How a Trip to the Dentist Illustrates America’s Healthcare Problems

Dear Dr. XXX:

I wanted to bring to your attention my recent experience at one of your offices. As a fellow business owner, I would want to know when one of my customers had a bad experience since transparency and feedback are great remedies. In that spirit I wanted share my recent experience at your office. I am not sure whether it was your team’s fault, or whether our healthcare system just creates perverse incentives.

In five minutes in your office, in my opinion, you see an attempt at insurance overbilling, a lack of bedside manner and an attempt at unnecessary prescribing of medication.

I arrived with a minor ache in my lower right wisdom tooth.

Your team’s first protocol was to take x-rays. No one had yet looked into my mouth and no one had checked my chart to see that approximately three months prior I was in your office and had x-rays. I politely declined saying I would like to see a doctor first.

So one of your doctors came to see me. She greeted me with a very stern, “I understand you refused x-rays”. I explained that I really would prefer if someone took a look in my mouth first.

She proceeded to take a look.

In less than ten seconds came this, “well that wisdom tooth has to come out, and if you take the bottom out you might as well take the top one out, and the other side will probably cause a problem too, so we should just do them all at once.”

Four teeth should get removed because I have discomfort in one? I was stunned.

I asked her if it mattered that this was the first time I had ever had this pain. She pondered a bit and said “not really”. I asked if I had any other options.

“Sure” she said, “you can take an antibiotic and see if the infection goes down”. So now there is an infection? She had not stated this previously after her ten second assessment. So possibly without knowing if there really was an infection she prescribed antibiotics? Is she aware that our oversubscribing of antibiotics is considered by many to be one of the largest problems facing modern medicine?

“Any other options?” I asked.

“Well you could see if it goes away on its own” she replied.

I quietly got out of the chair and said I would choose that option.

I arrived back at my office a few minutes later and logged back into ZocDoc, a service that not only allows you to make appointments but also allows you to rate medical professionals.

Your team got one star. I wrote that I was concerned that your team may be more concerned with billing my insurance company than with patient care. I didn’t mention the unnecessary (in my opinion) antibiotics recommendation and I also didn’t mention your colleague’s bedside manner.

I can only hope that social recommendations and the transparency of information provided by services like ZocDoc will one day align the interest of doctors and patients. If patients know a doctor is doing everything she can to get and keep them healthy then they will let people know and more patients would come; of course the opposite is also true. I put my hope in social recommendations because the fundamental reworking of our healthcare industry seems a tad beyond us right now. Until then, know that not everyone will give up their teeth so easily.

But I do want to thank you for one thing. I now understand why so many loved my father, William Wald, DDS. Yes, it was a different time, but he cared more about his patients than he did about making money. He would never have x-rayed unless needed, he would not prescribe an antibiotic so quickly and he certainly would not have tried to take out any teeth unless absolutely necessary.

By the way I saw another dentist and he said it was just some minor irritation. The pain subsided in two days and I am fine.

Regards,
Jeff Wald