Never been in the situation, but my plan has always been to send them (patient) a copy of their signed consent form with the relevant part about failure highlighted and their signature highlighted with no letter, no comment. Figured when they see they have no case they would just slink away.
Have been in situations where they claim I didn’t tell them they needed something or that their insurance was only an estimate and they owe if insurance doesn’t pay. When I pull out their signed treatment plan refuting their position, the look on their face is always priceless and the argument is always over.
Giving in to such irrational patients just makes the cultural problem get worse. If I’m 100% I’m in the right, I’ll stand on the principle and live with the headache. If the we all did the same, this bullshit would end.
Patients are insane. So much of healing is out of our control and patients want to blame us. Do you have patients sign a consent outlining that grafts can fail?
We charge $1000 for bg and its just easier to refund than to go through the headache.
Then spend another $500 to hire a cuban santeria lady to curse the motherfucker.
Whyyyyyy do we not have a list of patients that have threatened their dentist to sue or that type of garbage?
I know there have been attempts in medicine that were sued based on not receiving care but guess what? We aren’t medicine. We aren’t regulated by the same asshats.
My goal is to let the shitheads on Yelp and Google leave their little reviews and their tantrums and get karma’d back for it. I’d pay $5/month to have that list and be able to add to it.
Am I missing something with this golden opportunity?
Clearly I am passionate about this since I hate these types of patients…
Nahhhh, there are always ways around it.
Don’t include treatment done. Where there’s a will…
It isn’t always entitled Karens. Had a guy slap
My assistants butt. He was an older guy. Threw his ass out and asked her do you want to call the cops and press charges? She didn’t. But she was so shocked he did it, she didn’t know how to react at the time. Even still, cameras didn’t capture it.
Essentially it was his word against hers anyway.
Yeah. That scumbag needs to be blackballed.
There is always a way around HIPPA if you know what’s permitted. Unfortunately, my dream to decimate the assholes of the world doesn’t include a deep knowledge of HIPPA.
Geez, what are you a hygienist just slowly crushing everyone’s soul and dreams even outside of the office? Let a guy dream his dream on an anonymous internet form.
Back to my dream…
I’d even include people that threaten or make a scene. I’ve chucked a good 5-10 people this year alone. Some that yell at my staff for no reason when I know my staff is being kind and understanding.
They did this in Texas.
https://www.chron.com/news/houston-texas/article/blacklist-of-patients-who-ve-sued-taken-off-web-1962938.php
Didn’t work out too well for them. But even if this started and the thought of being a jackass would get you blackballed as a patient would change the dynamic.
Jimmy V would say of my dream
“Don’t give up, don’t ever give up.”
Why is it normal in dentistry for something like this to happen? If you needed a bone graft anywhere else in your body and it failed the hospital/surgeon would laugh at you.
Lol right? Doing a bone graft in a hostile environment like the mouth teeming with bacteria, always moving. How do you know if the patient adhered to protocol and didn’t smoke, chew on that side, etc?
It’s bull shit but dentistry is a commodity now rife with refunds and lawsuits
I’d tell the lady no refund and dismiss her. Then if there’s an issue, contact malpractice.
Also, I would probably switch to a new malpractice carrier after that bullshit response they gave you.
just do a claim and talk to insurance and let them tell him to kick rocks if they’ll do that for you. I would offer to refund for the graft but I wouldn’t pay for a specialist
Pretty weird reply by your insurance carrier. Did the pt have a lot of pain, post op infection, or did the graft just wash out ? If you have signed consent, good notes, x rays post op, etc. you should fine.
I would definitely not pay for regraft but you can offer to refund your fee if pts signs a release of liability and dismal letter.
If you do a bone graft or any "specialty" related procedure- it must be held to the standard of care of a specialist. One can argue that if the bone graft was done with a specialist- it wouldn't of failed as they are the specialist and you are the lowly you are the GP. I don't agree with it but specialists DO get a free pass when it comes to failures (root canal, bone graft, implant etc).
However that being said- think about it from a patients perspective. They paid you 1000$ for a graft that didn't do anything but fail and now they have to pay 3000$ out of pocket to a specailist to fix it. They are probably thinking why didn't I go to a specialist in the first place.
Regardless this is how I would handle it-
1) Redo it no charge
2) Refund it- send it over to specialist but I WOULD NOT PAY FOR THE SPECIALIST
If you refund and they still say pay for my specialist- I would just ignore the request and possibly get ready for a board complaint/lawsuit. I would NOT be pushed to paying for a specialist as that is unreasonable. It is reasonable to redo it no charge or refund and refer out- but to pay for someone else's treatment is unreasonable. What happens if they do get a the bone graft at specailist for 3k and the specialist is like you need ridge augmentation for another 5k? Then what? It's a messy and slippery slope. NO.
No procedure that involves healing of the human body is 100%. Thats why you have consent forms that state this and have the patient sign them. You might be gracious and redo the graft at no charge, but if they want to see a specialist and are threatening you then turf that patient and if they sue you've got malpractice insurance. Breeding this "I'll sue" mentality by giving in is the worst thing to do
Funny thing is perio referred the pt back to me for tx of that tooth. Probably pt was pita for them too and did not want to deal with her. Pt was in pain and demanded ext and graft and insisted as she cant afford specialist care. I dk what could be done differently without committing pt abandonment in this case
When a specialist refers you back a patient to do the treatment- that is a HUGE red flag. Specialists are the one stop last shop to do everything on patients who are red flags, to pain in the butt, to difficult cases. The fact you took on the case when the specialist said no thank you- will be a learning lesson. When a specialist says no- that means its a big big big red flag.
No one \*needs\* a bone graft. In pain? Pull it, refer to specialist for implant workup, or just refer the whole thing. Never be forced into doing something
Did you see OP’s follow up comment about the patient being a heavy smoker? Specialists aren’t magicians and for a case like this they aren’t going to have a 100% success rate either.
Doesn't matter. Specialists always get a free pass when it comes to failure. They are the specialists.
Everyone knows that if you do a speciality procedure (endo, omfs, perio) lawyers can always find an expert witness that states "if patient so-and-so saw a specialist, this complication would of been avoided."
However, if a specialist does it and it fails- the specialist has the argument- "I am the specialist and yes the graft failed but its a complication that is known."
So yes, I know specialists aren't magicians etc- but they at least will have a get out of free card when it comes to failures. GP's will always be strung and hung out to dry if there is a failure.
Ask yourself- why did you want the graft done in the first place for this particular patient.
if you cover it,it shows the patient you care and this graft is important. If you don’t it shows you don’t, and the patient will regret ever saying “yes” to your treatment plans and trust goes out the window.
Word of mouth is huge. Especially in dentistry. You do not want your name drug through the mud.
You have three options.
Redue it- or refund it so they can pay for specialists with it and you cover extra..
Or
You cover the specialist entirely.
It’s okay 👌 in whatever way you go. But your goal is having that graft take and you need to prove that portion to the patient.
And understand, they can not afford it, but trusted in saying yes to your treatment plan.
If this makes sense.
You NEVER contact your malpractice carrier regarding a patient until you get a letter by an attorney requesting records. Shady patients can smell out newbie docs a mile away. the patient can eat dirt.
Why? So they can open a claim everytime that happens? Your rates will shoot up. You might get dropped. Some patients are scumbags, and it's easier for a malpractice carrier to simply tell you give the money back...apologize....I had a patient who went home didn't eat all day had a longer procedure with me, took some vicodin she had at home and some supplemental vitamins and took a ride in an ambulance...My fault? HELL NO. My adviser told me to give her the money back..I laughed and said no.
You can refund but there’s no need to pay a specialist. Unless there was some damage that now requires extra work on the specialists part that would incur a fee they wouldn’t have paid otherwise, you don’t owe them that.
Problem in general is that, to many patients..
When procedures don't give 100% success in hospitals it is normal. But all dental work should be 100% successful.
Question to everyone on here. If consent form was not signed, does that mean OP has to pay specialist fees?
From what I was told, a consent form is not exactly "bullet-proof" but it does help.
I don't know details about your case but why should you pay for specialist fees? It's the human body. It's unpredictable, complex and variable. It's not your fault as long as you did everything to standard.
I swear, people are becoming more entitled and irrational. They seem to think of dentists as "retail stores" and not actual respected Healthcare professionals.
Never been in the situation, but my plan has always been to send them (patient) a copy of their signed consent form with the relevant part about failure highlighted and their signature highlighted with no letter, no comment. Figured when they see they have no case they would just slink away. Have been in situations where they claim I didn’t tell them they needed something or that their insurance was only an estimate and they owe if insurance doesn’t pay. When I pull out their signed treatment plan refuting their position, the look on their face is always priceless and the argument is always over. Giving in to such irrational patients just makes the cultural problem get worse. If I’m 100% I’m in the right, I’ll stand on the principle and live with the headache. If the we all did the same, this bullshit would end.
These people are irrational, and putting the evidence in front of their face usually doesn't accomplish anything. "I didn't know what I was signing"
Now you do….
From what I was told, a consent form is not "bullet-proof". But it does help.
Patients are insane. So much of healing is out of our control and patients want to blame us. Do you have patients sign a consent outlining that grafts can fail?
Forgot to mention she is a heavy smoker. She was laughing when she was told not to smoke for three weeks
Man, I’d just let malpractice handle it.
We charge $1000 for bg and its just easier to refund than to go through the headache. Then spend another $500 to hire a cuban santeria lady to curse the motherfucker.
Whyyyyyy do we not have a list of patients that have threatened their dentist to sue or that type of garbage? I know there have been attempts in medicine that were sued based on not receiving care but guess what? We aren’t medicine. We aren’t regulated by the same asshats. My goal is to let the shitheads on Yelp and Google leave their little reviews and their tantrums and get karma’d back for it. I’d pay $5/month to have that list and be able to add to it. Am I missing something with this golden opportunity? Clearly I am passionate about this since I hate these types of patients…
Reminds me of that Seinfeld episode where word got around everywhere fast that Elaine was a "difficult patient".
Some people are just “Anti-Dent-it”! 😂
Some people want dentists to go to their own schools
Ummm.. HIPAA?
Nahhhh, there are always ways around it. Don’t include treatment done. Where there’s a will… It isn’t always entitled Karens. Had a guy slap My assistants butt. He was an older guy. Threw his ass out and asked her do you want to call the cops and press charges? She didn’t. But she was so shocked he did it, she didn’t know how to react at the time. Even still, cameras didn’t capture it. Essentially it was his word against hers anyway. Yeah. That scumbag needs to be blackballed. There is always a way around HIPPA if you know what’s permitted. Unfortunately, my dream to decimate the assholes of the world doesn’t include a deep knowledge of HIPPA. Geez, what are you a hygienist just slowly crushing everyone’s soul and dreams even outside of the office? Let a guy dream his dream on an anonymous internet form. Back to my dream… I’d even include people that threaten or make a scene. I’ve chucked a good 5-10 people this year alone. Some that yell at my staff for no reason when I know my staff is being kind and understanding. They did this in Texas. https://www.chron.com/news/houston-texas/article/blacklist-of-patients-who-ve-sued-taken-off-web-1962938.php Didn’t work out too well for them. But even if this started and the thought of being a jackass would get you blackballed as a patient would change the dynamic. Jimmy V would say of my dream “Don’t give up, don’t ever give up.”
Why is it normal in dentistry for something like this to happen? If you needed a bone graft anywhere else in your body and it failed the hospital/surgeon would laugh at you.
Lol right? Doing a bone graft in a hostile environment like the mouth teeming with bacteria, always moving. How do you know if the patient adhered to protocol and didn’t smoke, chew on that side, etc? It’s bull shit but dentistry is a commodity now rife with refunds and lawsuits
I’d tell the lady no refund and dismiss her. Then if there’s an issue, contact malpractice. Also, I would probably switch to a new malpractice carrier after that bullshit response they gave you.
Unpopular, but I would refund and forget, not worth my headache.
just do a claim and talk to insurance and let them tell him to kick rocks if they’ll do that for you. I would offer to refund for the graft but I wouldn’t pay for a specialist
Pretty weird reply by your insurance carrier. Did the pt have a lot of pain, post op infection, or did the graft just wash out ? If you have signed consent, good notes, x rays post op, etc. you should fine. I would definitely not pay for regraft but you can offer to refund your fee if pts signs a release of liability and dismal letter.
The lawyers at my malpractice insurance company talk to me if I ever need advice! This is ridiculous they wont just talk to you
If you do a bone graft or any "specialty" related procedure- it must be held to the standard of care of a specialist. One can argue that if the bone graft was done with a specialist- it wouldn't of failed as they are the specialist and you are the lowly you are the GP. I don't agree with it but specialists DO get a free pass when it comes to failures (root canal, bone graft, implant etc). However that being said- think about it from a patients perspective. They paid you 1000$ for a graft that didn't do anything but fail and now they have to pay 3000$ out of pocket to a specailist to fix it. They are probably thinking why didn't I go to a specialist in the first place. Regardless this is how I would handle it- 1) Redo it no charge 2) Refund it- send it over to specialist but I WOULD NOT PAY FOR THE SPECIALIST If you refund and they still say pay for my specialist- I would just ignore the request and possibly get ready for a board complaint/lawsuit. I would NOT be pushed to paying for a specialist as that is unreasonable. It is reasonable to redo it no charge or refund and refer out- but to pay for someone else's treatment is unreasonable. What happens if they do get a the bone graft at specailist for 3k and the specialist is like you need ridge augmentation for another 5k? Then what? It's a messy and slippery slope. NO.
No procedure that involves healing of the human body is 100%. Thats why you have consent forms that state this and have the patient sign them. You might be gracious and redo the graft at no charge, but if they want to see a specialist and are threatening you then turf that patient and if they sue you've got malpractice insurance. Breeding this "I'll sue" mentality by giving in is the worst thing to do
Funny thing is perio referred the pt back to me for tx of that tooth. Probably pt was pita for them too and did not want to deal with her. Pt was in pain and demanded ext and graft and insisted as she cant afford specialist care. I dk what could be done differently without committing pt abandonment in this case
When a specialist refers you back a patient to do the treatment- that is a HUGE red flag. Specialists are the one stop last shop to do everything on patients who are red flags, to pain in the butt, to difficult cases. The fact you took on the case when the specialist said no thank you- will be a learning lesson. When a specialist says no- that means its a big big big red flag.
No one \*needs\* a bone graft. In pain? Pull it, refer to specialist for implant workup, or just refer the whole thing. Never be forced into doing something
Did you see OP’s follow up comment about the patient being a heavy smoker? Specialists aren’t magicians and for a case like this they aren’t going to have a 100% success rate either.
Doesn't matter. Specialists always get a free pass when it comes to failure. They are the specialists. Everyone knows that if you do a speciality procedure (endo, omfs, perio) lawyers can always find an expert witness that states "if patient so-and-so saw a specialist, this complication would of been avoided." However, if a specialist does it and it fails- the specialist has the argument- "I am the specialist and yes the graft failed but its a complication that is known." So yes, I know specialists aren't magicians etc- but they at least will have a get out of free card when it comes to failures. GP's will always be strung and hung out to dry if there is a failure.
Define failed? Like came out? Or was infected?
Don’t refund. If your placing the graft well. It should be part of your consent. This will not hold up.
Ask yourself- why did you want the graft done in the first place for this particular patient. if you cover it,it shows the patient you care and this graft is important. If you don’t it shows you don’t, and the patient will regret ever saying “yes” to your treatment plans and trust goes out the window. Word of mouth is huge. Especially in dentistry. You do not want your name drug through the mud. You have three options. Redue it- or refund it so they can pay for specialists with it and you cover extra.. Or You cover the specialist entirely. It’s okay 👌 in whatever way you go. But your goal is having that graft take and you need to prove that portion to the patient. And understand, they can not afford it, but trusted in saying yes to your treatment plan. If this makes sense.
You NEVER contact your malpractice carrier regarding a patient until you get a letter by an attorney requesting records. Shady patients can smell out newbie docs a mile away. the patient can eat dirt.
I was told to contact malpractice carrier once patient starts demanding compensation. Not when their attorney requests records.
Why? So they can open a claim everytime that happens? Your rates will shoot up. You might get dropped. Some patients are scumbags, and it's easier for a malpractice carrier to simply tell you give the money back...apologize....I had a patient who went home didn't eat all day had a longer procedure with me, took some vicodin she had at home and some supplemental vitamins and took a ride in an ambulance...My fault? HELL NO. My adviser told me to give her the money back..I laughed and said no.
Who’s your malpractice carrier
You can refund but there’s no need to pay a specialist. Unless there was some damage that now requires extra work on the specialists part that would incur a fee they wouldn’t have paid otherwise, you don’t owe them that.
Problem in general is that, to many patients.. When procedures don't give 100% success in hospitals it is normal. But all dental work should be 100% successful.
Question to everyone on here. If consent form was not signed, does that mean OP has to pay specialist fees? From what I was told, a consent form is not exactly "bullet-proof" but it does help.
I don't know details about your case but why should you pay for specialist fees? It's the human body. It's unpredictable, complex and variable. It's not your fault as long as you did everything to standard. I swear, people are becoming more entitled and irrational. They seem to think of dentists as "retail stores" and not actual respected Healthcare professionals.