Im tired of issues. Recently, I had another one with a horrible dentist. Luckily, I saw the light before consenting to extensive treatment. Here is my letter to the recent bad dentist I saw: Dear Dr. Schimanovsky: After seeing you in November, I wrote a detailed letter to you in order to point out that prior to, during, and after my visit, you engaged in professional misconduct. I wrote directly to you because I believe a patient or client should talk directly to the provider if he or she feels individually wronged by malpractice instead of going to the State or using legal avenues. I learned that in my studies about dispute resolution and in the mediation of such disputes while being an advocate. My letter was not simply an expression of “concerns,” but rather I wanted to explain your misconduct and give you an opportunity to apologize and take necessary actions to remedy the situation. Your letter failed to address most of my allegations, and with your written words, you put forth more false information about what happened at your office and about what was conveyed to me while there. When my husband contacted your office, he was clear that this was a dental emergency and asked about the cost of replacement of the onlay and basic appointment fees. In fact, no specifics were discussed about typical comprehensive exams with him or me or about what I would have to pay in particular. I would have to be seen first, according to your own staff and you. And, no specific discussion of this occurred while I was at your office either. I wasn’t your only patient that afternoon, and you only came in to talk with me after your dental assistant had met with me. Based on knowing the exam fee, I brought a money order for the amount of the appointment, adding in enough for one x-ray. Because you did tell me about a discount for those that pay with check in full, I deducted 5% and paid with a check. I figured it was better to come with excess money than not enough. When I arrived, I waited for about 30 minutes and was then taken back to a dental room in the back. Your dental hygienist was the person that saw me first. She said she had to take an x-ray and proceeded to take three views. I remember this, because I was wondering why more than one x-ray was being taken and if there would be additional cost. Then, I thought, “Maybe the first two x-rays are counted as one in the first appointment and the third wouldn’t count because it was a mistake?” I wasn’t prepared for what was happening and that is why I was having all of these questions run through my mind about the bill at the time. In fact, I discussed this with you just before we finished our visit, which I will discuss later in this letter. To continue, the first view taken was to look at the tooth--for the determination of its health. After the first one, she said she needed to take another, and as I mentioned in my previous letter, it was my vague understanding that this was aken to see how my teeth came together. It wasn’t explained at all like you make it sound in your letter. She just took x-rays as though she had been given the authority to do so. Then, she said she needed a repeat of the last x-ray due to an inadequate image. All x-rays were taken with no explanation from you, because you were not present. It did not happen the way you stated it did. You didn’t come and take one x-ray, examine me, and then call for another to confirm the cavity. Again, these were done by your dental assistant with no prior explanation given by you to me. Therefore, your assertion that I was able to consent to a second x-ray is false. The time when you entered the picture was after those three x-rays had already been taken. I remember you walked in and abruptly told me about the cavity. No x-ray was taken after you informed me about your diagnosis of a cavity. I remember, because I was surprised by your statement. To add to this, the “cavity” that you insist “clearly shows on an x-ray image” was not confirmed by my dentist. Not only did he say there was no decay, but he stated that there was no evidence of a cavity after x-ray analysis and examination. Further, the statements you have made both during the office visit and in your letter dated December 7, 2014 are inconsistent with your own treatment plan and estimate, which I will enclose. On your estimate, you make no mention of any teeth that have caries. This is true even though you claim this cavity has affected the dentine layer. Instead, you put figures for a four-surface porcelain onlay and “crown buildup, including any pins.” Even this estimate shows porcelain as the material of choice, with gold being optional for $100.00 more. This shows your inconsistency. Regardless, it is standard practice and the duty of a dentist to indicate any teeth with known cavities in a treatment plan. If you were so concerned and sure, why is it absent from your estimate and treatment plan? I want to touch on a couple of things again, because you failed to acknowledge them when you responded to my last letter, and your letter exacerbated the situation in general. When I first spoke to you on the phone, you stated to me that porcelain was a durable material today (like gold) and suggested that it was an option even knowing the exact tooth that was affected, a back molar--a tooth used for grinding food during eating. When we actually met, only then did you say to me gold would need to be used, because there was fracture potential with porcelain, noting it was a in a location where gold holds up better. This is something you should have told me right away on the phone, because I told you the affected tooth, my history of grinding, and expressed wanting porcelain for safety reasons. I still don’t understand why you would do this, because it is clear to me now that gold is typically used where chewing forces increase fracture potential. I feel this deception was used to get me into the office. The next issue was made worse by your own words from the letter sent to me. At the end of our visit, I was trying to get specifics about cost from you. I asked for an estimate of cost for the diagnosed cavity. You stated that you could not tell me the exact cost, because you had not obtained a proper x-ray of the tooth adjacent to the back molar. This is in direct conflict with your letter’s contention, where you state, “During exam I noted a cavity which required another x-ray to make sure we had all the details.” If you had all of the details from the x-ray, why couldn’t you tell me the cost of fixing the decayed area? You would know the number of surfaces, having all the necessary details you had gathered. Instead, you stated that it would likely be covered in the cost of build-up. Build-up is something my current dentist told me was obvious I didn’t need. He also told me that you had captured an image of more than just that tooth, and that the tooth next to the molar that needs the crown showed no evidence of a cavity either. It is this lack of explanation and the obvious misstatements you have made that cause me to distrust you and your practice of dentistry. Why would you tell me you could not see the adjacent tooth if you have properly x-rayed the troubled area? When I saw the dentist, I provided a set of previous x-rays from 2009, after talking to him and his staff. This allowed for a look at that same tooth years ago. Before these x-rays were taken in 2009, I had seen another dentist. In order to make flossing easier, he had used a small dentist circular saw between my bottom molars and some teeth on the top. This caused a space between my teeth to show on x-ray. It was the new dentist’s diagnosis that it was this gap showing on x-ray, and that there was a slight snag caused when the previous dentist sanded to allow for flossing. So it wasn’t a cavity but an actual space on both 2009 x-rays and yours. There isn’t a cavity, and this is shown clearly when you compare the old x-rays to the new. The teeth look the same in views taken years apart. My doctor explained that part of the restoration involves removing the cement used and preparation of the tooth by the removal of some tooth material, done so the tooth will accommodate the new onlay. After doing this, the gold restoration easily fit on my tooth and corrected the issue with flossing and gapping that was caused by the original dentist’s work. Basically, cavity or not (and there wasn’t one), that part of the tooth had to be removed to allow for the placement of the onlay anyway. I’m going to enclose a copy of my dentist’s treatment plan and estimate. One thing you will notice when comparing his to yours is that neither one has any mention of a cavity. The other thing that will stand out is that unnecessary build-up charges are included in your estimate while they are not present on his. The final thing that anyone examining this will notice is that you have given an estimate for a porcelain onlay with the option of gold, which is in writing. The evidence of misconduct shows itself on your paperwork, and as you have provided nothing other than an untrue explanation, this really looks suspicious. By the way, my current dentist had no listed possibility for porcelain, because he explained it was not indicated for that type of tooth. On its surface, after looking at your insistence that there is a deep cavity versus what my dentist has stated to the contrary, it might appear that you are trying to bill me for unnecessary services purely for monetary gain. I have full confidence in my dentist’s opinion, being that he has twenty-five years experience with no complaints and an excellent reputation. In addition, he has been treating my mother for 16 years. Based solely on the logic of your letter, I shouldn’t have to pay you anything more. You stated that I was informed of the last x-ray, then consented, and I should pay due to these “facts.” I wasn’t informed by you, that is clear by this letter, and thus I never consented for the last x-rays in particular. Aside from your argument, I don’t see how you seriously could conclude that I am have no good reason or cause for wanting a refund and not to pay a balance for services performed unethically and without adequate discussion with me (your patient). When you told me lies and misdiagnosed, the reason for my request for refund and writing off of the balance should have become evident. In this case, that deception stands out on paper and provides a record of it. I am not going to submit further payment to you. I am giving you a chance to think about the valid points I’ve made. With what has occurred here, going to the State or reporting this on any level is definitely justified. I simply can’t tolerate unethical behavior from a provider. If you are unwilling to resolve the situation upon seeing my requests, I will file an official complaint with the State of Oregon’s Board of Dentistry. With the x-rays and paperwork I have, they will be able to investigate this easily. I place a high value on paying my providers in a timely fashion when they perform work within proper guidelines. However, you failed to do so. This is not a large amount of money, however, and I am taking Christmas break until January 2nd, 2015. I prefer to work this out between us, but that is in your hands.
Posted on: Tue, 16 Dec 2014 19:40:55 +0000
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