me think of an annoying little kid who asks a question, and then responds why to the answer, and then responds why to the answer to that question. Eternal whys.

i guess that's the perspective of this dentist, too. it just happens to be a perspective that i disagree with.
i agree that i am always going to ask the 'whys'. if that's annoying, i'm really sorry. really. i don't get a kick out of frustrating people!
but see, i guess i am the kind of person who loves to ask 'why' but who also loves to teach. i love explaining things so that people 'get it'. and i guess i need a dentist who is also a good teacher.
and there are plenty of questions that there are no answers for, sure- but the questions you ask of your dentist aren't those kind of questions. the way i see it, if you have good answers for the questions, then you won't be afraid of the questions. 🙂

did you know, the word 'physician' actually means 'teacher'?? i know dentists don't call themselves 'physicians' per se, but i sure would like to find one who doesn't mind some teaching. one of the other dentists i went to (higher priced) seemed to have more of this quality and so I am going to set up my appointment with her now.

 

[datu]

The real question Care Bear is why do you have a quote from Corinthians in your post?

Say what? Is there something wrong with that?

"And we know that all things work together for good to them that love God, to them who are the called according to his purpose." (Rom. 8:28)

 

[Biogirl361]

dentists don't like booting patients - that is money out of their pocket as well as possibly contributing to a bad reputation if the person goes around town badmouthing them. I'd think a patient has to be pretty noncompliant, obnoxious or seem like the litigious type before a dentist would kick them out of the practice. maybe with this being your first visit to this doctor, visiting 3 dentists previously asking about pricing and following that up with questions about removing healthy tooth structure, you seemed like a high risk for 1) not liking the outcome and not paying 2) suing them with the claim that they didn't explain some basic part of the procedure to you, and 3) being some kind of scam artist going around to the local dentists until you find one to do the above to. the dentist may have red flagged you and left instructions for the front desk to boot you if you did anything else unusual.
I'm not saying that you are this, just that you have to try to see this from the dentist's point of view as well as yours. It's sad that today's society is such that doctors and dentists have to look out for these things, but that's how it is. If a patient seems suspicious you have to draw the line somewhere to protect yourself.
I do think it's kind of rude to not transfer you to someone that knew more about your question, which is why I kind of think they were already under instructions not to deal with anymore.
well anyway good luck finding another dentist.. 👍 maybe this time you can just be more accepting of what they tell you or make sure to phrase your questions as respectfully curious rather than controlling or questioning the dentist's decisions. in my experience many dentists take offense easily if you don't say your questions carefully, even if you didn't intend to sound critical.
ok, i'll quit procrastinating on my cell bio studying now 🙂

 

[LADoc00]

I love the exhilartion of refusing service, I shouldve gone into dentistry.

WTG Dentist Office!

 

[EHA DDS]

Care Bear, I don't think that you were being unreasonable at all. My question was just why do you have a quote from Corinthians? Like what compels someone to put a quote from the new testament on SDN? I am asking in all seriousness

 

[DDS2BE]

No offence, but you must be a very annoiying patient and I already see a problem customer as well. I’ve been in computer sales business for 6 years. People with your personality are the worst customers one can ever get. You don’t trust anyone but yourself and this is the most anoying thing for a professional of any kind.
I don’t think your questions pissed them off, but your attitude sertanly did.

 

[mike3kgt]

No offence, but you must be a very annoiying patient and I already see a problem customer as well. I’ve been in computer sales business for 6 years. People with your personality are the worst customers one can ever get. You don’t trust anyone but yourself and this is the most anoying thing for a professional of any kind.
I don’t think your questions pissed them off, but your attitude sertanly did.

I am not a dentist yet, but I'd like to ponder two concepts:

1. I would like to believe that educated patients will respect and value your work much greater when they are knowledgeable about the factors that go into the high quality care that you are providing. I.e. A quality fitting crown procedure takes years of training, expensive chair time, and costly laboratory fees to provide the service. If the patient is aware of these factors, I do believe that it makes for a better case-acceptance (in terms of $$ amounts)

2. I am fully in favor of accepting and rejecting patients based upon whatever merits I deem so. If I am unhappy with your attitude as a prospective patient (case-by-case basis because even the most stand-offish people can become great patients) or that you seem like the type that would over-analyze my work and question the price I am charging by comparing to 4-5 different dentists around town keeping in mind that when considering start-to-finish no-one in this world can cut a crown the same exact way as another person. If a patient inquires about the price and I am aware that they are barely making ends-meat, I would consider adjusting the price slightly. But I would happily consider refusing to treat a patient that was coming across in a belligerent manner!

-Mike

 

[airvent]

so i had questions about the crown. after she described it as 'a big filling' I said, 'you know, would you mind checking with someone else? or you know what, could you just have some info on crowns ready for me when i come for the sedation appointment?' and she said , 'well, didn't you watch the video on crowns when you were here for the initial consultation?" and i said 'i remember watching the one on root canals but not the one on crowns. could you just ask someone else or get some info for me'? it went on and on. she insisted that she knew what a crown was and didn't need to check with anyone else. finally she said she would have the office manager call me back. . .and the mgr. called me back and dropped me.

We have the same problem with our receptionist. She has been working there for many years and is actually quite knowledgeable on many of the procedures. However the doctor has caught her a few times giving her opinion on what the diagnosis may be over the phone "Sounds like you need a root canal" and she had to remind her that it is the DR's job.

Also the “big filling" description would have had me asking to speak to the Doc also. The office you went to could have been more of a Dental "Mill" where office mangers run the show instead of DRs. I think in most small offices the Doctor would have spoken to you or called you back later. If you call an office and ask to speak to the doctor and are denied or not told to wait for a call back...find a different office.

 

[delicious]

Also the “big filling" description would have had me asking to speak to the Doc also .

Some of you people are being way too kind to this person. Remember, carebear had spoken to four (that's right, four) dentists before this receptionist described a crown as being a "big filling." If you didn't understand what a crown was by this point, you're mentally challenged.

I'm very tired of political correctness these days. I mean, I agree with human rights and being nice to people. But at some point, to keep the world moving you have tell people to shut up, or get out of their office. I too would have no problem denying dental services.

If it were illegal to deny dental services, I would've gone into medicine.

 

[Jediwendell]

You know, if the dentist doesn't want to do the work for you because of what he or she perceives as a poor patient-doctor relationship, it is probably best for you in the long run. Just as the patient has a right to refuse any treatment, the dentist has the right to refuse any treatment. As a practicing dentist, I will give the patient the options that I feel are viable, and if they aren't convinced, I will refer them. I have a lot more content patients that way. As a whole, if the patient continues to second guess my treatment plan after what seems to be reasonable education, I will refer out of what is best for the patient. I don't want unhappy patients.

 

[WildcatDMD]

did you know, the word 'physician' actually means 'teacher'?? i know dentists don't call themselves 'physicians' per se, but i sure would like to find one who doesn't mind some teaching. one of the other dentists i went to (higher priced) seemed to have more of this quality and so I am going to set up my appointment with her now.

Not to be a johnson, but i think you need to review your latin, care bear. I pretty sure "physician" does not mean "teacher". The word "doctor" is latin for "teacher" and dentists also hold that title. Just making a correction. 🙂

 

[airvent]

Some of you people are being way too kind to this person. Remember, carebear had spoken to four (that's right, four) dentists before this receptionist described a crown as being a "big filling." If you didn't understand what a crown was by this point, you're mentally challenged.

Yeah, it was a conscious effort on my part. My first thought was that it was a med student(or any student be it Law/Dent/Med/whatever) that was a little to full of themselves and was being condescending to the receptionist.

However, she does sound like a true Nervous Nelly which could explain her obsessive behavior.(4 consults is a bit much) Nervous patients can be annoying and they definitely test your patience.

I was torn between which patient to respond to, so I took the road less traveled.

Also I would have no problem not treating patients that are disrespectful. I think the "must treat" policy is only for life threatening emergencies

 

[care bear]

wow, lots and lots of posts still coming.

to answer the poster above me, i suppose i am a nervous patient- and I am also a med student too. i think maybe i needed to watch my tone in the office. i don't mean to but people have told me before that i just naturally have a kind of condescending tone to my voice.
that was probably exacerbated in this situation by the fact that the receptionist (i felt) was being condescending to me first. . .she kept calling me 'honey" (this woman was not over 30-35!) and she just kept saying things that rubbed me the wrong way. like "Ok. let me explain it to you one more time, now. when ya got a little hole in your tooth, you get a regular filling. when ya got a big hole, you get a crown- a big filling!" and things along those lines.

to answer the person who said i was 'mentally challenged', well i need a lot of dental work done. i need several fillings in addition to the work on this tooth. so at each appointment i had a lot to discuss in a short time with the dentists. i knew what a crown was but until yesterday i thought i was only getting a crown if i needed a root canal (bc/that is what some other dentists were going to do.) so i hadn't thought about the idea of getting a crown b/c there was too much decay. that is why i had new questions even after so many appointments.

and wildcat, you are right!! i am sorry. doctor means teacher not physician. . .so. . great! i need a dentist who is a true 'doctor'.

thanks for those who actually put themselves into my shoes. you are very kind. and you are all right that i need to see things from the doctor's perspective too. this thread (even though it has been really mean at times!!) had helped me do that a little better. and to the person who said he had probably 'red-flagged' me before yesterday's call, well that makes a lot of sense. . .it would explain why she could call me back so quickly.

finally. . .why do i have the corinthians quote in my signature??
i guess because it is a quote that inspires me. . .and lots of people have quotes that inspire them in their signatures. it also reminds me to have my posts be as loving as possible (i know, on this thread I have really fallen short of that) and exposes people who may have never read the new testament to a very little piece of it.


i got really upset by this situation especially since i feel that out of the dentists i went to, this guy seemed like the best and i wasn't really happy with various others, especially their pricing. I am in NC, and this particular dentist was in Raleigh- he seemed top notch. the other dentists i went to were in Chapel Hill, where I live (30-45 min away). . . very high cost of living and so all their prices were higher than his! even though they didn't seem quite as top rate. . . . so now i think i am going to have to go to some more consultations. i know that might sound crazy but the fact is, i'm a med student and this dental work is going to be a HUGE chunk of my 'income' (loans). it's not something I want to do casually.

so yes, i have been mulling over this all day. i emailed the dental office and i called one of the other dentists to see if she could lower her prices for sedation . ..$400! for oral sleeping meds!! other than that i liked her. but no go with the price lowering 🙂 so i'm still looking around. . .

anyone in the Triangle area in NC know a great dentist who offers sedation or NO, let me know!

alright, enough from me. . .

 

[Energon]

Care bear, I am really sorry about what happened to you. Rest assured if you were a patient at my office, you would have definitely got to have a chat with me before you were refused service.

However, dentists and some medical specialists have to be very careful about offering services to patients who will never be happy with whatever they get and will then keep blaming the doctor for it.

Having said that, it seems to me that you were just a concerned patient with a medical background and the dentist should have talked to you in person before making a decision to turn you away.

In the future, the best thing to do is go to a good dentist and get a variety of treatment options and then just contact different dentists and ask the price range for those procedures

 

[aileen]

I was hesitant about posting, but I have to...

Why do you think the dentist charges less than others? Because he is doing charity work? Because he has no student loans or home mortgage to pay off? He is charging less because he wants to see/treat more patients in less time than other dentists. I totally understand your behavior and respect you because I'm like you, too.

Consider that he did you a favor by refusing to treat you, otherwise there could've been more complicated problems between you DURING treatment or AFTER treatment. You two just didn't click...

It's a stupid analogy, but I can't help it. Imagine a customer walking into McDonald's and asking the cashier what kind of beef, what kind of potatoes they use for their bigmac and french fries.

 

[lnn2]

wow, lots and lots of posts still coming. .

yes, we do care 😀

i think maybe i needed to watch my tone in the office. i don't mean to but people have told me before that i just naturally have a kind of condescending tone to my voice.

you're on the right track! the first step in solving a problem is admitting that you have a problem, j/k 😀

that was probably exacerbated in this situation by the fact that the receptionist (i felt) was being condescending to me first. . .she kept calling me 'honey" (this woman was not over 30-35!) and she just kept saying things that rubbed me the wrong way. like "Ok. let me explain it to you one more time, now. when ya got a little hole in your tooth, you get a regular filling. when ya got a big hole, you get a crown- a big filling!" and things along those lines.

Now, that made much more sense! I thought that you were a nice gal (maybe with a condescending tone!) all along 🙂 yeah, that would tick me off too! Next time, request to speak only with a dentist who is the only one qualify to make diagnosis and answer technical questions.

. . . so now i think i am going to have to go to some more consultations. i know that might sound crazy but the fact is, i'm a med student and this dental work is going to be a HUGE chunk of my 'income' (loans). it's not something I want to do casually.

so yes, i have been mulling over this all day. i emailed the dental office and i called one of the other dentists to see if she could lower her prices for sedation . ..$400! for oral sleeping meds!! other than that i liked her. but no go with the price lowering 🙂 so i'm still looking around. . .

Stop the madness! You do sound crazy! Stop driving yourself and all of the dentists in town nuts! Choose a reputable dentist and get it over with. Never ask for a discount in a dental office. It's not a car dealership. You'll never get discount by asking. Discounts are given only at the dentist's discretion, voluntarily.

If you have to pay a little more to get a "top notch" reputable dentist then I would do it. It's worth it in the long run. Ask whether a dentist will take a PA (periapical) radiograph confirmation before cementing a crown to check for Open margins which are very important. A crown with open margin will cause the decays to occur again (recurrent decays)

Come to PA and I will take good care of you! I'll hook you up the whole nine yards, A to Z 😀

 

[ibo man]

I'll refuse you service too. You acting like you know more than the dentist, while you don't know jack about dentistry.

 

[eddiescott]

I am sorry but I wouldnt give service to this guy.

no way.

 

[delicious]

... people have told me before that i just naturally have a kind of condescending tone to my voice.

You might want to work on that before you become a doctor.

CareBear, even after you've clarified your story I still feel like this is ridiculous. The moral to this thread is this: you're not the center of the world. I would never, ever try to monopolize the receptionist at a dental or medical office for 20 minutes. I mean seriously!! Do you think these people have nothing better to do. You've been to a dental office right? Mayhem all the time! That conversation with the receptionist was the root of all your problems. Be more careful next time. I wish you the best at med school, and with your teeth!! 😀

 

[Tarheel]

Care Bear I am a third year Dental student hear at UNC-CH. Have you considered becoming a patient at the dental school here at Carolina? Our prices are about 1/3 (on average) the price charged in private practice. It is close since our building's are connected(unless your a Dukey living in Chapel Hill) . You will get 3 hours for each appointment which will allow you to ask plenty of questions. You can get consultations from specialists. The only drawback is you do have to apply through a lottery system. This may or may not take a long time for you to be accepted as a patient. If you are interested let me know and I will explain to you how to apply to become a patient. Also if you have an infection that is near the pulp you need to get treated as soon as possible. Otherwise I may be seeing you in the emergency/urgent care clinic one day. Good luck!

 

[sdog]

You know, if the dentist doesn't want to do the work for you because of what he or she perceives as a poor patient-doctor relationship, it is probably best for you in the long run. Just as the patient has a right to refuse any treatment, the dentist has the right to refuse any treatment. As a practicing dentist, I will give the patient the options that I feel are viable, and if they aren't convinced, I will refer them. I have a lot more content patients that way. As a whole, if the patient continues to second guess my treatment plan after what seems to be reasonable education, I will refer out of what is best for the patient. I don't want unhappy patients.

I agree with what Jedi says. I, too, am a practicing dentist and I am very competent at communicating with my patients. I will answer questions and provide all necessary information. However, I will not treat a patient who I feel, after all procedures, costs, etc. have been explained, still questions what I do. I don't go to any of my physicians and question every single thing he/she is doing- multiple times! That's because I trust that they went to school to do this and that they are knowledgeable and competent professionals. If I didn't think that from the start, I wouldn't be at that person's office in the first place. Same goes for us..... If I feel that a patient won't be happy with my services before services are even rendered.... he/she will be kindly referred to a specialist or other general practitioner (depending on the treatment needs) and yes- a dentist can refuse treatment by referring the patient to another professional that he/she feels can better meet the patients needs (In fact- I just did it today with a VERY fearful and difficult extraction patient) What Jedi says is correct, it is for the best interest of both parties involved.

 

[care bear]

thanks everyone.

i really feel that questioning the office staff is much diff. than questioning the doctor. maybe that's my problem, i need to find a smaller office where i can actually ask questions of the dentist, b/c i guess it's true- i am inclined not to be as trusting of staff other than the dentist. this dentist seems to let his staff handle way too much IMO, and i really think my prob. could have been easily solved if i had had 5 min. of his time. instead, i got dropped. which is fine- i will just know what to look for next time!! 🙂

 

[toothache32]

As far as different dentists charging vastly different fees for "the same procedure," I hear this a lot from friends. What people don't understand is that every dentist has different office rent, overhead, and uses a different lab to make the crown. Even the crowns are made of different materials which changes the price the dentist has to pay the lab. Dentists in "nicer" parts of town with fancy offices have to charge more to pay for that leather chair in the waiting room, etc.

Also, a general rule of thumb I heard throughout dental school was that you don't want patients who are shopping around for prices, because they are generally not interested in the value and technical skill required in your services. And they still tend to complain even when they find a crown for $600. Dont take this the wrong way...I'm a resident and don't have any money either, so I know where you're coming from financially.

I don't know if anyone pointed this out: any posterior tooth with a root canal requires a crown. The root canal is really not finished until it has a crown seated, otherwise it will fail. At least that's how I learned it. Sure, you can do a huge amalgam like I did for many of my financially-strapped patients in dental school, but it will most likely fracture in a year or two and you're back where you started.

Just curious...did you tell the receptionist who dumped you that you had already talked with 4 dentists? That's a huge red flag for someone who will be high-maintenance and tough to satisfy.

I would bet a lot of money that you also have TMJ problems.

 

[DrJeff]

Here's the part that I'm having a tough time with. I realize that the combination of the comfort/trust factor in the doctor/patient relationship is important and per your statment, cost is an issue too. But 4 consults with the possibitly of more pending, I read that as you've already paid for 4 consult visits(an presumably 1 set of radiographs). In my neck of the woods, a consultation visit runs just under $100. so you've added a couple of dollars to your bill already(and the drill hasn't even been turned on yet) 😱 😕

As per the front desk's handling of the situation. What is often the case is as a student, you have this rosy, idealistic view of the world and how a practice, be it dental or medical will operate. In actuality, the unfortunate thing is you are dealing with money, and getting people to pay you for your services, and while most people don't have a problem with it, a small portion do, and it is this small portion that creates ALOT of headaches/stress for the people in the office responsible for billing/collections (often the receptionists job duties may include this). Any office staff member who has been doing their job for a while has learned that people with certain personality traits are much more likely to become one of "those patients" who will cause "headaches" for the staff and/or the doctor. Frankly if an office is busy, as most dentist offices are these days, and the staff recognizes some of these traits, they'll tell the doctor and often they may not treat that patient. (In my office we call these people the PITA patients - Pain In The A#$ )

Right or wrong, I've learned that if one of my front desk staff lets me know that there is a new patient in my schedule who they feel has a high PITA potential, and I get that feeling after meeting them, I'm more likely to "encourage" them to seek care elsewhere, or refer to a specialist for treatment of a procedure that I'd typically do myself. Franly I just don't need/like the added stress in my day that this minority of patients cause (rule of thumb, 1% of your patients will cause 90% of your headaches).

Care Bear, the things that you did that would raise the PITA factor to most offices are:

1) An excessive number of consults(1 or 2 2nd opinions is considered okay on the PITA scale)

2) 20 minutes on the phone, I know you have questions, but that long, no matter what its for even with some staff run around really raises the PITA suspicion

3) Desire for sedation. Major, major PITA warning flag. Frankly the $400 you were quoted isn't just the fee for the meds, but ALOT of that is for all the extra chairtime during med induction and the expected extra time away from other patients that your follow up in the subsequent days with likely questions will take. Remember, while we're often a very caring, compationate group, we also have bills and staff to pay, and when were not running the drill because were on the phone, the bills aren't getting paid. You'll see this in the future when you enter practice.

 

[drat]

holy cow, holy cow, holy cow. i cannot resist the opportunity to offer my opinion because i think this situation is absolutely ridiculous.

care bear, perhaps you'll have better luck with a pediatric dentist (wucka wucka); they are a bit more patient. i was going to suggest (but someone beat me to the punch) that you should check out the dental school affiliated with your med school (if there is one). the root canal/crown will take awhile, but all along the way, a faculty member will be helping the dental student. plus it is cheaper, and price seems to be an important factor for you.

which leads me to my next point...asking for a discount? when i shadowed, one of my dentist's patients asked if he could get his crown for 25% off. my dentist said, "sure, but i'll only do 75% of the job." good luck finding that deal of a century from a dentist, especially when you're a difficult/time consuming patient to begin with. dentists aren't trying to be heartless, but there is a business to run. when was the last time you shopped at Macy's and got a discount on a sweater because you're in med school and don't have a lot of money? i'm really not trying to be mean -- just realistic...

anyway, before you go on another consultation joyride, i recommend 2 things. 1.) check out UNC's dental school. it's a great school and there is an enthused student waiting for you. 2.) talk to your professors or neighbors in Chapel Hill and get dentist recommendations. you admit you don't know anything about dentistry, so how would you know a good dentist from a bad dentist?

 

[DcS]

I have a question for you dentists. Is it common practice to refuse service to a patient b/c (s)he 'second-guesses' you or basically asks too many questions?
I just had that happen and I was floored!!

I had made an appointment for fillings and a possible root canal next week, and I was talking to the receptionist today about financial stuff. on the phone with her, I remembered a question I wanted to ask the dentist. she said 'oh i can help you with that' . . .anyway, in the process of getting to my real question, I asked if any healthy tooth structure is removed when a crown is placed. my understanding was that yes, that is the case. we went on for about 20 minutes, b/c the receptionist kept telling me that a crown is 'just a big filling' and she seemed pretty irritable. when I asked if she could check with someone else, she had the office manager call me back. . .and refuse me service, cancelling my appointment!

can you guys answer for me: 1. is any healthy tooth structure removed to place a crown on a tooth that has a large cavity? and, my next question was going to be: 2. how much is removed? ie. what is left of the tooth?
and finally 3.- is refusing service something that dentists regularly do?? as a medical student, I am taken aback. the only time I have known MDs that I have worked with to drop patients is if they just don't pay. anyway, i am looking forward to hearing your responses. take care!

All that I can say is that there are two sides to every story, I'm not saying it in your case but in my experience the patients I have that are problematic aren't very likely to tell the whole story. I think you should understand that most on here are students and aren't in the position to comment on your treatment, because none of us truly knows exactly what happened. You can gain education on crowns here etc, but neither I nor the people on this board are in a position to comment on if that dentist was justified because we do not know the whole situation. If you feel like you were unjustly dismissed, I would recommend contacting your state's dental association.