How do you feel about patients that struggle to afford your work?

[thrillbabythrill]

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Was shadowing and a few patients came in needing major work. One 75+ year old lady only had a couple teeth left and was having constant denture problems, so the dr. went to recommend basically a full mouth replacement, which was way beyond her means. Didn't push it on her, and it kind of seemed like a major bummer for her to know there was something that could work for her, but that she just straight up could not afford.

Another dude came in with some serious perio problems and the bill was going to run him about 8k. He was grateful for the chance to save his remaining teeth but was still going to pay a huge sum out of pocket and it clearly wasn't going to be easy on him.

I know dentistry is still a business, loans need to be paid off, and some of these procedures are pretty involved, like the full mouth work. Nonetheless, I felt kind of bad for these folks. How do you feel when patients struggle to afford your work?

 

[thirstyscholar]

Order a few filet mignons and a cask of aged scotch.

Cry foul when the bill comes.

 

[thrillbabythrill]

Well the lady didn't opt for the full rehab because she couldn't, and the dude was probably going to opt for financing or something. I'm saying more like, people come to you and you have a treatment that can improve their quality of life tremendously but they can't get it because insurance won't cover it or they are just too broke.. To break it down even further, it seems like its a common part of the job to say "Can't afford it, sucks for you"..

 

[mr24]

you could always do it for free, but then you would be broke. its definitely gotta be hard to say "sucks for you", but its not our fault they didnt take care of their teeth in the first place.

 

[oralcare123]

To be at peace with yourself you need to offer several options, which in most cases you can. Old lady could have had new better fitting dentures and later opted for the implant support. There is always a payment help, like offering to pay in three installments or in office financing.
After all you can find free services for needy.
Anyway you need to think about yourself first.

 

[Shunwei]

To be at peace with yourself you need to offer several options, which in most cases you can. Old lady could have had new better fitting dentures and later opted for the implant support. There is always a payment help, like offering to pay in three installments or in office financing.
After all you can find free services for needy.
Anyway you need to think about yourself first.

Offering payment plans is like inviting trouble. Maybe except for long time pts with an excellent payment hx, I wouldn't touch that option with a ten yard pole.

 

[oralcare123]

There has to be a balance to make sure your karma is OK. Give a list of options, let them make a choice.
I have been in situations, when I went out of my way to help a patient to get what they need, but it only caused me trouble and patients tuned out to be ungrateful and irresponsible.

 

[thrillbabythrill]

Thanks these are the kinds of opinions I was looking for. With dental insurance being so limited, it seems like a lot of the time people who need serious treatment are left hanging. Seems like a trade off between being able to make someone better vs. putting them under financial strain. But hey, if someone doesn't take care of themselves it's not the dentists fault.

 

[yappy]

@thrillbabythrill

I try to stay as objective as possible. We live in a finite universe. The development of technology has created a disparity between those that have access to technology and those that do not - an inequality. Because of this there will always be a curve that represents the world population as a function of their ability to obtain different technologies. This includes dental services and the medium of exchange that we use in the US. Therefore, it is only logical that there will be people that cannot afford to receive dental services.

Well the lady didn't opt for the full rehab because she couldn't, and the dude was probably going to opt for financing or something. I'm saying more like, people come to you and you have a treatment that can improve their quality of life tremendously but they can't get it because insurance won't cover it or they are just too broke.. To break it down even further, it seems like its a common part of the job to say "Can't afford it, sucks for you"..

 

[beannaithe]

I always give options. Ideal (implants for missing teeth, crowns for cracked teeth, aesthetics, etc) vs. sorta ideal (taking care of all the active disease and stuff that could break) vs. doing nothing. I always tell them (esp. with dentures that they don't have to do anything but it could make their life easier) Most people elect to do SOMETHING, be it a couple fillings or SRP or whatever. But what I've found most is that if patients want something, they will absolutely find the money to take care of it.

I feel bad for the patients who truly can't afford it, but they are few and far between. You'll find the longer that you do this, you'll get people who say they can't afford it. But they can and don't want to. Neglect is expensive and unfortunately, people who don't value their teeth are sometimes the ones that won't want to put the money into it. You also can't make it your problem, it's the patients'. They need to own it.

I had a patient in yesterday for an emegerncy. Most of her teeth are bombed out. She needs to have #19 out, but wants to be put to sleep. Nice and easy, right? Yeah, I don't think so. She couldn't take a referral to any of the local OMFS's because she owes all of them money. So she asked me what she was supposed to do. There isn't a whole lot I could do there...pay the bill and get the tooth out. Or pay me up front and stay awake, but she HAS to be sedated. Well, then there's really nothing I can do there.

 

[Contach]

You can't judge people by how they walk into your office. If they look like they are poor, or say they are broke, you never know what their financial situation is. or where their values lay. The same goes for someone who looks like they may have a lot of banked $; you never know (think: elite athletes). Because of this, you must always provide the option of the absolute best treatment and more affordable alternatives. Anything less is unethical.

 

[dieanotherday]

GE has a lot of credit card options for a lot of small businesses, see if they will work with your dental office
if the patient qualifies for interest free financing for a procedure it will be worth it to apply and see if they can get that credit card

 

[Silent Cool]

http://www.carecredit.com/

Any of ya'll use carecredit?

Seems like a good option.

 

[thirstyscholar]

Carecredit has it's plusses, but usually not worth the headache of dealing with their 'representatives.'

Cash is king.