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Discussion Starter · #1 ·
My dentist got really upset when I told him that I was a customer, not a patient. It all started when he charged me for work that had no chance of success. I felt that he should deduct it from the bill. He refused, saying that he is a health provider, and that unlike machainics, do not have to make good if it does not work out. My retort was that since he made the wrong diagnosis, he should make good.
 

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tofurkey hunting
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from what you've said, it sounds like he should not have charged you...but on the patient v. customer issue, i totally agree with your dentist.

students aren't customers either. you should receive good care and fair treatment because you are a patient...but not because you are a customer.
 

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Windrider (Stubborn)
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daniell said:
My dentist got really upset when I told him that I was a customer, not a patient. It all started when he charged me for work that had no chance of success. I felt that he should deduct it from the bill. He refused, saying that he is a health provider, and that unlike machainics, do not have to make good if it does not work out. My retort was that since he made the wrong diagnosis, he should make good.
The only difference between a mechanic and a doctor is the complexity of the machine.

I hope he understands that no matter what he calls it, his revenue comes from it......which means that success depends on how he interacts.

Len
 

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Discussion Starter · #6 ·
Customer not patient

I already found a new dentist.
What irked me.
The dentist argued that since I was not trained in Science, I could not make that determination. I replied by saying, whether I should pay for something that I did not need, does not lend itself to a scientific discussion.
 

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Captain Obvious
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i'm sure he was taken off guard. especially since most billing issues are probably with an insurance co. and not a patient/customer.
 

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Fini les ecrase-"manets"!
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The short answer: If the dentist feels that way, you can't make him make good without suing. He doesn't give a sh*t what you think about his skills or his ethics. So you tell him you're walking, and you walk. Pay your bill, under protest (loud, in the waiting area if possible) and never go back.

To me, the notion that patient and customer aren't the same thing is outdated. The idea that you can behave however you want to a patient goes back to when people didn't have a choice. Your town had few doctors, or your insurance (HMO, maybe) locked you in.

My insurance and the fact that I live in a Metro area give me a LOT of choice. So you'd better have at least SOME sense that I'm a customer as well as a patient, or I'm out the door and you'll never see me, nor anyone I can influence against you, again.

I can't equate the doctor/dentist thing with students at all. If I have a teacher who's not very effective, I can see part-way through the semester that there's a problem, and I can learn on my own, work with other students or ask for extra help from the teacher. If my dentist ruins my teeth by employing a procedure that's ill-advised, I can't do any extra studying to make it better, and I can't see the trouble coming.

I am not asking for perfect results from my doctors. There are some places where they're just not sure what's going to work and what won't. I expect them to level with me on the risks. If they do that, then I can feel some responsibility and I'm generally OK with paying even if things don't work out.

And yes, I've received plenty of sub-par medical and dental care, as well as been subjected to poor teachers most of my school career, unfortunately.
 

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Fini les ecrase-"manets"!
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tomk96 said:
i'm sure he was taken off guard. especially since most billing issues are probably with an insurance co. and not a patient/customer.
Well, unnecessary procedures are also unethical and possibly illegal. So you can bet your butt he's never going to admit to the OP that it was unnecessary, if that's the deal.
 

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Delusions of grandeur in the medical professions?

As I've mentioned before, a couple of my good friends are doctors, and several others live in the neighborhood (an expensive subdivision grew up around our once-rural house). Some of them are really good guys, but many have a skewed perspective on their situation relative to the rest of humanity.
I've been involved enough in medicine at a very low level (Army medic, EMT, ambulance attendant) to understand it's an uncertain business. There isn't always a clear or successful answer to every question. Some docs don't seem to be able to admit that, or to live with the understanding that they can't solve every problem (that's a mixed bag, though. If i need fast medical help, I want somebody with confidence to be administering it. That's not a time for doubt and indecision).
Still, many of them have commercialized their practices, running patients through as fast as they can, treating only the complaint or the condition, not the person (a cliche, but still true), overbooking appointments so you have long waits, stuff like that. If they treat you like you're waiting in line to buy a hot dog, seems to me they can't complain when you regard them as vendors. FWIW, surgeons and some dentists seem to be the worst. But my sample in those areas is pretty small.
Side note illustrating their insularity: Everybody's taken a huge financial hit lately, of course, and that's been a frequent topic of conversation on our weekend rides. I was moaning yesterday about how our meager portfolio has declined, and an oral surgeon commiserated with me.
"I know what you mean," he said. "We just talked to our guy (financial adviser) last week. You can't retire with less than $10 million, and we're down to about six."
You can't retire on SIX MILLION BUCKS? I'd have to work five more lifetimes.
 

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Scary Teddy Bear
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I hate.

HATE, HATE, HATE, the term customer when applied to patients.

Traditional business paradigms, to the chagrin of so many health administrators and press ganey, do not apply well to health care.

There are significant risks of ANY procedure, medication, or basically anything I do as pertains to it not working, not working correctly, or even causing harm. The human body is FAR to complex, and our methodologies do not always work on EVERY patient. What works for one, may not for another, and vice versa. To compare a healthcare provider to a car mechanic shows a total naivete, and complete disregard for the complexities of medicine.

Implying that they are the customer, implies that they are always right, and should get what they want.

I guess I should have written that drug seeker for his oxycontin last night then?

I guess the woman with 5 months of neuropathic pain in her leg who showed up in the ED expecting an instant diagnosis and treatment should have been completely cured when she left?

It's not the same thing as selling a product, or fixing/repairing a TV or car. TV's and cars don't have postoperative infections after they are repaired, they don't go into AFib and have a watershed event after being repaired, they don't have a clotting cascade nightmare and go into DIC. See where I'm going here?
 

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2 busy workin' 2 hang out
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daniell said:
My dentist got really upset when I told him that I was a customer, not a patient. It all started when he charged me for work that had no chance of success. I felt that he should deduct it from the bill. He refused, saying that he is a health provider, and that unlike machainics, do not have to make good if it does not work out. My retort was that since he made the wrong diagnosis, he should make good.
How do you know it had no chance of success?
 

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Discussion Starter · #13 ·
Customer not Patient

The dentist said that the bite was off so he ground down the crown. For that he charged me. I was there for a crown, not soley for the tooth in question. I then went to an oral surgeon who found that I had an infection in the root. I had to pay the for two consultations for the same problem. The surgeon did the surgery and it now feels better.
When I entered the office of the oral surgeon the first thing I saw was a big sign saying that he accepts credit cards. Don't tell me that it is not a business.
 

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Windrider (Stubborn)
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physasst said:
HATE, HATE, HATE, the term customer when applied to patients.

Traditional business paradigms, to the chagrin of so many health administrators and press ganey, do not apply well to health care.

There are significant risks of ANY procedure, medication, or basically anything I do as pertains to it not working, not working correctly, or even causing harm. The human body is FAR to complex, and our methodologies do not always work on EVERY patient. What works for one, may not for another, and vice versa. To compare a healthcare provider to a car mechanic shows a total naivete, and complete disregard for the complexities of medicine.

Implying that they are the customer, implies that they are always right, and should get what they want.

I guess I should have written that drug seeker for his oxycontin last night then?

I guess the woman with 5 months of neuropathic pain in her leg who showed up in the ED expecting an instant diagnosis and treatment should have been completely cured when she left?

It's not the same thing as selling a product, or fixing/repairing a TV or car. TV's and cars don't have postoperative infections after they are repaired, they don't go into AFib and have a watershed event after being repaired, they don't have a clotting cascade nightmare and go into DIC. See where I'm going here?
I don't think it's an either or.

If you set up a scale where patient was on the left end of the scale (say 0) and customer was on the right end (say 10)....where do you theink the person getting care falls on the scale?

I think that most receivers of care would tell you that they should be treated as a 6 1/2+ while most providers of care would say they are less than a 3........that is the disconnect....and that's one of the reasons that so many "paients" are unhappy with the care they get.

I also object strongly to the premise that you promulgate that medicine is too complex for mere patients to understand.........I've been involved in too many cases where it was clear the "patient" understood their illness better than the "professional".

Doctors are providers of a service.....it may be an important service, but it is still a service.....too many medical professionals treat their "Patients" as opposed to "People". Medicine, in general, looks down on it''s "patients".

And I don't agree that " ...they are the customer, implies that they are always right, and should get what they want." Rather, I would say that looking at them as a customer recognizes that they have a choice in providers, that they have a right to question their care & that they are integral with their care. Unfortunatly, in my experience, too many medical professionals don't want their "patients" to have any of that.

Len
 

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You need to
a) Learn how to work on your own teeth
b) Let your new dentist know how you feel about being a "customer"
c) Tell your doctor, the same thing, next time you hit the ER.
 

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Scary Teddy Bear
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Len J said:
And I don't agree that " ...they are the customer, implies that they are always right, and should get what they want." Rather, I would say that looking at them as a customer recognizes that they have a choice in providers, that they have a right to question their care & that they are integral with their care. Unfortunatly, in my experience, too many medical professionals don't want their "patients" to have any of that.

Len

I actually agree with this part. Patients DO have a choice where they get their care, and my job, and duty is to provide them with the very best medical care they can get.

My problem lies in institutions and administrators getting too hung up on Press Ganey scores, and not thinking about the various situations. By treating patients as customers, we have created an environment where more testing is done, and unnecessary prescriptions are often written. It creates an environment where a patient who has a normal ankle exam, and has a sprain by the Ottawa ankle rules, and DOES NOT need an xray, gets one, because his wife says, "Well aren't you going to xray it?, Why the hell did we come here then?, I can't believe this, you know, I'm going to call someone about this."

Or the PCP or Peditrician who caves to the parents DEMANDING antibiotics for their childs case of the sniffles, because the parents threaten to complain to the "hospital board" for the negligent care.

Or the migraine patient who gets a week supply of percocet because "It might come back, and you have a duty to treat me".

It's created a situation where you have providers, not all of them thankfully, but a lot that are more concerned with making the patient HAPPY, then taking good care of them.

Of course I want all of my patients to be satisfied with the care they recieve, but I also know that that is simply not possible, at least one patient every week or so will be pissed off at me about something. I am far, FAR more concerned that they recieve the very best, most appropriate care for their various complaints, than I am whether or not they "like me".
 

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You actually pay a DR for an opinion, you know that going in. To pretend otherwise is not being truthful. There is a movement in the insurance industry to reward Docs on "performance". This is utterly ridiculous. Your performance is directly related to the type of patients you serve (rich or poor), and the type pf pathology you treat. People are not cars, there's noblueprint (DNA aside),we are pretty much guessing (so to speak).
 

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Len J said:
I don't think it's an either or.
Interesting. And whether I think of myself as a customer or a patient, I want whatever it is fixed and I know that part of the cost will come out of my own pocket so don't waste my time and money. Bottom line.

New dentist screwed up in December. I had my second cavity (evar) filled and they misplaced my chart so he couldn't do it (secretary left early and he didn't know how to find it, new office...). He fit me in the next day at a convenient time and didn't charge me a cent. Like in any business, mistakes happen but what matters is how they're corrected. This guy gets it.
 
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