And What About Dentists?

by Ben Goldfarb on April 20, 2006

in General, Health

Aside from their willingness to explore dark, moist, cavernous spaces, a propensity proposed by The Redhead as common to dentists and gynecologists, dentists are worth including in the health care morass we’ve expounded upon here. So, I’ll now give you a dentist story or two.

But first, let me say that I don’t have dental insurance, so my relationships with dentists are not complicated by third-party payers. I’m the guy writing the checks and making the decisions.

My periodontist, a real dick, is all about money. Now, you know that the periodontist thing is a yuppie phenomenon—we aging Baby Boomers, if we’re of any means at all, are supposed to have both a G.P. dentist and a periodontist. So, it’s a scam. It’s all about generating revenue by charging a fortune for semi-annual cleaning and inspection, while the G.P. dentist takes care of cleaning and X-rays two more times a year. In any case, I suspect that we’d be just as well off with the old gold standard of dental cleaning and check-ups every six months—period—but I digress.

Yes, my periodontist is a real dick. Two times in the past two years he’s missed appointments. Normally, that wouldn’t bother me, because he’s such a dick, and the hygienist who I’d deal with in his absence is very nice. However, the dick charges his normal fee when he doesn’t show up, and that’s what sticks in my craw. I was supposed to be getting a cleaning and an inspection by a periodontist, for which I’m paying over $100, and all I got those two times was the cleaning. The high-priced doc didn’t show up for his cursory inspection, which normally takes all of 30 seconds. So why the hell is he charging the full fare? Because the doc is a dick.

I even asked his people when they called me to tell me that he wouldn’t be there if his not being there would mean that I would get an appropriate discount. “We don’t do that,” said the receptionist. Of course they don’t do that! Why? Because not only is my periodontist a dick, but also he is a money grubbing dork.

Regarding my most recent appointment, which was to have been about seven weeks ago, I got a call three days in advance saying that my appointment would have to be moved because the hygienist wouldn’t be there that day. Why the hell not just close down the operation completely? So, anyway, in their desire to maximize revenue, they’ve been calling me every couple of weeks saying that they can squeeze me in here or there. “Can you make it at 8:30 AM tomorrow?” Hell no, I can’t. Next time, it’s, “Can you make it at 1:30 PM tomorrow?” Hell no, I can’t. Give me more notice, won’t you? I made my appointment six months in advance. YOU cancelled it. Now, you’re wanting to get me in there on one day’s notice? The response was comical: “We’re trying hard to accommodate you.” To accommodate ME? By disrupting my schedule on short notice? My ass! You’re trying hard to accommodate ol’ doc’s revenue maximization program. I’m not playing that game.

This, of course, is typical of the arrogance one encounters in the dehumanizing health care industry. To reiterate what I’ve said here before, you wouldn’t take this kind of crap from your accountant, your lawyer, or your landscaper. You’re paying them all a fee for services, so they treat you well because you’re their client or their customer. Why the hell does being a patient, as opposed to being a client or a customer, reverse the relationship between service provider and customer, such that the paying patient gets pushed around by the money-grubbing service provider? “My money, my deal” applies everywhere else, but not in the medical arena. Would your gardener raise his rates without discussing the new rates and the reason for the increase with you? Would your accountant? Hell, no—if they were good businesspeople, they would never do that, or they would risk losing you as a customer. On the other hand, my periodontist, who is a dick, raises his fees every year but neither he nor his people make any mention of it. I get the bill—that’s the only “notice” I receive telling me that the fees have increased. And another thing—would your lawyer or your accountant require that you pay the bill on the way out of the office? Hell, no! However, not only is this standard behavior in the medical professions, but also more and more practices are collecting in full on the way in! So much for the trust relationship. Trust is expected, but not given. One-way trust. Why the hell do they think they can get away with this arrogant bullshit?

OK, so speaking of revenue, recall that when I was checking out physicians, I looked at the value of their houses to determine whether they were more interested in making money and hanging out at the club than treating patients. I decided to do the same for my periodontist, who is a dick. It was no surprise that his house is valued right around a cool million. My guess is that he missed my appointments to plan the new north wing or something. All big houses should have names. Let’s call this one Chateau le Dicque.

Let’s contrast my periodontist, who is a money-grubbing dick, with my G.P. dentist, who is a nice guy. My G.P. dentist’s people tell me that if the dentist is not there, they never charge for his services. “That wouldn’t be ethical!” said the hygienist. Out of the mouths of babes—and she is a babe. The last time I went to see the dentist on short notice because a tooth was bothering me, not only did his staff accommodate me with a timely appointment, but also the doc spent a fair amount of time with me discussing the situation and telling me that it would probably resolve on its own—which it did. And when I was done, I went to the front desk and asked how much I owed. I almost wasn’t surprised that the answer was, “Nothing at all this time.” Where do you get something for nothing these days in the allied health care industries? At my dentist’s office and damn few other places. That’s because my G.P. dentist is a nice guy. He is fair, he is competent, and he is a nice guy. What more could I ask?

So, it was no surprise that upon checking my dentist’s property value, I found he was living relatively modestly, in a house worth about $380,000. I also found that he had substantial other real estate investments in the area, including his office building, that came to a couple of million bucks. Good for him. Why? Because he’s a nice guy.

And my periodontist is a dick.

preston, douglas April 20, 2006 at 8:50 pm

I hate going to the dentist just as everyone does. But I’m lucky to have a good one who is a decent guy. I once had a chucklehead tell me that I should have all my silver fillings removed so that I wouldn’t become “psychotic.” Just who was crazy?????

The Nittany Turkey April 21, 2006 at 1:24 am

Yeah, Preston, nobody likes going to the dentist, particularly when one’s dentist treats one’s wallet the way one’s proctologist treats his rectum. But seriously, though, perhaps it’s the mercury in my old fillings that is responsible for my perversion.

preston douglas April 21, 2006 at 11:30 am

I couldn’t agree more about doctors and dentists who raise their rates without giving notice. But there’s something else that they do which I find rather shocking in its disrespect for patients. Many doctors now ask you to make your co-pay at the beginning of the visit, not the end! Message? Making money is more important than your health. It’s so incredibly cynical.

The Nittany Turkey April 21, 2006 at 11:41 am

I mentioned that practice of collecting money before rendering services in my rant, too. It is not only the money aspect that bothers me. It is the distrust. My FICO credit score is over 800, yet I have no credit at my medical providers’ offices. What’s up with that? When I went to the ER with terminal chigger bites last summer, I was accosted by a broad from patient accounts while still in the examining room (“curtain,” as they’re called), asking me how I was going to handle my co-pay of $100. I handed her two fifties and she looked at me quizzically, as if nobody ever gave her any money before. But I digress. Perhaps a hospital, where they don’t know me from Adam, is one thing, but whither the personal relationship with my family physician or my periodicktist (whom I’ve been seeing for 18 years)? Where have the trust and the compassion gone?

Sally April 23, 2006 at 1:30 pm

I’ve worked as a dental assistant for over ten years now. I’ve also worked the front desk. I have come to the conclusion that the majority of dentists are greedy and unethical. I have worked for many of them. And yes they make alot of money but they are very stingy with it. They do not pay well and most of them treat their assistants like shit. I’m convinced that it time for a career change.

Julia Smith August 28, 2009 at 12:37 pm

I fully agree with you. I work for a dentist now and she is so greedy. it’s sad. It is more about the money than the patient and now with the economy the way it is, she refuses to understand why patients don’t have money growing in the back of their house. I work the front office. Maybe I am to nice to be in this position, but I feel for the patients. I put myself in their position, as far as financially. I know that had they gotten the treatment when it was first recommended they wouldn’t be in this predicament, but they are still human beings. I have fillings myself and I have to go elsewhere because it’s not enough production ($$) for her to be interested in doing. I could go on all day about this place and the way we are treated when the schedule falls apart. (again not my fault. but they don’t understand that) I would love to find an patient that comes in and the first question they ask is “how do you treat your patients and your staff?” this will determine if I become your patient. I would love to see the response that a peron gets. you can tell a BS’r from the start. Maybe not “all” dentist are greedy. I would just like to find one that isn’t forcing patients to do tx to pay for their ridiculous spending habits. And they tell us not to live above our means! I can’t wait until my husband finishes school. I just hope that I never become one of these greedy snobs. and this crap about “the lab charges so much to make your pieces” is a load of crap. If you only knew what the dentist actually makes you would croak

The Nittany Turkey April 23, 2006 at 10:15 pm

Thanks for bringing an “inside” perspective to this discussion, Sally. I’m wondering whether all this greediness is a product of our current times. Fortunately, there are still examples of compassionate dentists such as my G.P. His staff all love him; I would suspect that he takes good care of them. My late uncle was a dentist, and he would have given his eye teeth (pun intended) for his small staff. His receptionist was with him for 40-some years. I’m happy that there are counterexamples, but I am sad that your experience suggests that those counterexamples are almost impossible to find these days. Although I hope you can find a genial practice that will reward you appropriately for your skills and loyalty, recognizing that you might not do so, I wish you well in whichever new career path you choose.

Rich S January 25, 2008 at 9:11 am

Hey, lets not forget the cheap bastard dentist who farms his crowns and bribges to China and Mexico for $25. each crown! He still charges his patients upwards of $1000. each! They ARE truly a bunch of greedy fucks!!! P.S, they take full credit for a beautiful job done by another party( HIS LABORATORY!), to whom he probably hasent paid in the last 3 months!

The Nittany Turkey January 25, 2008 at 10:46 am

Rich, you get the Turkey Award for Promptness in Responding to a Post. You’re the unequivocal champ. Thanks for reviving the thread and for your opinion, with which I happen to agree.

—TNT

JR June 13, 2008 at 8:24 pm

I don’t think I will ever see a as big of greedy piece of shit then this last Dentist I fired. This asshole ripped me off so bad that I threatened to sue, build a website devoted to how he screwed me, and report him and the dental corporation he was a member with, to the Attorney General of my State. I am now awaiting a response from them (it’s only been a week) I was told by a dentist I now have (actually did some work for free when my insurance cap of $1,000.00 ran out) that he at one time worked for a “Dental Corporation”, very much like the one I had a nightmare experience with. He said that what they do is get these young dentists right out of dental school and put the pressure on them to produce a minimum of $2,500.00 a day, or be fired. Since the first dentist I had at that rip-off clinic seemed to be a nice young female, who quit and moved to California (or so I was told by the clinic) that part made perfect sense. The one that took over, and started reaming me good, was this greedy little Rolex-wearing puke named “Dr. Mike”. His real name didn’t sound anything like mike, so this was obviously his “Adopted American name”, I’m not racist by nature, but I have noticed some tendencies. My new dentist also said that he has told others to threaten the corporation or the dentist them self, and sometimes the dental corporation that screwed them will cut them a check for a grand to shut them up. Speaking of Rolex watches, I have never bought one. But I did inherit my Grandfathers beautiful Rolex gold and Stainless steel “Thunderbird” model that he bought in the 80′s. I haven’t worn it in a couple of years (to ostentatious for me now), but I did wear it for almost a decade. In all that time the only people who ever noticed it and made a comment about it were Medical Doctors and Dentists. And ALL the ones I met, which were about a dozen in that span, made a comment pertaining to it (“Hey that’s a nice watch”, was the least of the comments I got). Not even attorneys noticed it or made comments. So this tells you partly why health care in this country blows big-time compared to the rest of the Western World, and also sadly to say, that it probably always will. There is a “Greed Fest” that has been going on since the end of the seventies. Most people are shocked by, but don’t really understand why medical, dental, hospital, drug company’s etc. add nauseam, costs are through the roof. I used to live in Europe, and the people over there think that Americans are A. Stupid as a whole B. Getting dumber by each generation C. definitely pitied D. A good place to go if you really want to get rich quick, and once achieved, get even wealthier. I’ve seen and met some very self made wealthy Europeans, so please don’t give me that “They are taxed to death, and they can’t get rich” B.S. Even in Sweden I met some nouveau riche folks. Once you even visit a true democracy that exists in European countries like the UK, Sweden, France, etc. you can’t help but get a real culture shock, as the paradigm shift sets in that you really are surrounded by happy and caring people. This country is screwed. I have studied the rise and fall of other civilizations, and the overriding and foremost reason that starts the ball rolling is always “Unbridled Greed”.

dental hygienist October 4, 2008 at 3:27 am

For the whole 10 years I have worked as a dental hygienist, in the US and abroad, I realized that dentists are all mostly alike! Somehow they are this breed of greedy, cheap, and unethical (whethere to patients or to their employees). Sally is absolutely right, they treat their employees like shit. They have this God syndrome, and they think they don’t have to pay you because somehow they probably think your pocket is as deep as theirs (worse abroad, I haven’t been paid for 2 months!).

The Nittany Turkey October 5, 2008 at 3:32 am

I am happy to be served by the exception to your sad tale. My GP dentist is kindhearted and his staff loves him. They’re always smiling. One time I was there, they were particularly happy. I asked why. The receptionist said, “Dr. P is attending a dental conference in Las Vegas in October and he’s taking all of us with him as his guest!”

Recently, two of his employees, a receptionist and a hygienist who had been with him for 20 years both became seriously ill, the former requiring open heart surgery and the latter, treatment for lymphoma. Dr. P is involved in both their lives, helping their families, and keeping patients involved in their progress.

My cousin was a dentist who served in the Army in World War II and who established a practice in a town in Pennsylvania afterward. His wife was always getting on his case because he refused to charge people he knew were unable to pay. A bygone era? Perhaps, but I want to believe that such people exist today in the profession.

It sucks when your chosen profession becomes unrewarding because of the personalities involved. I hope you can eventually find an exceptional dentist with whom you can be happy.

—TNT

Malia M. December 15, 2008 at 2:57 pm

Wow, just as I thought. The “you have periodontal disease” is a crock of crap. Having what I believed to be a full mouth of healthy teeth, apparently appeared to be a mouth full of monsterous bacteria to my dentist. Several hundred dollars later and my teeth seem to be in the same shape they were when I arrived… healthy. It’s sure is quite a profit they are rackin’ in. Great story, glad to know I’m not the only one who has experienced this, but how unfortunate.

The Nittany Turkey December 15, 2008 at 3:51 pm

You’re lucky you got away with only several hundred bucks down the proverbial drain. For me, it was thousands. I added it up and found that I wound up having paid that periodontist about $10,000 through the years.

I now have a deal with my GP dentist. Clean my teeth four times a year, inspect my mouth twice, x-ray it once a year, and check the periodontal pockets twice a year. If anything requires a periodontist, we’ll discuss a referral (but not to the same one I had before, the dick). When I get a cleaning and don’t see the dentist, I’m charged substantially less. It works for me.

I hope you can find something you can live with.

Susan Housekeeper January 2, 2009 at 12:57 pm

I have for a long time wondered if the woes of healthcare costs are in any part due to greedy practitioners. Dentists in my opinion are the worst. My son had to have a procedure to expose a tooth for orthodontic work, as well as removing 2 baby teeth. Now, the whole orthodontic work costs about $5000, which seems like a lot, but is a relative bargain. That is the ENTIRE fee, over the course of the 2+ years anticipated. The ORAL SURGEON charged $2100+ for the consultation and procedure under general anesthesia (we deemed necessary because of fears of my son). It took less than an hour from start to finish. The general anesthesia part cost $600. We have no dental insurance, so I tried to negotiate a bit, asking for a break since it was to be paid entirely up front, no billing ins co, etc. They gave us 5% off their full rate! That was it! I suspect an insurance company would compensate a lot less but that is a guess.
Then there are regular dentists. OUrs charges $1500 – $2000 for a crown. Again, no breaks for paying up front. (They used to do that, “a service” they claimed; no patient has a right to anything; we have to beg!)
It’s not that we don’t know other professionals such as lawyers and accountants also overcharge. But somehow it seems particularly egregious when the going rates (if that is what these examples are) are driven by the inflated amounts they quote to insurance-covered patients. And don’t believe their malpractice insurance rates are so high that they “must” charge these amounts to “cover their costs.” According to one website I checked out, they still cleared PLENTY!
I believe they get away with gouging on prices because they can. True, perhaps they are overworked, and have to do something to limit the number of patients. I just think they should be examining their consciences a little more.

Ashley July 30, 2009 at 4:53 pm

I’m so sick of these greedy dentists!! I need work done on 4 of my front teeth, but I can’t get it done, because I have Medicaid! They don’t want to accept it cuz they don’t get paid enough! I hope one day they are in the same position as I am!! The last dentist I saw was a jerk! I went there, he looked at my teeth and the xray and try telling me I was completely missing a tooth. I’m like no…It’s there, there’s just a tiny bit of it left. And he tried to argue with me. Then he relized I was right. Then he told me to find someone else that with except Medicaid to put my crowns on…JERK! And he didn’t even clean my teeth! Not only that, I know I have a cavity forming and he told me I don’t. I feel it everyday a**hole and I’ve had a different dentist tell me that I do! If I don’t get at least the one crown put on that tooth that is almost completely gone..it’s gonna cause me medical problems. GET OUT OF YOUR STATE OF GREED! YOU’RE BETTER OFF THAN MOST OF US. BUT I GUESS WE POOR PEOPLE DON’T MATTER TO YOU!

A March 17, 2010 at 6:01 am

I’m a dentist and I do pretty well, well enough that I don’t need to overcharge and play games with people or their insurance cos. To the original poster this is America if you are unhappy with the service don’t keep on going to the dick periodontist, I’m sure he isn’t thE only game in town. I expect to be compensated for my time and work don’t hate dentists just because your time and work are not valued by society as much as ours. We work hard, undertake considerable expense and training to provide you ungrateful complainers with care that could have been avoided in the first place had you listened to us and brushed / flossed your teeth. An ounce of prvntion. Do you judge your accountant and lawyer by the value of thier homes? I find it ludicrous that dentists are derided for our ambition / business sense as long as the work done meets or exceeds the standard of care like any other busness we are free to charge whatelver we like if you don’t like it you should have the lowest bidder do your work. Which is cool because when it’s time for it to be redone right I’ll be ready I need a new bimmer anyway. Troglodytes.

The Nittany Turkey March 17, 2010 at 3:02 pm

Being an American, I did, in fact, shitcan the dick periodontist shortly after I wrote this piece, as a subsequent post will attest.

You seemed to read wealth envy into my post, which is an incorrect interpretation. I drive a Bimmer myself and I couldn’t care less if you decided to get a Bugatti Veyron as your next car.

I really don’t give a shit what you drive or where you live, as long as you do your job. What I do care about is whether you show up for appointments and perform the agreed upon work. If you leave it to an assistant and charge me the same rate as you would have charged me for your own services, I reserve the right not only to change dentists, but also to exercise my constitutional right of free speech to grouse about it in public.

I’m a retired professional, and I would stack up my earning potential against a dentist’s anytime. I’ll buy the best dental work I can get, which is what I have with my GP dentist, who practices in a high rent district and is certainly not a cut-rate, low-bid operation. I just wish that all practitioners were as humble, gracious, and competent as he. I’d pay double his going rate.

You responded to me, but you did not address the issues raised by many of the commenters in this thread. Are you also dismissing them out of hand as being motivated by wealth envy alone?

Enjoy the new Bimmer.

—TNT

Solly August 11, 2010 at 1:35 am

Wow. I found this website by accident while researching average dentist fes for my area. I’m a dentist myself and I just found out that my ofice fees are the lowest in my region. But I’m not going to increase them because I have watched with much sympathy and pain as more of my patients lose their jobs and can’t afford to pay me, or even to make their insurance copays. I’ve practiced for over 27 years, owned 14 offices, and am happy with what I earn. I routinely do work for free on people I know have no money. I treat my staff like family and have zero staff turnover. I treat my patients as I would like to be treated myself.
I’m sorry so many of you have had such bad experiences, but I know many dentists personally, and I really must say that I believe only a small percentage are really greedy people who are in this just for the money. True, we do have overhead to pay (dentists have the highest overhead of any medical specialty, with an average of 63% and routine highs of 75% in high-rent areas). So we only take home a fraction of what we charge. Contrast that with a GP physician with a 25% overhead who gets paid far more per hour of work and does far less physical labor. And no one I know uses Chinese labs. We support olur local lab men even though it means paying more for crowns and dentures.
if anyone posting on this blog has run their own business they will understand high overheads and the need to collect all balances due as soon as possible. Your accountant may bill you monthly, but if you don’t pay he will refuse to prepare your tax returns until you do pay. What’s a dentist to do with a patient who refuses to pay? Take their dentures away from them? And you may have the best credit score on earth, but we don’t run credit checks on our patients, so how would we know who to trust and who is a scammer (yes, there are plenty of them too. Run up a $5,000 bill and disappear. It’s happened to all of us).
So if you think your dentist is ripping you off, walk out the door and down the block. There are plenty of us around who will be happy to see you and treat you like a valued customer rather than a walking expense account. But don’t tar all of us with the same brush.

Dental assistant December 29, 2012 at 9:10 am

I’ve been a dental assistant for almost a decade I’ve worked for several of dentist. Not only are they greedy they are unethical and don’t care about anybody but their wallet’s, the hottest car they drive, their real-estate, the heck with their staff. I am a male dental assistant working for a male dentist is very rare because the male dentist (married dentist) like to hire the female assistants that are flirtatious and if only his wife knew he would probably be in the dog house everyday. However, working for the female dentist isn’t any better either they are controlling to the point they scream at you, pay you like crap, and think your always out to destroy their equipment and steal something from them. However, I am in school now in another field. In addition, I wouldn’t suggest anyone to work in the dental field it is heart breaking I’ve been let down by many of dentist and throughout all the years of my life I only met 2 dentists out of the 15 I worked for treated me fairly and payed me well and we are friends to this day….ALL I CAN SAY PEOPLE THANKS FOR THIS BLOG IT IS VENTING AND I THOUGHT I WAS THE ONLY ONE WHO THOUGHT THAT DENTISTS ARE BUTT HOLES AND MISTREAT THEIR STAFF.

Canadamontreal April 21, 2013 at 12:27 am

I feel like periodontists are the most greedy ones. Because all they do is gum grafts. I went to two different periodontist to compare their opinions and both wanted me to do grafting on different parts of my gingivitis. Which only means that actually i dont any grafting right now. It looks like they make that stuff up. My gum recession (practically nonexistent) should just be watched.

Hygiene101 October 6, 2013 at 9:25 pm

I totally agree with everybody here! I worked with around 10 dentists since I started with this profession and ALL of them are Greedy in different different ways! One of the dentist I worked cheap out when it comes to paying us. Some disgustingly recycle a lot of things that should be disposed after one usage. Some milk out money from their clients. honestly, I’m so disgusted with this profession.

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