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Medical Forum / General / Dentistry / February 2004unpaid bills & removing braces
A friend of my niece's reports that his orthodontist refuses to remove his braces because his parents can't pay their bill. I can understand denying further treatment, but isn't it dangerous to leave untended appliances in a person's mouth? Is this sort of neglect illegal, unethical or just par for the course? Yes all of the above! JOEL >A friend of my niece's reports that his orthodontist refuses to remove >his braces because his parents can't pay their bill. I can understand >denying further treatment, but isn't it dangerous to leave untended >appliances in a person's mouth? Is this sort of neglect illegal, >unethical or just par for the course?  SignatureJoel M. Eichen, . Philadelphia PA DISCLAIMER FOLLOWS: ********* Dental health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the SciMedDentistry gang or any other official agency either actual or fictitious or Steve Mancuso. Advice on the treatment or care of an individual patient should be obtained through consultation with a dentist who has examined that patient or is familiar with that patient's dental history. STANDARD DISCLAIMER I would document in writing to the orthodontist and send Return Receipt Requested, just in case of damage to the teeth. >A friend of my niece's reports that his orthodontist refuses to remove >his braces because his parents can't pay their bill. I can understand >denying further treatment, but isn't it dangerous to leave untended >appliances in a person's mouth? Is this sort of neglect illegal, >unethical or just par for the course? SignatureJoel M. Eichen, . Philadelphia PA DISCLAIMER FOLLOWS: ********* Dental health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the SciMedDentistry gang or any other official agency either actual or fictitious or Steve Mancuso. Advice on the treatment or care of an individual patient should be obtained through consultation with a dentist who has examined that patient or is familiar with that patient's dental history. STANDARD DISCLAIMER Joel, congrats on undermining everyone here. The deadbeat wants the orthodontist to remove the braces on a completed case without being paid. There is NO legal obligation to do so > I would document in writing to the orthodontist and send Return > Receipt Requested, just in case of damage to the teeth. [quoted text clipped - 4 lines] > >appliances in a person's mouth? Is this sort of neglect illegal, > >unethical or just par for the course? The patient is (apparently) a minor. The parents are responsible for the finances of the treatment plan. What is the *actual patient* supposed to do??? Surely you don't think the kid should remove the orthodontics in the privacy of the home... Whether or not the parents are "deadbeats" is something that you can't prove here in smd. And whether or not this case even exists is not something you're likely to prove *here*. Let's just say this kid is 16 years old. In two years, can you bill the 18 year old for what the parents never paid since the orthodontic appliances are *in the mouth of the 18 year old not the parents*??? It seems that when doctors get into care that is going to span a period of years, a relationship should have been established along the way to prepare for financial hardship. I do wonder how much money is a stake in this case. It doesn't matter what kind of healthcare you practice, there will be bills that will not get paid. It isn't just a problem for orthodontists. TW > Joel, congrats on undermining everyone here. > The deadbeat wants the orthodontist to remove the braces on a completed case [quoted text clipped - 11 lines] > > >appliances in a person's mouth? Is this sort of neglect illegal, > > >unethical or just par for the course? Signature-- Sabra Broock <sabrabroock@earthlink.net My take on EVERY case ,,,,,,,,, first I decide what is best in terms of therapy with no knowledge about whether it is paid or not paid ,,,,,,,,,, then I do what is required ,,,,,,,,, JOEL >The patient is (apparently) a minor. The parents are responsible for >the finances of the treatment plan. What is the *actual patient* [quoted text clipped - 34 lines] >> > >appliances in a person's mouth? Is this sort of neglect illegal, >> > >unethical or just par for the course? SignatureJoel M. Eichen, . Philadelphia PA DISCLAIMER FOLLOWS: ********* Dental health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the SciMedDentistry gang or any other official agency either actual or fictitious or Steve Mancuso. Advice on the treatment or care of an individual patient should be obtained through consultation with a dentist who has examined that patient or is familiar with that patient's dental history. STANDARD DISCLAIMER >It doesn't matter >what kind of healthcare you practice, there will be bills that will not >get paid. It isn't just a problem for orthodontists. > >TW Disagree on this point, if I'm not paid the patient wins a trip... ...down to the courthouse to see the judge. Small claims court is a wonderful tool. If the amount is over $5K it's called grand theft. -- &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& "Pathetic Earthlings...if you had known anything about the true nature of the universe, anything at all, you would have hidden from it in terror." - Emperor Ming &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& That's why small claim courts exist. I have no problem with that whatsoever. Believe me. I know all about patients not paying their doctor bills. TW > >It doesn't matter > >what kind of healthcare you practice, there will be bills that will not [quoted text clipped - 15 lines] > from it in terror." - Emperor Ming > &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Signature-- Sabra Broock <sabrabroock@earthlink.net Actually I had a similar case,,,,,,, the first molar rotted out for a lovely young patient and someone removed it and moved the orthodontic band to the second bicuspid ,,,,, rampant decay on the anteriors, etc. My decision was to remove all the bands and restore the decay FIRST. No one agreed, but believe me it happened! Documenting care and lack thereof is necessary ,,,,,,,,,, if damages occur, then the health care provider better be on firm ground! JOEL >Joel, congrats on undermining everyone here. >The deadbeat wants the orthodontist to remove the braces on a completed case [quoted text clipped - 11 lines] >> >appliances in a person's mouth? Is this sort of neglect illegal, >> >unethical or just par for the course? SignatureJoel M. Eichen, . Philadelphia PA DISCLAIMER FOLLOWS: ********* Dental health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the SciMedDentistry gang or any other official agency either actual or fictitious or Steve Mancuso. Advice on the treatment or care of an individual patient should be obtained through consultation with a dentist who has examined that patient or is familiar with that patient's dental history. STANDARD DISCLAIMER there is NO law that says I have to remove braces from a patient who owes me money. Par for the course. Of course being a deadbeat seems to be par for the course too. > A friend of my niece's reports that his orthodontist refuses to remove > his braces because his parents can't pay their bill. I can understand > denying further treatment, but isn't it dangerous to leave untended > appliances in a person's mouth? Is this sort of neglect illegal, > unethical or just par for the course? >there is NO law that says I have to remove braces from a patient who owes me >money. Public Law #25467-3 section b ............ Kidding. Actually, if removing the braces is necessary to prevent further damage and further damage occurs,,,,,,,, guess who gets slammed? You. >Par for the course. >Of course being a deadbeat seems to be par for the course too. [quoted text clipped - 3 lines] >> appliances in a person's mouth? Is this sort of neglect illegal, >> unethical or just par for the course? SignatureJoel M. Eichen, . Philadelphia PA DISCLAIMER FOLLOWS: ********* Dental health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the SciMedDentistry gang or any other official agency either actual or fictitious or Steve Mancuso. Advice on the treatment or care of an individual patient should be obtained through consultation with a dentist who has examined that patient or is familiar with that patient's dental history. STANDARD DISCLAIMER And slammed it should be. TW > >there is NO law that says I have to remove braces from a patient who owes me > >money. [quoted text clipped - 15 lines] > >> appliances in a person's mouth? Is this sort of neglect illegal, > >> unethical or just par for the course? Signature-- Sabra Broock <sabrabroock@earthlink.net > And slammed it should be. > > TW The law is on your side on this one, but I feel it is wrong. People can screw me for payment, yet I am "ethically" obligated to continue to provide care for them. I have been through this, and did the "ethical" thing, because there is little option for me. The courts seem to feel I should paint a big target on my a.s with a sign that says "feel free to screw me, the courts are on your side". If you feel that is the way it "should be", I can only hope you get screwed in this manner some day and come out feeling it "should be" this way. I have had non-payers many times and get tell you with absolute certainty that NONE of them screwed me due to financial hardship. People in genuine dire straights will tell me, and I will work with them...people who just don't pay their bills are usually habitual offenders who do so as a way to pay for what they really can't afford. Sensitive subject...there is nothing like the feeling of caring and being trusting and taking one up the a.s as a reward. T >Sensitive subject...there is nothing like the feeling of caring and being >trusting and taking one up the a.s as a reward. > >T Without the consideration of a reach-around ? -- &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& "Pathetic Earthlings...if you had known anything about the true nature of the universe, anything at all, you would have hidden from it in terror." - Emperor Ming &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Well... it is a sensitive subject. Did you mean to say this to *me*???? T wrote in part in his reply to my post: > > If you feel that is the way it "should be", I can only hope you get screwed > > in > > this manner some day and come out feeling it "should be" this way. T, I don't think I should have to tell you what kind of bills I got stuck with by a particular dental professional... a lifetime of bills ... **and** he was paid in full for his "care". TW > > And slammed it should be. > > [quoted text clipped - 24 lines] > > T Signature-- Sabra Broock <sabrabroock@earthlink.net > Well... it is a sensitive subject. Did you mean to say this to *me*???? > T wrote in part in his reply to my post: [quoted text clipped - 8 lines] > > TW So do you feel that is the way it "should be"? Those were your words, not mine. I take exception (and perhaps I misunderstood your words) to the concept that anyone should be obligated to continuing care when they are not being paid. I know that is reality, but I will never agree that it is the way it ":should be". I don't feel your situation is the way it "should be", but your situation and the question of the original poster are two different things. You describe paying for care that didn't work, the original poster took no issue with the care, only the fact the doctor wasn't willing to finish without getting paid. As I said, I am well aware of my legal obligations in such situations, but don't ask me to like it. T No it isn't exactly what I meant and I don't think I want to continue this discussion because it seems to all be based in a hypothetical situation at best and I don't have enough information to properly formulate my actual opinion. What happened to me wasn't about the "care that didn't work". It was about the surgeon who provided negligent care, got all of his money for doing so, and then we got stuck with finding the money for a lifetime of problems caused by "the guy" who never had anything to do with anything... or so it seems. Anyway, I don't want to argue with you. I just think that it gets really sticky when children-patients are involved in elective dental or medical procedures. Remember, my husband spent his career in private pediatics and if you think every parent paid every bill ... you should probably think again. If you think every health plan pays up ... well... Listen, have a good day and let this thing go ... ;-) TW > > Well... it is a sensitive subject. Did you mean to say this to *me*???? > > T wrote in part in his reply to my post: [quoted text clipped - 26 lines] > > T Signature-- Sabra Broock <sabrabroock@earthlink.net Using a minor child as a patient-hostage in a financial dispute between doctor and parent/s seems like a very cruel and unethical thing to do. Patients have been known to walk out of hospitals against medical advice. Maybe some of them have done so because they couldn't imagine how they could ever pay the bill. Oh well ... TW > And slammed it should be. > [quoted text clipped - 20 lines] > > >> appliances in a person's mouth? Is this sort of neglect illegal, > > >> unethical or just par for the course? Signature-- Sabra Broock <sabrabroock@earthlink.net > Using a minor child as a patient-hostage in a financial dispute between > doctor and parent/s seems like a very cruel and unethical thing to do. [quoted text clipped - 5 lines] > > TW Hostage is a very strong word. Not removing braces is not going to harm anyone any more than putting them on in the first place did. At worst it may be an inconvenience. Leaving them on a patient who probably has wanted them off since day may be the only leverage a doctor may have. For a reluctant payer, removing the last factor that may prompt payment pretty much guarantees you will be screwed. Can't and won't are two very different things. In my practice, I find a way to help people who can't, which is perhaps why I resent those who won't so much. T Yes, "hostage" is a strong word. I suppose this is one of those times when I wonder who advocates for the poor kid who may just have deadbeat parents ... or who may have parents who just aren't doing the right thing for their child. Do add insult to injury, it isn't likely the patient will learn a positive lesson from the whole thing. That saddens me. TW > > Using a minor child as a patient-hostage in a financial dispute between > > doctor and parent/s seems like a very cruel and unethical thing to do. [quoted text clipped - 21 lines] > > T Signature-- Sabra Broock <sabrabroock@earthlink.net > Yes, "hostage" is a strong word. I suppose this is one of those times > when I wonder who advocates for the poor kid who may just have deadbeat [quoted text clipped - 4 lines] > > TW Agreed, either the child is learning that his parents cannot or will not meet their financial obligations, or that those in the healthcare profession are sometimes pushed into ugly choices. Neither is pleasant. Kids get caught in the middle of too much crap these days, don't they? Put in the perspective you place it, it is most certainly sad. T Yes, they do. TW [clip] > Kids get caught in the middle of too much crap these days, don't they? > > Put in the perspective you place it, it is most certainly sad. > > T Signature-- Sabra Broock <sabrabroock@earthlink.net >Using a minor child as a patient-hostage in a financial dispute between >doctor and parent/s seems like a very cruel and unethical thing to do. Yeah, I say take 'em to court. -- "I can dance on the head of a pin as well" -Yoshimo > >Using a minor child as a patient-hostage in a financial dispute between > >doctor and parent/s seems like a very cruel and unethical thing to do. > > Yeah, I say take 'em to court. > -- Thanks for the laugh, not what she intended but quite applicable in many cases. Excellent point though, when communication is lacking the matter is not simple black and white. carabelli Yup! If I see something bad or dangerous ....... I DO NOT CARE who paid or did not pay ........ >And slammed it should be. > [quoted text clipped - 19 lines] >> >> appliances in a person's mouth? Is this sort of neglect illegal, >> >> unethical or just par for the course? SignatureJoel M. Eichen, . Philadelphia PA DISCLAIMER FOLLOWS: ********* Dental health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the SciMedDentistry gang or any other official agency either actual or fictitious or Steve Mancuso. Advice on the treatment or care of an individual patient should be obtained through consultation with a dentist who has examined that patient or is familiar with that patient's dental history. STANDARD DISCLAIMER My 2 cents... When I start an ortho case, I contract with the parents for a monthly payment plan. If the parents miss one month, treatment halts. If they miss a second month, the bands and brackets come off. This is a contract in writing, which the parents sign. This way I never get screwed for $5000. just my 2 cents... ~Tony > Yup! > [quoted text clipped - 25 lines] >>>>>appliances in a person's mouth? Is this sort of neglect illegal, >>>>>unethical or just par for the course? And nobody is running around with bands and brackets for 8 years. Good job, Fawks > My 2 cents... > [quoted text clipped - 6 lines] > > ~Tony |
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