Like Pulling Teeth

I had a tooth pulled today.

The estimated cost was $310.  In the waiting room, filling out paperwork, I noticed three interesting things:

1. No payment by checks allowed.
2. 5% discount for paying with cash.
3. And, on that long checklist that doctors require new patients to answer (medical history, medications, etc.) a very curious question:  “Do you need to speak privately with the doctor?”

I had a bankcard, but intended to write a check.  I asked the office worker if I could have a minute to run to the bank and get cash, thereby saving 5%.  She got out a calculator, in order to see how much money I would save.

“Fifteen dollars,” I said.

She had to check for herself.

“That’s right,” she said, after completing the calculation.  “Fifteen dollars.”

My bank was close.  I could be back in five minutes.  She let me go.

I would have very much liked to speak with the doctor privately.  $310 dollars, today, cleans me out.  In fact, I had an appointment last week and had to postpone it because we did not have the money.  But, I had finished the anti-biotic and the infected tooth could not wait.  I did have $310 today, and not much more.

Back up a week and ten years.  This tooth has given me a problem for ten years and cost thousands of dollars.  Two weeks ago, it became clear that it needed to come out soon.  Business being what it’s been — I asked the oral surgeons in town if they would trade me for an ad in our weekly paper (our livelihood).  I know a painter who trades paint jobs for dental work and thought I’d give it a try.  I made a generous offer.  One of them has advertised with us before.  They both declined.

So, if I had had the opportunity to speak with the doctor privately, I would have asked for the trade.  Alas, the office manager had done the asking two weeks ago, and the answer was no.  So I did not bring this up again and did not check this box.  No speaking privately with the doctor.

With blogs, Facebook, Twitter, YouTube, etc., we have a world in which most people really enjoy communication.  Most businesses want to communicate with customers.  But when you see a doctor for an extraction, the development of a doctor patient relationship is discouraged.

She gave me an opening.  Everything was ready.  X-rays complete.  Chair.  Lights.  The doctor, who I had never met, enters the room.  She introduces herself and shakes hands.

“Has this tooth been bothering you long?”

So I thought I’d find out if we could have a word before she pulled the tooth.

“Ten years,” I said.  “You want to hear the story?”

“How long will that take,” she said.

“Thirty seconds.”


I spoke quickly.  “Years ago, hours after a cleaning at the dentist’s office, the tooth began to hurt.  I went back the next day and got a filling.  It hurt worse.  He referred me to another dentist for root canal.  She sprayed cold water on the tooth and it was the most pain I’ve ever felt and she told me I did not need a root canal but had TMJ.  Went to another doctor for treatment for TMJ and he said it was not TMJ.  Lived with the pain until one rough day at work with a tough 7th grade class when, on my way to my car after work, I chomped a piece of gum and broke the tooth.  Went to a different dentist who did the root canal.  Got a crown.  A few weeks later, the crown came off.  Back to the dentist for a titanium post.  When it came out, as the dentist said “whoops,” I was told to see an oral surgeon and have it pulled.  That was two years ago.

“Was that less than 30 seconds?” I asked.  The doctor had already left the room, but the assistant told me it was.

No more talking with the doctor.  When she reappeared she said things like “lean back” and “tilt this way.”  When the procedure was over – and it was quick – she was out of the room.

I said “thank you” several times – because I very much appreciate such a skill that can alleviate my pain and put me back in action.  She was fast and efficient – and it didn’t hurt at all.  Nobody in the office thanked me.

In my view, medical care should be free for everybody, paid for with our taxes.  However, since it’s not, then why not thank the patient?  If private health care is supposed to be better because of free market competition, etc., then why does everybody act like it’s a government mandate?

When I was in Russia, just after the fall of communism, I noticed that waiters didn’t care too much about service.  The idea of gratitude toward one’s customers did not seem to exist.

On the other hand, when I was in an Italian hospital for ten days in 1976, everybody was extremely friendly – always – and that was a government system in which there was no private payment at all.  There was no discussion of a bill.  And – the doctors took great pains, and a lot of time, to communicate – taking the time, in fact, to help me look up words in my Italian-English dictionary – so we could be clear, despite the fact that they spoke no English and my Italian was really lacking, about why I was so damn sick and how they were going to help me get better!

I got lucky.  The doctor was able to pull the tooth without cutting it out, so it was only $209 (with the 5% discount for cash payment).  Ironically, they offer a discount for cash but don’t often deal with it.  They had some difficulty making change for the hundred-dollar bill.  Fortunately, one of the assistants helped out.  She had some money in her purse.

Do I need to speak privately with the doctor?  I guess not.