Rights and Obligations as Associate Dentist

[jh1581]

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I left my last job as an associate dentist (NOT independent contractor) in June because the owner is buying more offices giving it a corporate feel, because of differing philosophies (mine focuses on the patient, theirs is leaning more about financial gain), and to have a new job closer to home. I received 30% of whatever I produced when I worked for them.

I have since gotten a new job, but recently I was contact by the office manager of my old job. She stated that a previous patient was "very upset with my work on her bridge because it was done wrong". The office manager stated that the patient did not want to travel to my new job to get it looked at, so I would have to pay for the bridge to be redone. The bridge was done in 2009 and the patient recently had a root canal done of one of the abutment teeth. At her 1 month rct post-op, the endodontist wrote a note to evaluate an open margin.

I immediately asked the office manager for the patient's phone number so I could speak with her directly because I was concerned for her. When I spoke with the patient, I found out that the office manager had been dishonest about what happened in her conversation with the patient. The office manager even stated that the patient "cursed her out." The patient said that never happened and was shocked that the office manager said that. I know this patient very personally and I know she would never have done that.

The patient told me she was upset with the office, NOT me, because they refused to do anything about her bridge. The patient stated that she has always been very happy with my work and that the endodontist told her that it appeared as if some cement broke the seal which caused the open contact and that's why the bridge would need to be redone. The patient stated that they were very rude to her and that she was upset because they kept telling her that she needed to contact me. The patient stated that she wrote the check to the office, not me because I just worked for them, so why should she have to come to me at my new location. The patient apologized to me for their involving me because she felt like they had responsibility to take care of the situation. I told the patient that she could come to me anytime and I would look at it and do any treatment necessary. I left my cell # so that she could reach me at any time.

I haven't had the chance to speak with the endodontist yet, but the office manager continues to contact me threatening to send me a bill for the bridge to be redone. CAN I be billed when I worked only as an associate for these people? I only received 30% of what was produced from the total cost of the bridge so if I paid a bill from them, it would be like paying them for the bridge twice. I'm not really sure it's anyone's fault that the bridge has an open margin and it could've happened during the root canal. But I haven't seen the patient to examine her myself because I no longer work at that office. I have offered to see the patient at my new place of work, but she feels it is the old office's responsibility to rectify the situation since she paid THEM for the bridge, not me directly. But they continue to state that they "will not do anything for free."

Basically, what are my rights and obligations as someone who no longer works as an associate at the office in question? Am I obligated to pay their bill for a bridge that I did when I no longer work there and I've offered to take care of her at my new job (mind you, these people never paid me for my last 2 weeks of work before I left)? Can they refuse her treatment just because a doctor that performed the work on her no longer works there?

Thanks so much.
~M

 

[cnoordma]

Post the same question on dentaltown and I am sure you will get some answers. Good luck.

 

[CanuckDDS]

I left my last job as an associate dentist (NOT independent contractor) in June because the owner is buying more offices giving it a corporate feel, because of differing philosophies (mine focuses on the patient, theirs is leaning more about financial gain), and to have a new job closer to home. I received 30% of whatever I produced when I worked for them.

I have since gotten a new job, but recently I was contact by the office manager of my old job. She stated that a previous patient was "very upset with my work on her bridge because it was done wrong". The office manager stated that the patient did not want to travel to my new job to get it looked at, so I would have to pay for the bridge to be redone. The bridge was done in 2009 and the patient recently had a root canal done of one of the abutment teeth. At her 1 month rct post-op, the endodontist wrote a note to evaluate an open margin.

I immediately asked the office manager for the patient's phone number so I could speak with her directly because I was concerned for her. When I spoke with the patient, I found out that the office manager had been dishonest about what happened in her conversation with the patient. The office manager even stated that the patient "cursed her out." The patient said that never happened and was shocked that the office manager said that. I know this patient very personally and I know she would never have done that.

The patient told me she was upset with the office, NOT me, because they refused to do anything about her bridge. The patient stated that she has always been very happy with my work and that the endodontist told her that it appeared as if some cement broke the seal which caused the open contact and that's why the bridge would need to be redone. The patient stated that they were very rude to her and that she was upset because they kept telling her that she needed to contact me. The patient stated that she wrote the check to the office, not me because I just worked for them, so why should she have to come to me at my new location. The patient apologized to me for their involving me because she felt like they had responsibility to take care of the situation. I told the patient that she could come to me anytime and I would look at it and do any treatment necessary. I left my cell # so that she could reach me at any time.

I haven't had the chance to speak with the endodontist yet, but the office manager continues to contact me threatening to send me a bill for the bridge to be redone. CAN I be billed when I worked only as an associate for these people? I only received 30% of what was produced from the total cost of the bridge so if I paid a bill from them, it would be like paying them for the bridge twice. I'm not really sure it's anyone's fault that the bridge has an open margin and it could've happened during the root canal. But I haven't seen the patient to examine her myself because I no longer work at that office. I have offered to see the patient at my new place of work, but she feels it is the old office's responsibility to rectify the situation since she paid THEM for the bridge, not me directly. But they continue to state that they "will not do anything for free."

Basically, what are my rights and obligations as someone who no longer works as an associate at the office in question? Am I obligated to pay their bill for a bridge that I did when I no longer work there and I've offered to take care of her at my new job (mind you, these people never paid me for my last 2 weeks of work before I left)? Can they refuse her treatment just because a doctor that performed the work on her no longer works there?

Thanks so much.
~M

I think you handled that dirty situation well. It does not seem like your old place of work is doing the same.

If it were me, I would write a letter to the regional board about their behaviour.
If that manager called me up again, I would tell her to f-off and I would call the owner directly.

Listen, don't be held hostage by some crooked DDS that is ONLY concerned about the bottom line. We as a profession (hopefully) are better than this.....

 

[jh1581]

Thanks so much. Additional replies would be great.

Who in the regional board should I direct the letter to? Or should I call and ask?

Thanks again,
~M

 

[Mackchops]

I'm really interested to hear how this plays out...

Why didn't they pay for your last two weeks of work? Sounds like that's something you could hold in front of them to make them stop bugging you?

I feel sorry for the patient the most though...

 

[yunowu]

The same happened to me when I was an associate about 14 years ago..Get a lawyer and contact the board. Good luck..It is all about the money, isn't it ??

 

[jh1581]

So I contacted the board this morning anonymously and told them the complete situation. They said that "it's not really something that falls in their jurisdiction, but if a complaint was filed, at the end of the day, it's my responsibility whether it means pay them or whatever." I also called the patient this morning to follow-up with her. She said the old office told her they "would take care of it." They are NOT telling her that the contingency behind that is if I pay the bill to have it replaced. I just don't feel like I should pay them in full for something they've already been paid for. I don't mind paying a lab bill, but to pay them for the entire thing when I'm fully capable of replacing it myself (and WANT to take care of the patient myself).

I have no idea why they didn't pay me when I left. They did the same thing to another associate who left 6 months before I did.

I'm so stressed out about this and hate that this situation revolves around money. This is the very reason I left that job is because of their "we'll do nothing for free" mentality instead of focusing on taking care of the patient. What type of lawyer should I contact?

Should I respond to any additional emails I receive from the old manager? Anymore more thoughts on what to do?

 

[omaralt]

first off, just relax.. dont contact any state boards, dont contact any lawyers. whatever work you did, is your responsibility. having said that, if the bridge had to be drilled through to do a root canal, could have caused fracture of porcelain, possibly causing an open margin. at the end of the day, it's going to be easiest, cheapest for you to just pay to replace the bridge. i'm assuming that they're not asking for the $3K to replace the bridge, just the lab fee? if they're asking for the $3k (or whatever the normal price for a bridge is at that office) i'd tell them to go to hell. if it'll just cost you a few hundred dollars, just pay it and count this as a cheap life lesson; the quicker you open up on your own, the happier you'll be. good luck

 

[gryffindor]

first off, just relax.. dont contact any state boards, dont contact any lawyers. whatever work you did, is your responsibility. having said that, if the bridge had to be drilled through to do a root canal, could have caused fracture of porcelain, possibly causing an open margin. at the end of the day, it's going to be easiest, cheapest for you to just pay to replace the bridge. i'm assuming that they're not asking for the $3K to replace the bridge, just the lab fee? if they're asking for the $3k (or whatever the normal price for a bridge is at that office) i'd tell them to go to hell. if it'll just cost you a few hundred dollars, just pay it and count this as a cheap life lesson; the quicker you open up on your own, the happier you'll be. good luck

+1

But before you pay them any lab fees, have you reminded them about where your last paycheck is? Maybe you can offer a truce - give me my last paycheck and I will write you a check the same day for the lab cost of the bridge. Don't give them the opportunity to deduct the cost of the bridge from the last paycheck because magically the cost of the bridge will be equal to the paycheck.

If they don't want to reason, then realize there are many sucky associateships out there and they are not worth contacting the dental board. Contacting dental boards generates paperwork now and in the future, try to avoid it. I would avoid any phone calls and ignore their emails and all attempts from them to contact you. You have nothing to gain from this office, try to make yourself invisible from them.

 

[CanuckDDS]

While I like everyone's responses. I don't necessarily agreed with them. This dirt bag is just going to do the same thing to his next associate and keep ripping off his patients. My wife was in a situation like this. The guy knew he was crooked and caved once the threat of anybody looking at his unethical practice tactics was mentioned. The fact is, if he is willing to rip off a colleague he is NOT servicing patients ethically.

I'm glad I don't have to deal with this $hit anymore as it makes me embarrassed to be a DDS...😡

 

[jh1581]

Thanks everyone for the responses. I actually received more responses here than on DentalTown. I've spoken to the patient today and she stated that she will come to me at my new job to let me take care of it for her. Plus it will give me the chance to see what happened to cause it to fail (whether it was accessing the canals during the root canal, faulty cement, etc). If it was caused by something I did or didn't do it will give me the chance to evaluate my own work to see if there is anything I can do to prevent it from happening ever again in the future. Now I just have to figure out when to bring her in and get permission from my new employer to do so.

I have and will continue to ignore the office manager at my old job. Her persistence and constant threats to charge me for the cost of the bridge amaze me. I feel sorry for their new associate and can only hope they don't treat him the way myself and the associate before me was treated, but I get the feeling that some things will never change in that respect. I know that ultimately, they will screw him over as well. It's really unfortunate and it just shows me the kind owner I never want to become.

 

[CanuckDDS]

Thanks everyone for the responses. I actually received more responses here than on DentalTown. I've spoken to the patient today and she stated that she will come to me at my new job to let me take care of it for her. Plus it will give me the chance to see what happened to cause it to fail (whether it was accessing the canals during the root canal, faulty cement, etc). If it was caused by something I did or didn't do it will give me the chance to evaluate my own work to see if there is anything I can do to prevent it from happening ever again in the future. Now I just have to figure out when to bring her in and get permission from my new employer to do so.

I have and will continue to ignore the office manager at my old job. Her persistence and constant threats to charge me for the cost of the bridge amaze me. I feel sorry for their new associate and can only hope they don't treat him the way myself and the associate before me was treated, but I get the feeling that some things will never change in that respect. I know that ultimately, they will screw him over as well. It's really unfortunate and it just shows me the kind owner I never want to become.

jh,

you are a good dentist. The fact that you are taking such good care of your patient is admirable. Keep up the good work. 👍

 

[mike3kgt]

jh,

you are a good dentist. The fact that you are taking such good care of your patient is admirable. Keep up the good work. 👍

👍

The fact that you are concerned is admirable. Certainly you could argue that your major motivator is because of potential complaints and/or board involvement but stuff like this happens to ALL OF US at some time or another. It has happened to me, it has happened to my wife (a dentist) and it will happen to everybody on this board at some point in various aspects of dental practice (ortho, endo any of them).

Now for the reasons the margin "opened" is debatable but I seriously doubt that the "cement seal" didn't give or "the root canal procedure caused the problems." Most likely the films you took to confirm a full seat were at an off-angle and you couldn't see the restoration fully seated. Maybe the endodontist took a PA film and the film is skewed to show an arbitrary open margin. You just don't know until you see the patient yourself. Reasons for this is why I take a BWX and a PA at the seat appointment of any fixed restoration.

Now if you have a great set of BWX or PAs that show a full seated restoration and now you have one that isn't and it's been a period of time since the cementation, then you might have a leg to stand on in regards to your obligation to the patient.

Translation, if you have a good film that shows a good seating restoration, your culpability is diminished (not gone, but diminished). Now if you don't have seat films (which a lot of docs don't do) you really don't have a choice but to replace it at your cost.

I'd say if your former employer is aggressively targeting you about one patient, more might come. I'd contact an attorney regarding the matter because more cases might come, even for simple stuff like "my white filling that I had done 3 months ago chipped when I bit on ice" and that could get expensive.

Good luck!!

 

[jh1581]

👍

The fact that you are concerned is admirable. Certainly you could argue that your major motivator is because of potential complaints and/or board involvement but stuff like this happens to ALL OF US at some time or another. It has happened to me, it has happened to my wife (a dentist) and it will happen to everybody on this board at some point in various aspects of dental practice (ortho, endo any of them).

Now for the reasons the margin "opened" is debatable but I seriously doubt that the "cement seal" didn't give or "the root canal procedure caused the problems." Most likely the films you took to confirm a full seat were at an off-angle and you couldn't see the restoration fully seated. Maybe the endodontist took a PA film and the film is skewed to show an arbitrary open margin. You just don't know until you see the patient yourself. Reasons for this is why I take a BWX and a PA at the seat appointment of any fixed restoration.

Now if you have a great set of BWX or PAs that show a full seated restoration and now you have one that isn't and it's been a period of time since the cementation, then you might have a leg to stand on in regards to your obligation to the patient.

Translation, if you have a good film that shows a good seating restoration, your culpability is diminished (not gone, but diminished). Now if you don't have seat films (which a lot of docs don't do) you really don't have a choice but to replace it at your cost.

I'd say if your former employer is aggressively targeting you about one patient, more might come. I'd contact an attorney regarding the matter because more cases might come, even for simple stuff like "my white filling that I had done 3 months ago chipped when I bit on ice" and that could get expensive.

Good luck!!

I'm certain there was no open margin at delivery as I checked with the explorer before and after seating and took a BWX and PA (I ALWAYS do this when I deliver crowns and bridges). None of them indicated an open margin. Especially not one as large as seen on the root canal follow-up BW. This is a big reason why I am eager to see the patient, so that I can figure out what could have possibly gone wrong since then.

I hope I never hear from my old job again. Her contacting me again any little thing has me worried. If she does start contacting me about every little thing, I will assume it is personal because when I was their employee, I re-did work on several occasions that was done by other dentists and not once did they try to contact those individuals to "pay the bill" or "do it themselves."

My current boss said bringing her in to see me is not a problem at all. Thanks for the responses everyone!

 

[OldestAppl]

JH1581,

I think you've had some reasonable advice, but in 18 years in practice, I've learned something about cases like this when I was an associate. Rely on those whom you ahve entrusted your future.

If I was in your shoes, I would have made a call to my malpractice carrier and asked them what you should do. Your rates won't go up, and they have an entire team of legal minds solely related to cases like this. They will tell you exactly what you should and shouldn't do. They want you to call them, and you're already paying them, so there are no additional fees. Furthermore, if a case became litigious, they would have been involved from the beginning. Even now, it's not too late to call them. You may be surprised by what you learn.

For instance, if you remake the bridge and it then needs endo and the patient blames you for re-prepping the bridge, is your previous boss "off the hook"? Did you have any responsibility to replace the bridge? Should your previous boss pay you back for any remedial work because he has already been paid for this?

Just my 2 cents...