It's Friday, and I have had a tough week. Not tough like I am crazy busy but more emotionally draining. I think if I'm not that busy at work, it is really emotionally draining. So I got a lot of that stuff going on. And the Magic lost.
I am not that busy at work, and people have come in that have challenged my ethics. I want to talk about a couple of scenarios that have I had to deal with this week.
Here in Orlando, I deal with a lot of snow birds: retired people who have two homes. They have one home in the South for the winter and another home in the North for the summer. Great people for the most part. A little tough because you are not their only dentist, but for the most part, they are people with means and that makes it a little easier to say, "Hey, you have a cavity. We should fix this." Most of the time they say, "No problem. When?"
But I saw a woman yesterday and we were replacing an amalgam filling that had a hole in it. Then she had some decay on the incisal of #26 and a small cavity on the facial of #11. I told her that when people "mature," their teeth nerves get smaller and sometimes they don't even need anesthetic. I told her, "Why don't I start and if you have any issues please let me know." She was game.
The facial on #11 took about 2 minutes, the incisal took about 4 minutes, and the MO took about 12 minutes. After all the talking, after the fillings, all the saying goodbyes for the winter the max amount of time she was in my chair was 30 minutes - tops.
Now, in the talking time of this appointment, we got to talking about the cruise she was going to go on next week. I talked about how I am looking forward to the days where tuition for the kids, school loans, practice loans, and mortgages don't consume my thoughts. I am looking forward to being able to take my grown kids on cruises.
She then goes on to tell me that her and her husband love cruises and one time she paid for all her kids and her grandkids to go on a cruise - THIRTEEN PEOPLE in all. So, although you would never know it, this was a woman of significant means. Back to the 30 minutes in my chair. You are thinking, "What is the dilemma so far?"
Well, my one surface anterior restoration fee is $160; she got two of those. I then did a three surface posterior restoration which, in my office, is $280. If I charged her full fee this is a grand total of $600. For 30 minutes of my time? To me, this is too much. Some people might say, "This is what she got, this is what she is going to pay for."
Not me. I can't stomach charging someone $160 for something that really only took me 2 minutes to do. I know. I used products to clean the room, I used the same amount of bonding materials, but I don't want people to feel ripped off here. So she was going to pay for her and her husband's cleanings, her and her husband's x-rays and exams. So really if I charged her full feel, she wasn't going to notice because it was going to be expensive.
I just couldn't do it. I think I charged her the full fee for the posterior restoratio,n but only $100 each for the two facials. I took off $120 of the bill. Her total bill was $980. AND I am just finding out now that my front desk person told her how much it was going to be (full fee) before we started. So, she was even prepared to pay the whole thing. Arghh!!!
I still think I am ripping people off if I charge someone $160 if it literally takes me two minutes. But $120 more for the day would really be nice, especially if I do it 4 times during the day.
What do you do? Is it full fee regardless? Do you feel the same way as me? Let me know. I don't think I am devaluing myself; I just think I am being fair. Kind of the way I want to be treated. Like if you go to a mechanic
(definitely the sphitzer valve)
and you know that it doesn't take very long to do X but the book allows them to charge 2.5 hours of labor for that X. Just because you can charge something doesn't mean you always have to.
Okay, next one. I am a tooth saver. My Pankey training has brainwashed me to always thinking of ways to save a tooth (that can be saved). Now a guy comes with a tooth that is broken off at the gum line. The tooth could have been saved. But you know as well as I do this is some major dentistry.
He just got a new job and is going to be getting insurance soon. I start telling him how much it is going to be to save this tooth: $850 for the root canal, $375 for the post and core, $1150 for the crown. I am thought this was a ton of money for this guy, so I told him that I could put him on antibiotics until he gets his insurance stuff squared away with his new job. I just wanted to help this guy, but wouldn't just taking his tooth out be helping him too?
In last 10 years or so, I have softened my "not taking teeth out" stance. I have died on that hill before and I feel great about it. I have told people that they are at the wrong office if they want that tooth taken out. Some have actually gotten up and left and others have tried to save the tooth.
But $2400 could have been a month's worth of pay for this guy. He had missing teeth in two other quadrants. I think it can be done case by case. I don't think that prognosis on this tooth would have been excellent. It would have been good, but not excellent. Is it okay to just take 15 minutes and take this tooth out? He thought about it for a sec and decided to have it out, and I was okay with this.
I feel like I educated him on what his issue was, on what we could do, and on what would happen if he took it out. I let him make the decision. I took the tooth out.
I don't think I am selling out or doing him a disservice. I think I met a guy where he was at.
What do you think? Any Pankey guys out there who are shaking their heads at me?
Okay, that is it for this week.
Have a great weekend.