I have had an interesting week when it comes to dentistry and it overwhelmed whatever else I was going to write about for this week’s update. Anyone who follows along at my Facebook or Twitter pages will already know that I had some emergency oral surgery. Everything seems to have worked out for the best as it is Sunday and I am writing my Monday update, but it was a little rough from Tuesday on through Saturday.
Monday and Tuesday I had some pretty intense pain in the left side of my mouth. I have been putting off a couple of root canals so I assumed that my time had come. I went to my dentist after work on Tuesday finally conceding to the pain. My dentist took one look at me and said “well, those bad boys need to come out” and sent me right back to the waiting room. I was more than a little concerned at this point. I was brought back in to Vince’s office and was given the news. Four teeth needed to be pulled. Tomorrow morning. Call out of work, do not make plans, bring your checkbook. I was told I needed a ride to the office and a ride home as I was being knocked out for the operation. I was also told that it would take all of my insurance plus an extra $500, payable in the morning. After I went as white as a sheet Vince told me not to worry, maybe I could do half down and we worked out an easy monthly payment schedule. Vince was also kind enough to let me know other problems he saw in my x-rays and told me not to worry, we could work something out there as well. He gave me my finance sheet and I asked a few questions such as when to show up and what would happen as we missed those points. I also asked if there was anything else I needed to know and he said nope, good luck.
I went home and scrambled to find some money and to break it to my wife. Thankfully she had time to drop me off in the morning and her mom could pick me up. My work was extremely understanding. I really couldn’t ask to work for a better company. I spent the night slathering on toothache cream from CVS and tossing and turning. I finally gave up and got out of bed at 2:00 deciding to let my wife sleep. I went downstairs and watched some late night TV and drank some coffee. I really couldn’t stomach food but the coffee helped calm my nerves. Around 6:00 I got ready to go and started pacing back and forth until it was time to leave. Things then took a turn for the worse.
Vince is a finance guy. He is great at what he does which is get patients to pay their bills and sent up payment plans. He isn’t so good at giving instructions. He failed to mention that someone had to stay the whole time I was at the dentists’ office. I was being sedated and they needed someone there with me. It made sense in retrospect, but not telling me the night before was an oversight. I was emotional and nervous and I wasn’t thinking things through. Thankfully my wife could juggle her schedule and make things work. She was in a very busy time at work, but her coworkers were amazing and understanding. Vince also failed to mention that I wasn’t supposed to have anything to eat or drink after midnight. This wasn’t that big of a deal in some ways, I was far too nervous to eat anyway, but that calming coffee was going to have a very adverse effect after all. I was asked repeatedly why I drank and didn’t I read the directions. No one believed me at first that I was never given directions, just a bill. I finally showed them the packet I received from Vince. Then the office staff started to rail against Vince. At first I felt bad until someone finally told me why it was so important not to eat or drink. I would not be able to be sedated. I would be awake the whole time.
At this point the oral surgeon started to examine me. He immediately had questions about the prognosis from the other doctor, asking me who saw me and why the decided what they did. I remembered my dentist’s name (it’s a huge practice where you see different doctors every time) but I really didn’t know why he decided anything, I assumed it was just what needed to be done. Nextt came extra x-rays and more consultation between doctors and a new plan was decided. Only one, maybe two teeth would come out. That made me feel better as it was less for me to deal with, but also a little nervous as all I really wanted was to fix the pain.
We finally got underway and I had my first dose of nitrous oxide. Wow, what a weird sensation. I still felt everything and was awake, but it was like I was drunk the whole time. It still hurt like hell. A quick trip to the pharmacy and a day and a half of recovery and I made it back to work on Friday looking like I got punched in the side of the face but able to function. All in all, a great result as long as nothing else goes wrong. It’s Sunday night and I am feeling better and almost eating solid food.
I try not to get political, but I think that my trip through my dentist’s office might shed some light on what’s really wrong with healthcare these days. Don’t get me wrong, I am extremely lucky that this was dental work and not life threatening and I am even luckier that I have insurance. At the same time, it was interesting to me that the finance person was the one most involved in deciding my level of care. He expertly used all of my available insurance plus some money out of pocket. I say this because I found out later that it was my option to be sedated. I could have chosen nitrous oxide and local anesthesia from the beginning for a substantial discount. He never asked me. I ended up not paying anything out of pocket because of that change and the amount of teeth being removed but I would have still managed to not pay if they took four teeth instead of two without the sedation included. Vince decided the level of care and never told me there was a cheaper way; just that he could set me up on monthly payments. Even when the office staff and surgeon were angry with him my first thought was that I hoped he didn’t get into trouble over me because I needed to be on a payment plan.
Should a finance person be the last arbiter of the level of care you receive when you go to a doctor or dentist? I would hope not, but this isn’t the first time it has happened to me or my family. It seems that your credit score determines your level of care as much as your insurance or actually health needs. That seems counterproductive to anyone but the finance person that is trying to drive business. Incomplete care will cause you to return for more work which will cause more monthly payments which will drive up the margin of profit per patient.
If we are reforming healthcare, perhaps we should talk about this idea. I would think that one of the ways to drive down cost is to solve as many problems as possible in a few visits as possible, even if the initial visit costs more. I know that there are many sides to this issue, and I am not a political blogger. I try very hard to stay out of that arena and I don’t pretend to have enough knowledge to speak to most topics, this is just one thought. What would you fix with the healthcare system if you were king for a day?
Big Joe's Soap Box 
I.m just glad all worked out for you
My husband and I used to receive our dental care from a place similar to what you describe here. Ours was definitely a big box operation, tended by people who at best, gave very impersonal service. We eventually left after a female dental attendant made this comment to me on June 30, two years ago: “Look at you, in your short shorts!” (The shorts were normal length for a respectable female to wear.) I swear she had a sneer on her face. I think of myself as a fairly classy woman; I don’t wear anything tight, too short, too revealing, etc. I dress with taste, purpose, and on good mommy days, a splash of color and fashion. I had no idea what brought this comment on, or why she thought she had a right to say it to me. Granted, she had conducted several of my previous visits, but what correlation my attire had to what she needed to do for me, I’ll never understand. She was older, so maybe it was partially spoken out of jealousy. Whatever the case, I was so taken back by her words, all I managed to say back was, “It’s almost July…,'” my tone asking her what her point was. I never went back. In fact, they never bothered that day as I was leaving to schedule my next visit. My underlying point (I think I have one..) is that I am glad that it all worked out for you, but it doesn’t at all sound like you got the type of service that was required or that you deserve.
I would have the doctors or dentists make the decisions regarding the level of medical care.
What a roller coaster ride. That’s the way I view most healthcare today, and that’s why I avoid it at all costs. I haven’t been to a doctor or dentist in years. That aversion is mostly from my bad experiences while in the Navy. Long story.
I went to the dentist about 2 or 3 years ago, just to use my insurance for the free annual cleaning/checkup. Insurance has gotten so expensive that they dropped from two free visits to one per year. The dentist office dug their claws in after that visit and continue contacting me in an attempt to have me come back for more frequent checkups. Now I see why their offices are so beautiful. No thanks. I take care of my teeth with myself and my trusty research team (ie. Google).
My company is small and can’t afford to offer multiple healthcare plans. They offer a one size fits all plan and they are forced to negotiate annually to keep cost increases down while giving up benefits. My wife and I budget our healthcare, and that’s tough to do with four kids. They have to reach a certain level of “sick” before we pull the trigger and go to a doctor. That forces us to self-diagnose and medicate at home. I’m okay with that as I feel that many people overuse healthcare anyway. If you have a cold, you have a cold. There is no magic pill to make that go away, so stay home, drink water, take over the counter meds, and move on. If we reduce the strain on the overall system (not likely, but needed), we could see costs stabilize. I don’t see that ever happening, but I’m concerned with my wallet size and not the country’s wallet size.
I have to say I hate the way that healthcare is becoming a luxury. I think there has to be a social justice issue in this more than anything else. There are so many issues but I OK now that I don’t know enough about the issues to speak about them more than to say that no parent should have to put off taking their kids to the doctor yet most of us have to do exactly that.