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Medical Forum / General / Dentistry / January 2007Proper Approach for 2nd Opinion?
I want to ask my dentist in town to share the X-rays and results with a dentist nearer to me. What is the proper way to approach this? I don't want to ruffle any feathers, but I do want to see if the dentist closer to me has lower prices for re-doing some ancient fillings. The dentist in town uses a laser for small cavities. I want to see if I can have the dentist with the laser fill the small cavities in front and do the "cosmetic" parts of what I need done. How do I go about letting both of these dentists know that I want to "use" each one for different things without upsetting either one of them? The dentist in town is extravagantly expensive, I think. I have an appointment with his dental hygienist next month. I have an appointment for a consultation with the dentist nearer to me in March. Do dentists get insulted by this kind of thing? I want to handle this in a professional manner and need a little advice about how to tell them. I'm sort of a timid person, but I need to stand up for myself here and insist on doing this my way. Thanks in advance for any advice you have. Eva couple of things. a laser is not going to give you any kind of advantage over the modern drill. In fact it will take longer to explode away the decayed tooth structure. having a second dentist treat you, you may find a considerable difference in philosophy and the amount of work that is recommended to be done. If you are happy with your current dentist and the only thing that is stopping you from continuing is cost on a few fillings, you may find that taking a chance with someone else long term this may not be the best cost savings. There are patients that switch for this reason end up going to a cheaper clinic to then having to return to the original dentist or someone else with far more work and problems. That said if you still want to visit the other office, ask them to obtain the records for you. But my advice is to stick to one office it makes things a lot easier for warranty purposes and you are dealing with somebody who knows your mouth. > I want to ask my dentist in town to share the X-rays and results with a > dentist nearer to me. What is the proper way to approach this? I don't [quoted text clipped - 18 lines] > > Eva Forgive the top posting. I'm responding through google groups because your original message does not show up in my dinosaur newsreader. I could only see responses to your post. I'm curious about your statement that the laser will take longer to "explode" (geez, does it have to explode??) the decayed part of the tooth. In my understanding, the laser is painless and doesn't require numbing. Does the fact that it will take longer affect the quality of the work done? I appreciate your response, and I am trying to figure out which dentist to use. My niece has gone to the first dentist since she was very little, and he has been very good to her and has not caused her to be afraid like I am. Maybe you can tell me what you think of his prices -- I have an estimate here in front of me. The first item is "onlay 4 surf (porcelain) -- $1,101.00." Is this a good price? I think that just means replace an old filling -- yes? I'm trying to do my homework. Cost is important. I'm on early retirement and get a small pension. I was forced out before I reached full retirement because I was sick a lot with Meniere's Disease. OK, sad story over -- back to basics. I want to get my teeth fixed if I can. I am going to have numbers 21, 28, and 29 removed by an oral surgeon the first week of February. I went to see him today, and he gave me a price of $860. Sounds reasonable since I will be in la-la land and won't have to go through the procedure awake. He says my other teeth are good -- look strong -- and should be fixable. Trouble is -- I'm looking at about $7,000 that would wipe me out. So I really need to research prices. Whatever advice/help you can offer is very much appreciated. This whole thing gives me a headache. The problems are my fault -- stayed away from dentists a long time because of fear and some bad treatment. I found a good one -- very skilled, but not a nice man. He scared me away again, and now I'm losing these three teeth that could've been saved if I hadn't been so scared. Now that you've read this whole long message (at least I hope you have), can you advise me? Thank you, Eva On Jan 21, 1:22 pm, "Alexander Vasserman DDS" <purple543...@yahoo.ca> wrote: > couple of things. > a laser is not going to give you any kind of advantage over the modern [quoted text clipped - 36 lines] > > > Eva- Hide quoted text -- Show quoted text - > Forgive the top posting. I'm responding through google groups because > your original message does not show up in my dinosaur newsreader. I [quoted text clipped - 35 lines] > > Thank you, Eva Eva: I'm sure Alex can speak for himself, but the "explode" part is a bit...florid. There is a popping noise from water particles being energized. Laser advocates say it is pain free, but I've gotten differing opinions. Since you are not using pressure as you would with a drill there is little heat generation within the substance of the tooth. I doubt very much that it would be totally pain-free, esp. if you're close to the nerve, but there may well be an advantage. Still, I look at it this way. Even if the pain is less, to be totally relaxed you will want to know you will have no pain, and there's no way to guarantee that without local anesthesia if the patient is conscious. Once you have well-administered anesthesia, it doesn't matter from a pain standpoint whether you're using a laser for decay removal or a low-speed handpiece with a #8 round bur. I can equip my operatory with handpieces for a couple of thousand bucks. The laser may be $20-30K. There is nothing you can do on hard tissue with a laser that you can't do with a high-speed and a low-speed air driven handpieces more quickly and obviously more cheaply. If money is a concern, I would go for solid, well-done restorative dentistry and skip the ray gun razzle dazzle. Call me an old fart--I'll pass on the laser. Steve > On Jan 21, 1:22 pm, "Alexander Vasserman DDS" <purple543...@yahoo.ca> > wrote: [quoted text clipped - 39 lines] >> >>>Eva- Hide quoted text -- Show quoted text -  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I like top posting. <G> Anyway, I'm an old fart *with* a laser. IME, (other laser 'experts' may disagree with me) 'laser anesthesia' is a bunch of crap. Like Dr. Steve says, it is a less traumatic method of removing decay and tooth structure, but it is *not* pain free. Most of the time that I use it, patients are numb. There are definitely patients who need little (and even no) anesthesia for dental treatment. In a metro area, there are probably thousands of people who would rather not be numbed for most dental treatment. With a laser, these people will be very happy. They are likely to believe it is the magic of the laser, but it is probably more within their own nervous system. IME, most people will still need anesthesia. Advantages of the laser: It does not induce cracks into the enamel as it cuts. Patients like not feeling vibration and pressure. I can trim soft tissue with very little hemorrhage. The lased surface is supposed to bond better to filling material. The laser actually destroys bacteria as it works. Disadvantages: Initial expense (my Waterlase was ~$50K). It does cut slower than a bur. It won't cut amalgam (or other metal). It does not live up to the hype put out by the laser companies. I love it for decay along the gum line and most restorations on anterior teeth. I don't like it for occlusal or interproximal decay on posterior teeth. After all of that, I don't think your decision on which dentist to 'trust' should come down to the laser or other pieces of equipment. Cost of treatment (though a very real issue) is also seldom a great factor when determining quality of care. As a lay person trying to judge dentists, you are at a distinct disadvantage. Kind of like me picking a jeweler, ophthamologist, surgeon, mechanic, or electrician. I don't know any secrets that will allow you to make the 'right' choice. Best wishes, D >> I'm curious about your statement that the laser will take longer to >> "explode" (geez, does it have to explode??) the decayed part of the [quoted text clipped - 9 lines] >> surf (porcelain) -- $1,101.00." Is this a good price? I think that >> just means replace an old filling -- yes? >> Whatever advice/help you can offer is very much appreciated. This >> whole thing gives me a headache. The problems are my fault -- stayed [quoted text clipped - 5 lines] >> >> Thank you, Eva > Still, I look at it this way. Even if the pain is less, to be > totally relaxed you will want to know you will have no pain, and there's [quoted text clipped - 11 lines] > > Steve > I like top posting. <G> > [quoted text clipped - 55 lines] > Best wishes, > D Thanks--it's good to get some perspective from a user, and better when it's not a self-serving uncritical rave. I imagine the thing about better bond strengths is because the laser might not create a "smear" layer? Steve >>> I'm curious about your statement that the laser will take longer to >>> "explode" (geez, does it have to explode??) the decayed part of the [quoted text clipped - 35 lines] >> >> Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> I like top posting. <G> Oh -- good. :) >> Anyway, I'm an old fart *with* a laser. >> >> IME, (other laser 'experts' may disagree with me) 'laser anesthesia' >> is a bunch of crap. Like Dr. Steve says, it is a less traumatic >> method of removing decay and tooth structure, but it is *not* pain >> free. Most of the time that I use it, patients are numb. So -- on a scale of 1-10, how much pain is involved with the laser? In your experience, does a person's fear factor increase the amount of pain they perceive? >> There are definitely patients who need little (and even no) anesthesia >> for dental treatment. In a metro area, there are probably [quoted text clipped - 3 lines] >> more within their own nervous system. IME, most people will still need >> anesthesia. I have no idea where I fall into these categories. I don't know if I could take this treatment without being numb. My biggest problem is fear. When I went to the oral surgeon -- just to talk -- they took my blood pressure, and it was 144/71. I have never, ever registered that high in my life. The highest reading I've ever seen, when I was rushing to get to an appointment on time, was 120/70. My normal is 100/70 -- right where it should be. I wonder if my fear will make me think I'm feeling more pain. >> Advantages of the laser: >> >> It does not induce cracks into the enamel as it cuts. >> >> Patients like not feeling vibration and pressure. I would like that part. Does this laser make a loud noise? Since I have Meniere's Disease, one of the most distressing things for my hyperacusis is hearing the drill sound. I have to wear an ear plug if they work on my left side. >> I can trim soft tissue with very little hemorrhage. >> [quoted text clipped - 15 lines] >> anterior teeth. I don't like it for occlusal or interproximal >> decay on posterior teeth. That's exactly what I've got -- decay along the gum line on anterior teeth. I can see these little red spots along the bottom edge of my teeth where they meet the gum. The laser wouldn't apply to my posterior teeth because they are the ones with old metal to be taken out and replaced. You lose me with the technical terms occlusal and interproximal, tho. >> After all of that, I don't think your decision on which dentist >> to 'trust' should come down to the laser or other pieces of >> equipment. >> >> Cost of treatment (though a very real issue) is also seldom a great >> factor when determining quality of care. That's where I get lost, too. It may be that one dentist charges less, but is more skilled at the task. An expensive dentist isn't necessarily better than one who charges less. >> As a lay person trying to judge dentists, you are at a distinct >> disadvantage. Kind of like me picking a jeweler, ophthamologist, [quoted text clipped - 5 lines] >> Best wishes, >> D Egad. How do I gain an advantage then in making this decision? There must be a way for a lay person to choose the best dentist. I do know of a really good one, but he's a real SOB. It's too bad because his skill is probably the best I've ever experienced. He could give me a shot where I barely felt it at all. That leads me to the question of skill being measured by the way a dentist gives a shot. If he can do it without my feeling it, does this always mean that he has more skill? This dentist I'm considering -- the one with the laser -- uses this vibrator. An assistant holds the vibrator on my face while he gives me a shot. If the metal syringe touches my teeth when this thing is vibrating, it drives me nuts! And why is he using a metal syringe? I thought those were obsolete. > Thanks--it's good to get some perspective from a user, and better > when it's not a self-serving uncritical rave. > I imagine the thing about better bond strengths is because the laser > might not create a "smear" layer? > > Steve I do appreciate the time you've both taken to answer my questions and address my concerns. I'm still kind of at a loss as to how to make this decision. I want to compare prices. I do have money in my savings, but I don't want to be wiped out. This is an awful position to be in. It's scary and so confusing. What is an onlay, and should it cost $1,000? I guess all I can really do is gather as much information as I can and try to go from there. Thanks! Eva >>> I like top posting. <G> > [quoted text clipped - 116 lines] > > Thanks! Eva Eva-- I might have top-posted too, but decided not to. Dartos (the other Steve) should answer the bulk of your questions, since he's laser-guy. An onlay is generally an indirect filling (IOW, it isn't formed like amalgam or resin just placed in the prepared tooth--an impression is taken or the tooth is scanned in a machine like a CEREC) that covers the chewing prominences (cusps) of the back teeth. This vibrator thing I know nothing about--sounds intriguing! Back in dental school we had an instructor who would grab the patient's cheek, retract and shake the living daylights out of the cheek. I figure it's some kind of distraction technique. As far as metal syringes, for some reason as local anesthesia developed in dentistry we use reusable (sterilizable) metal syringes and disposable single-dose cartridges of anesthetic, and a disposable needle. This is probably just tradition, but it's convenient. When I was a resident if I had to use anesthetic in the emergency room we generally used disposable syringes and a multidose vial of anesthetic. Steve > Eva-- > [quoted text clipped - 8 lines] > retract and shake the living daylights out of the cheek. I figure it's some > kind of distraction technique. This is the technique used by the dentist I went to before -- when they do the cheek pinch, it does work. I don't know if they're pinching a nerve or what, but I can't feel the shot when the dentist does the pinch. It makes me wonder why all dentists don't use this technique. It works well. > As far as metal syringes, for some reason as local anesthesia > developed in dentistry we use reusable (sterilizable) metal syringes and [quoted text clipped - 4 lines] > > Steve Oh, thanks for the info on that. I felt like I was in the dark ages when I saw the metal syringe. I wanted to get up and run away. It seems to me that dentists need to work on the environment they set up for a patient to endure. Scary things like metal syringes should be updated. I know there are lots of people like me who are scared of dentists. But it also seems that dentists are fairly unaware of this. Why is that? How can they not know how scary they are? I'm sure you don't mean to scare people, but there it is. OK, now I'm just venting I guess. Eva >> Eva-- >> [quoted text clipped - 36 lines] > > Eva Eve: I know I'M scary. But is a plastic syringe really less scary than steel? After all, the needle is still steel. Steel is real!! Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Within the last year, I have had the 'opportunity' to use plastic syringes. It is much more difficult to control the plunger to give a *slow*, steady injection (an extremely important aspect of a comfortable 'shot'). I think there are some new designs on the market with composite types of materials, but they were pretty expensive IIRC. Just keep the syringes mainly out of sight. One reason I have equipment that swings under the counter instead of over the top of the patient. Who wants to sit in the chair staring at all of the equipment and instruments right in front of them? D Scary things like metal syringes should be >> updated. >> Eva > I know I'M scary. But is a plastic syringe really less scary than > steel? After all, the needle is still steel. Steel is real!! > > Steve > Within the last year, I have had the 'opportunity' to use plastic > syringes. It is much more difficult to control the plunger to > give a *slow*, steady injection (an extremely important aspect > of a comfortable 'shot'). Ahhh, then it is a good thing. Maybe I should try to make friends with the metal syringe. It just looks so intimidating. > I think there are some new designs on the market with composite > types of materials, but they were pretty expensive IIRC. [quoted text clipped - 7 lines] > > D I think that's a great idea. The appearance of some of the instruments is scary in itself. I should never be allowed to see what will be used on me since I'm such a scaredy-cat. Geez, once I was sitting there in the chair ready to have a tooth pulled out, and they rolled in this cart with all kinds of horrific looking stuff on it. One dentist told me I had such a low threshhold of pain that it was hard to work with me. But I think it's not pain -- it's fear. He used to be angry if I made whimpering sounds. He would stop what he was doing and ask if he was hurting me. I'd say "no." Then I realized I had been making these noises just because the fear had taken over my brain. If only he had had a little more patience and took the time to talk to me, I could've kept going to see him. But he didn't. He yelled at me and made me cry. Scared the crap outta me, too. The new dentist understands that I might make these scared sounds, and he says that's OK. I am where I am now because the last dentist scared me so much. I stayed away from dentists for three years, and now I'm losing three teeth that could've been saved had that dentist not destroyed my trust in him. Eva > Scary things like metal syringes should be >>> updated. [quoted text clipped - 4 lines] >> >> Steve > I stayed away from dentists for three years, and now I'm losing >three teeth that could've been saved had that dentist not destroyed my >trust in him. > >Eva Blaming the dentist, eh ? I think they call that projection. >> I stayed away from dentists for three years, and now I'm losing >> three teeth that could've been saved had that dentist not destroyed my [quoted text clipped - 5 lines] > > I think they call that projection. Ummm, yes, I do blame him somewhat. I also know that the majority of the blame is mine. It's not like he tied me up and locked me in a room somewhere to keep me from going to the dentist. But he did take an already scared person and make the fear worse. He didn't do me any favors. I don't think I'm projecting at all. I have been completely honest here about exactly what happened. You seem to have read only the part of my post you chose to deem the most important. That's not really fair, is it? Eva >>> I stayed away from dentists for three years, and now I'm losing >>> three teeth that could've been saved had that dentist not destroyed my [quoted text clipped - 10 lines] >somewhere to keep me from going to the dentist. But he did take an >already scared person and make the fear worse. But it was your responsibility to find someone else > I don't think I'm projecting at all. Disagree >You seem to have read only the part Untrue, read it all. >That's not really fair, is it? Sure it is. Just responded to the part that I wanted to. My perogative. >Eva > Just responded to the part that I wanted to. > My perogative. Sure it is. It's also your prerogative to ignore the main reason I posted anything at all and focus in on one off-the-cuff remark made in a weak moment. But that's OK. Other people here have been very helpful and understanding. I've also said in here that the old dentist was very skilled, but was sorely lacking in people skills. My new dentist was gentleman enough to say, "I apologize for my colleague's bad behavior." There are gazillions of really good and caring dentists. I just happened to run into one who was good but not very caring at all. If you don't think that a professional has some responsibility in how his actions affect his patients, then we do indeed disagree. Eva > Oh, thanks for the info on that. I felt like I was in the dark ages when I > saw the metal syringe. I wanted to get up and run away. It seems to me that [quoted text clipped - 6 lines] > > Eva >>Steve wrote: >>I know I'M scary. But is a plastic syringe really less scary than >>steel? After all, the needle is still steel. Steel is real!! Ummm, yes, the metal syringe is much scarier to me than a plastic one. I can't say exactly why. I think a lot of people's fear of dentists comes from how things look, sound, and smell in the office. The appearance of this huge, scary-looking metal syringe makes me panic. The drill looks so mean and dangerous. I can't be the only one who thinks like this. I walk into a dentist's office, and the smell hits me. It is unmistakable and is associated with terror -- for me. OK -- so it might not make sense. But that's the way I see it. Maybe it's because the syringe looks so BIG -- I guess I think the needle will be BIG, too. If you're interested in a scared patient's point of view, here it is. The equipment is daunting -- the atmosphere is scary as hell. Here's this person standing over you. He holds all the power in his hands. You are at his mercy. It's very intimidating. It's one of the reasons I don't know how to ask about the 2nd opinion. I don't want anybody who might be slightly ticked off at me holding a big metal syringe and coming at me with it. Eva >Back in >dental school we had an instructor who would grab the patient's cheek, >retract and shake the living daylights out of the cheek. I figure it's >some kind of distraction technique. I use this technic, though gentle is good enough. This is based on the gate-controlled theory of pain perception. Closes the a-delta, and c fibers from propagating. ...so they say >>Back in >>dental school we had an instructor who would grab the patient's cheek, [quoted text clipped - 6 lines] > Closes the a-delta, and c fibers from propagating. > ...so they say I thought it was part of an interrogation technique he'd learned in the Turkish armed forces. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > So -- on a scale of 1-10, how much pain is involved with the laser? In > your experience, does a person's fear factor increase the amount of pain > they perceive? 1-10 <g>. It depends on what I'm trying to do, the patients perception of pain, the power level setting, and whether I've used any local anesthesia. IME, fear spikes quite rapidly when something is painful. The more it hurts, the greater the panic. >>> There are definitely patients who need little (and even no) anesthesia >>> for dental treatment. > I have no idea where I fall into these categories. I don't know if I > could take this treatment without being numb. My biggest problem is [quoted text clipped - 4 lines] > right where it should be. I wonder if my fear will make me think I'm > feeling more pain. My guess is that it wouldn't be a great idea to find out how much you could take without anesthesia. I would probably recommend nitrous oxide and plenty of local anesthetic before any treatment (laser or no). >>> Advantages of the laser: >>> [quoted text clipped - 6 lines] > hyperacusis is hearing the drill sound. I have to wear an ear plug if > they work on my left side. The laser makes a popping noise. It is certainly less shrill than the drill. Patients seem to not tense up quite as much (maybe just because they have 'learned' that the drill may hurt and the popping noises are not [so far] associated with pain). > That's exactly what I've got -- decay along the gum line on anterior > teeth. I can see these little red spots along the bottom edge of my teeth > where they meet the gum. The laser wouldn't apply to my posterior teeth > because they are the ones with old metal to be taken out and replaced. > You lose me with the technical terms occlusal and interproximal, tho. I'm sure these areas could be treated with or without a laser. The laser is nice due to lack of pressure, less and different sound, bleeding control, and *maybe* better bonding of the composite. Occlusal=biting surface of posterior teeth. Interproximal=between the teeth. Why are the metal filling being replaced? Age alone is not a good reason. > Egad. How do I gain an advantage then in making this decision? Friends and co-workers may be a good place to start. Try to find the difference between salesmanship and craftmanship. Comfortable delivery of local anesthesia is a big plus, but this may or may not mean the rest of the treatment is excellent. Usually I would throw out the cheapest and most expensive. Someone inbetween who doesn't rush through appointments. Busy, but under control. If you e-mail me privately with your general location, I might know of a particular dentist you might want to visit. D Yes, there is supposed to be no smear layer. But for SE Bond, isn't the smear layer part of the process? IOWs, I don't know composite bonds better with all systems (or even any). With 4.5 loupes, the surface is certainly 'rough' before etching or 'conditioning'. D > Thanks--it's good to get some perspective from a user, and better > when it's not a self-serving uncritical rave. > I imagine the thing about better bond strengths is because the laser > might not create a "smear" layer? > > Steve > Yes, there is supposed to be no smear layer. But for SE Bond, > isn't the smear layer part of the process? IOWs, I don't know > composite bonds better with all systems (or even any). With 4.5 > loupes, the surface is certainly 'rough' before etching or > 'conditioning'. I remember you posting a photo of you in your telescopes, but I don't remember them being the long ones. I'm still using my 2.5s, Mark is using about what you're using (he's so competitive--"mine's longer than yours). I use Pentron "Bond-1--I haven't worried much about what happens to the smear layer. Of course you're the resin-king. Steve > D > [quoted text clipped - 4 lines] >> >> Steve > I remember you posting a photo of you in your telescopes, but I > don't remember them being the long ones. I'm still using my 2.5s, Mark [quoted text clipped - 4 lines] > > Steve After I got the laser, I got a pair of 4.5s. Laser work (since you can't 'feel' anything, you need to see better) and endo get the 4.5s. Most other stuff is 2.5. I use Bond-1 for all regular bonding. Deep restorations, places apt to bleed (even with no apparent bleeding, the application of Bond-1 will often get it started...if it's oozing a little, it will gush), and pedo usually get Clearfil SE. D > I want to ask my dentist in town to share the X-rays and results with a > dentist nearer to me. What is the proper way to approach this? I don't [quoted text clipped - 11 lines] > > Do dentists get insulted by this kind of thing? They shouldn't. You are entitled to a copy of your records (including x-rays) and a reasonable fee for copying may be charged. You need not explain why, and any dentist who would be insulted IMO is a fool. I agree with Alex about the laser, BTW. Steve I want to handle this > in a professional manner and need a little advice about how to tell > them. I'm sort of a timid person, but I need to stand up for myself here [quoted text clipped - 3 lines] > > Eva I was talking with my brother in law who is a lawyer in personal injury and he was telling me that there was a case ruling that the original records are the property of the patient. In fact there was a case he mentioned where the original records were demanded by the plantif and the doctor did not want to give up the originals. the lawyer went to the judge and the judge placed a "body attachment warrant" on the doctor. I am told that a body attachment means the sheriff will actively search for the person and take them to jail in their underwear vs a bench warrant where they wait for the person to be pulled over for minor traffic violation etc... This is another good reason to go paperless and digital x-rays, this way both parties maintain identical electronic records. As far as I know from the dental practice act, doctor offices are allowed to charge a moderate fee for duplication of records. The issue here with duplicates vs originals is that when it comes to x-rays duplicate films are not the same quality as originals and sometimes this gets difficult because the originals deteriorate over time due to improper fixer time. and making a duplicate of a deteriorating original is even worse quality. Problem may arise if an insurance company wants to re-question a benefit payment and they ask to see the x-rays and the doctor then can not send them the same quality x-ray as original which may contain critical detail such as subtle decay explaining the procedure. Digital x-rays solves this problem although it requires software and hardware and database back-up maintenance which is still currently expensive. Therefore I do not forsee the modest duplicating fee disappearing anytime soon. > > I want to ask my dentist in town to share the X-rays and results with a > > dentist nearer to me. What is the proper way to approach this? I don't [quoted text clipped - 27 lines] > > > > Eva > I was talking with my brother in law who is a lawyer in personal injury > and he was telling me that there was a case ruling that the original > records are the property of the patient. In fact there was a case he > mentioned where the original records were demanded by the plantif and > the doctor did not want to give up the originals. Alex-- This is the first I've heard of this. Of course dental practice law may differ in California, but just a few months ago I took the web-based risk management course offered by the NYSDA, and it said in no uncertain terms that here the records were the property of the practice (so if the practice is sold, it belongs to the practice, and retiring dentists had to provide for access to the records). Of course, in this day of warrentless searches (yeah, I know, they're stopping that) and the executive branch searching congressmen's offices, things could change. the lawyer went to > the judge and the judge placed a "body attachment warrant" on the > doctor. I am told that a body attachment means the sheriff will [quoted text clipped - 17 lines] > maintenance which is still currently expensive. Therefore I do not > forsee the modest duplicating fee disappearing anytime soon. I agree. From a practical standpoint though, if a patient of mine leaves frequently I don't have a FMX-ray series under a year old, and the new dentist is going to want to take a new one. I've never had copies rejected in 30 years though, and I have no illusions that this had anything to do with the quality of the copies. Steve >>> I want to ask my dentist in town to share the X-rays and results with a >>> dentist nearer to me. What is the proper way to approach this? I don't [quoted text clipped - 26 lines] >>> >>> Eva The records of the patient belong to the PRACTICE. However, a copy of the entire record MUST be given to the patient. A nominal fee for copying,$25USD, is allowed. However if the pt. will not pay the copying fee, the office MUST still provide the copy. The ruling is for the consumer, but also protects the dentist by allowing to keep the originals. |
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