Training medical/dental staff how to extract more $$$

[4everHis]

Yesterday I heard from 2 friends, hundreds of miles apart, who in no way know each other. One is in the accounting side of medical type supply company, the other a dental hygienist.  Accountant had to attend class that taught dentists and doctors what steps to take to get patients to spend more money. Friend is outraged. Dental hygienist has worked over 25 years with dentist that is now retiring. New dentist is training them in 'new procedures' that are EXTREMELY more expensive and unnecessary. Ex. "Your blood pressure is elevated so we will have to do a special/new type of cleaning for you." Cost? $900. "You have signs of bacteria on your gums that will require "X" procedure/protocol."  Again, extra cost. The hygienist said the elevated blood pressure has never been an issue in cleaning teeth and EVERY one has always had this bacteria, it's just a new way to get more money. She is actually quitting her job over this.  

Is this just a fluke? Is this the norm? 

[Arcadia]

We have dentists trying to convince us that we need deep cleaning every two years or our teeth will rot. Braces is another thing that was being pushed at every visit since my DS13 was 7 and he doesn’t need it other than for a very mild cosmetic benefit. We switched to a nearer dentist for convenience and that dentist did not push for braces.

[Jean in Newcastle]

Between the four of us we see 3 different dentists and we have not seen this. Maybe it depends on the dentist?

[Mom0012]

My dh had this deep cleaning done and the dentist also recommends he come in 3 times a year for regular cleanings instead of two.  I would be suspicious but none of this is ever recommended for me or my children by the same dentist and they are actually very conservative with costs and extremely honest. I actually question their skills as dentists sometimes, lol, but have continued with them because I know I can trust them to tell me the truth.

On the other hand, I know there are many providers who are only in the field to maximize their profits at the expense of their patients.  I have experienced being lied to by a dentist about a cavities that did not exist.

ETA: Just remembered being shamed and threatened by the pediatric dentist we used to use for not wanting to put $600 of out-of-pocket expense sealants on my ds, a child who had never had a cavity.  Or for not wanting to fill a small cavity on a baby tooth that was about to fall out for my dd. And the orthodontist that put my dd (who had a beautiful jawline and a minor overbite and probably didn’t even need braces at all) in headgear for two years out of greed.

Edited March 12, 2019 by Mom0012

[4everHis]

7 minutes ago, Arcadia said:

We have dentists trying to convince us that we need deep cleaning every two years or our teeth will rot. Braces is another thing that was being pushed at every visit since my DS13 was 7 and he doesn’t need it other than for a very mild cosmetic benefit. We switched to a nearer dentist for convenience and that dentist did not push for braces.

 First 4 kids were told, about 5 years old each,  they would need braces.  New dentists asked when our kids had their braces removed. Uh, never, their teeth were always fine.🤨

[4everHis]

Just now, Mom0012 said:

My dh had this deep cleaning done and the dentist also recommends he come in 3 times a year for regular cleanings instead of two.  I would be suspicious but none of this is ever recommended for me or my children by the same dentist and they are actually very conservative with costs and extremely honest. I actually question their skills as dentists sometimes, lol, but have continued with them because I know I can trust them to tell me the truth.

On the other hand, I know there are many providers who are only in the field to maximize their profits at the expense of their patients.  I have experienced being lied to by a dentist about a cavities that did not exist.

We have also had this experience. Thankfully I took child for a 2nd opinion before anything was done.😡

[J-rap]

Our family dentist has always been very conversation (generally begins with the most conservative/least expensive approach), but that's one of the reasons we've stayed with him I guess.  When the kids were young, we did have to push against things here and there like routine x-rays, but that's all.  (And I know routine x-rays aren't always bad... but with 5 kids were just couldn't afford them as often as recommended.)

[DesertBlossom]

My nephew was told he needed a couple thousand dollars worth of cavities filled. He got a 2nd opinion and was told he didn't have any cavities.

I was taking my kids to a pediatric dentist and twice there were procedures on the bill my kids hadn't received. The office staff couldn't explain why they were on the bill. We switched.

[gardenmom5]

some have always looked to maximize their bottom line.  usually it's because they went into dentistry (or medicine, or law, or just about anything else.) with $$ in their eyes before anything else.

not all do that type of stuff - and I'd find a new one.

[Ottakee]

I have had that with a vets office.  I was shamed because I would not take my elderly dog (gotten as a rescue the week before) to see a dog specialist even though he would still be blind.

Same vet, a friend was made the feel bad b cause she would not pay $500 for doggy ICU Because the dog might be at risk of a seizure.  She took dog home and he was just fine.

[Jean in Newcastle]

15 minutes ago, gardenmom5 said:

some have always looked to maximize their bottom line.  usually it's because they went into dentistry (or medicine, or law, or just about anything else.) with $$ in their eyes before anything else.

not all do that type of stuff - and I'd find a new one.

Yes.  Greedy people are present in all professions and have always been there.  But there are plenty of great dentists, doctors, vets, etc. out there too.  Blasting everyone in a profession due to generalizations made from a few bad apples can lead to some people not getting needed dental and medical care for themselves and their pets.  I say that because I have known people in my life who have given me the "All doctors/ dentists are quacks out to gouge me" line as they have refused to take care of basic needs.  Yes, they ran into a bad practice at some point but I believe that their over generalized reaction caused them to have unnecessary pain as they didn't take care of their health.  (I don't know the OP's friend, but I bet that she could find a job with another dentist who does not employ those tactics if she wished to.) 

[4everHis]

9 minutes ago, Jean in Newcastle said:

Yes.  Greedy people are present in all professions and have always been there.  But there are plenty of great dentists, doctors, vets, etc. out there too.  Blasting everyone in a profession due to generalizations made from a few bad apples can lead to some people not getting needed dental and medical care for themselves and their pets.  I say that because I have known people in my life who have given me the "All doctors/ dentists are quacks out to gouge me" line as they have refused to take care of basic needs.  Yes, they ran into a bad practice at some point but I believe that their over generalized reaction caused them to have unnecessary pain as they didn't take care of their health.  (I don't know the OP's friend, but I bet that she could find a job with another dentist who does not employ those tactics if she wished to.) 

That is why I posted the question. I do not like generalizations and broad brush strokes over any 'group' so I came here where there is a wider scope for the question. My personal dentist now is great and conservative in his treatments.  To the bolded, I must have missed where someone was blasting everyone in a profession.

[Jean in Newcastle]

Just now, BlueGables said:

That is why I posted the question. I do not like generalizations and broad brush strokes over any 'group' so I came here where there is a wider scope for the question. My personal dentist now is great and conservative in his treatments.  To the bolded, I must have missed where someone was blasting everyone in a profession.

Keep reading.  The very next sentence I say "i say that because I have KNOWN PEOPLE IN MY LIFE who have. . . " 

[4everHis]

7 minutes ago, Jean in Newcastle said:

Keep reading.  The very next sentence I say "i say that because I have KNOWN PEOPLE IN MY LIFE who have. . . " 

Missed that and agree with you. I've seen those, too. 

 

[Hyacinth]

I, too, have had the "you better fill these cavities right away" lecture followed by a second opinion that revealed no cavities. It's infuriating.

It's possible that the newfangled deep cleaning process really IS a bit better. Who knows? But does that mean it's necessary? Or worth the extravagant cost to the average person who seems to have been doing fine with the regular cleaning?

Fear- and shame-based sales tactics are the absolute worst. And, sadly, they're used in nearly every industry.

[historically accurate]

I think my dentist is moving this way. We've been going to him for 15 years. In the past 2 years, I've noticed an uptick on recommendations for pricey things and at least one of us gets the "tiny cavity that needs to be taken care of now" every time we go in. 

For example, my oldest got her braces off and the first time she went to the dentist she was in the next hygienist's room while I was getting my teeth cleaned. The lady came over to me and told me that DD wanted the $600 cleaning (only $400 if we did it that day) to color her teeth correctly.  Apparently, it's really common to bleach the teeth when the braces come off? My oldest is not a person who asks for anything like that, so I hesitated. (Edit: She doesn't ask for much of anything, so when she does ask for something like this, we take it seriously and see if we can swing it.) I finally told the hygienist that I would discuss with DD and we just couldn't do it today. The lady kept telling me it would be a deal today, but I don't have $400 to spare, so I had to decline. When we got home, I talked to DD. She says she declined the treatment 3 times and finally muttered, "Fine, I'll talk to my mom about it. Give me the info." I was told by the same lady that DD really wanted it. I called and complained. 

If I had the mental energy, I would be looking for a new dentist. I don't, so I consider it practice on saying no firmly and repeatedly for me every 6 months.

Edited March 12, 2019 by beckyjo

[lynn]

I don't trust new dentist in pretty new buildings with all sorts of new dental technology.   I have been to the dentist every 6 months since I was 4 never once did I have a cavity in over 40 years.  We went to a new dentist they found 8 cavities.  I said "no you didn't"  the dental hygienist said "I've been doing this for over 15 years blah blah blah"...  Went back to old dentist again, he did not find a single cavity.   So no I don't trust dentists.   I tried to tell my niece to be careful and get second opinions when she brought her daughter to a medicaid dentist and sure enough 3 year old dd "had a cavity", let's fill it, next "lets cap it" then guess what "we have to pull it"  and get sealants and they still "find" problems with grand nieces teeth.   My niece just goes along with it.  Maybe there's a chance she has really, really bad enamel on her teeth.  My niece is a very good mother and always made sure her daughter brushed her teeth.   My dentist of over 20 years it getting ready to retire he sold his practice but is there a couple mornings a week for his patients but I know eventually we'll have to either stop going and hope nothing major goes wrong on trust the new dentist or find another older dentist in the area

[TravelingChris]

1 minute ago, lynn said:

I don't trust new dentist in pretty new buildings with all sorts of new dental technology.   I have been to the dentist every 6 months since I was 4 never once did I have a cavity in over 40 years.  We went to a new dentist they found 8 cavities.  I said "no you didn't"  the dental hygienist said "I've been doing this for over 15 years blah blah blah"...  Went back to old dentist again, he did not find a single cavity.   So no I don't trust dentists.   I tried to tell my niece to be careful and get second opinions when she brought her daughter to a medicaid dentist and sure enough 3 year old dd "had a cavity", let's fill it, next "lets cap it" then guess what "we have to pull it"  and get sealants and they still "find" problems with grand nieces teeth.   My niece just goes along with it.  Maybe there's a chance she has really, really bad enamel on her teeth.  My niece is a very good mother and always made sure her daughter brushed her teeth.   My dentist of over 20 years it getting ready to retire he sold his practice but is there a couple mornings a week for his patients but I know eventually we'll have to either stop going and hope nothing major goes wrong on trust the new dentist or find another older dentist in the area

1

 

[TravelingChris]

1 minute ago, lynn said:

I don't trust new dentist in pretty new buildings with all sorts of new dental technology

Over here, we went from a dental practice in a very old building that was trying to overdo cavities (plus my hygienist was not intelligent in a very annoying way, awful music was played in waiting room where you waited long, and fluorescent lights which made me loopy for the rest of the day.  

New dentist got the dental records of our family- didn't see the cavities they were going to fill, is very conservative in his treatment, has a lovely new building with almost never a wait, LED lights,  no annoying music, and hygienists are rock stupid too.  

[TravelingChris]

Oh and that great dentist is not on any dental plans but it still is costing us less than the prior dental practice.

[lynn]

6 minutes ago, TravelingChris said:

Oh and that great dentist is not on any dental plans but it still is costing us less than the prior dental practice.

Can you PM me the address and phone number.  Our dentist now is in Madison and we don't know when he's officially retiring.   

[itsheresomewhere]

Had this happen to us a few times.  Last time, DH was told he had eight cavities and needed root canals.  I insisted on a second opinion.  He had three and no root canals needed.

This is just an observation but I have noticed that if the office offers a lot of cosmetic dentistry, they tend to “find” more things wrong.  

[gardenmom5]

1 hour ago, Jean in Newcastle said:

Yes.  Greedy people are present in all professions and have always been there.  But there are plenty of great dentists, doctors, vets, etc. out there too.  Blasting everyone in a profession due to generalizations made from a few bad apples can lead to some people not getting needed dental and medical care for themselves and their pets.  I say that because I have known people in my life who have given me the "All doctors/ dentists are quacks out to gouge me" line as they have refused to take care of basic needs.  Yes, they ran into a bad practice at some point but I believe that their over generalized reaction caused them to have unnecessary pain as they didn't take care of their health.  (I don't know the OP's friend, but I bet that she could find a job with another dentist who does not employ those tactics if she wished to.) 

this applies to lawyers too.  I've known some (socially) who are very good people.

and I've known one (business colleague of dh's) that is a prime example of the reason lawyers have the reputation they do...  (I didn't even know it was him - and felt like someone dumped a bucket of slime on me as soon as he opened his mouth in a meeting.)

[Jean in Newcastle]

I find it very helpful to look up reviews for medical and dental professionals.  Healthgrades is just one site that reviews both doctors and dentists. I also ask friends and on sites like Nextdoor.   

[PeachyDoodle]

We ran into this with two different pediatric dentists. The cavities were always "OMG ALL HIS TEETH ARE GOING TO FALL OUT IF WE DON'T DO SOMETHING RIGHT NOW!!!" I was like, "They're baby teeth. They're supposed to fall out." But of course they make you feel like a terrible parent if you don't dance to their tune.

Finally I got sick of financing all their toys and fancy flat-screen TV's over every chair and took the kids back to our family dentist. Where, of course, they are just fine without the bells and whistles (ds loves picking out a sticker from the prize box more than he ever liked watching a movie during his cleaning). And neither has had a cavity since we left 5 years ago. Go figure. 

We recently switched to a practice nearer our home, where a family member is a hygienist, and we love this new dentist. He's fantastic with the kids, very thorough, and always upfront about any potential issues he sees. He gives a sound professional opinion as to whether to take action or just wait and see, and is cognizant of cost and insurance. For example, he recommended sealants for dd13 at her last cleaning but said, "Let's just see if insurance will cover it. If so, it would be good to do, but if not, it's not the end of the world." It did, so dd goes back for them in a few weeks.

My GP did tell me at my last check-up that several of her patients have told her their dentists are checking blood pressures now. I wonder if that has anything to do with the issues in the OP?

[4everHis]

1 hour ago, lynn said:

I don't trust new dentist in pretty new buildings with all sorts of new dental technology.   I have been to the dentist every 6 months since I was 4 never once did I have a cavity in over 40 years.  We went to a new dentist they found 8 cavities.  I said "no you didn't"  the dental hygienist said "I've been doing this for over 15 years blah blah blah"...  Went back to old dentist again, he did not find a single cavity.   So no I don't trust dentists.   I tried to tell my niece to be careful and get second opinions when she brought her daughter to a medicaid dentist and sure enough 3 year old dd "had a cavity", let's fill it, next "lets cap it" then guess what "we have to pull it"  and get sealants and they still "find" problems with grand nieces teeth.   My niece just goes along with it.  Maybe there's a chance she has really, really bad enamel on her teeth.  My niece is a very good mother and always made sure her daughter brushed her teeth.   My dentist of over 20 years it getting ready to retire he sold his practice but is there a couple mornings a week for his patients but I know eventually we'll have to either stop going and hope nothing major goes wrong on trust the new dentist or find another older dentist in the area

Too bad deciding who to trust can't be as easy as that. Nice new building=untrustworthy. Both dentist we trust have nice buildings so that can't be it. 

[Bluegoat]

So, I do thik this sort of thing is on the increase with dentists and vets.  And maybe medical clinics in the US. Funeral parlours do it too, and some car dealerships.

It seems to be part of the move to these sort of franchise clinics and businesses.  The business model works where clinics give over certain things to a larger company, but then they are largely locked into certain business practices that the company requires.  Most of them are directed to maximising profits.  So, they are always supposed to offer certain things, require certain tests, and so on.  

It's impacted places that are still independent too, and I think even practitioners who are basically good professionals end up bowing to this business model to some extent.  And newer people seem to just accept it as normal.

[KidsHappen]

3 hours ago, HeighHo said:

I've encountered two that are extracting cash.  They'll want you to come in for an OV to discuss your bloodwork, when its something simple like sugar in range, but close to limit and don't want to show you the data for anything..  One wanted me to use a totally different pharmacy, not the one I have my plan with.  Dental I'm seeing substandard cleaning, and I've switched over that as well as the practice of switching to balance billing without informing the patient.

What is balance billing?