Specialists referral culture, Please HELP !!

[tRNA]

I am not familiar with the "referral culture" between general dentists and dental specialists in the US...recently, I ran into this situation and it is really embarrassing, I do not know what is the best course of action in such situation. Hopefully, dear colleagues, you can rescue me. I am a general dentist who works for a cooperate company in which all dental specialists are readily available and obviously, if specialty is needed, in-house referrals are the first choice. External referrals are very rarely used.

As a dentist working for that company, the personal dental insurance I get only covers the dental services I get at that company, so if I go external it is an out of pocket charge. Recently, I needed to be evaluated by a periodontist because I had recession and I knew I was going to need osseous surgery so I wanted to go to someone who I knew would take care of me regardless of the cost. I asked one of the doctors I regularly take CE courses with and he recommended a specific periodontist in the area. I went to that periodontist and I felt very comfortable with her. She concluded that I need osseous surgery in the entire mandible and bilateral posterior maxillary teeth, and some areas may need bone graft.
The whole procedure costs about $10,000 I knew I was going to pay the whole amount and I was prepared for it. However, I was undergoing another surgical procedure at the time, also costing another $15,000 and also fully out of pocket. So, I spoke to the periodontist's financial office and asked them if it is possible to do half mouth now and the other half after 1-2 months, so I can have the funds to pay for both halves.
After asking the doctor, they told me that the doctor does not want me to break up the surgery in half and she is offering the whole surgery at one time for half price !!! they also said that the Dr. did this very special offer for me because she wants to take care of my patients in the future. I was shocked by this offer and I still do not know if I should accept it or reject it ???.

So far, I think she is a very good specialist to refer to but the company I work for now does not allow external referrals, at the same time I know I will not continue working for that company forever and some day I will have the freedom to refer to whomever I want to. I thought about accepting the offer for now just to get the surgery over with, then I would pay her the rest ASAP. What do you guys think? What is the ethical behaviour in this situation? Is there a rigid strict expectation tied to this deal or is it more of a loose expectation?? I didn't even call her yet to thank her for the generosity because I still don't know if I should accept or reject the offer.
Your help will be greatly appreciated

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[oralcare123]

You are overthinking. Just get surgery half price and say thank you. She is just building relationship

 

[yappy]

Two things are concerning to me in your post:
1.) Your insurance only covers your treatment if it's completed by the company you work for. That reminds me of the railroad work towns where you had to shop at the "company" store.
2.) You cannot refer patients to the specialists that you wish.

I agree with oralcare123.

 

[2TH MVR]

You are overthinking. Just get surgery half price and say thank you. She is just building relationship

Yep. Pretty sure she (perio) is aware of the Corp structure of internal referrals only. She is doing what ALL specialists do .... and that is to build a potential future referral relationship.

You are doing the right thing seeking tx outside your Corp office if you are not comfortable with the internal specialists. It's your money.

Interesting side note. After seeking tx OUTSIDE your Corp job .... your specialist (perio) corp colleague may look at your decision in a different view point. Right? If the specialists are older (like me) .... I could care less where you get your specialty tx. I would be happier if you did seek outside specialty care. Specialists treating dentists is always an odd dynamic. There's always that extra" pressure and/or stress" to make sure everything is perfect. Dentists by nature are very critical and may question every little detail of the specialty tx. But a younger Corp specialist may feel that you have no faith in their specialty abilities.

If you are young and are just passing through the Corp office. Who cares. Just get your tx where ever you want.