September 22nd, 2010


Eric Howton, DDS

Anna has a family dentist. We'll call him "Doctor 1." After my first visit, and seeing that my gums needed attention, he referred me to Doctor 2. (Remember the $20,000 of work?) After all of that fiasco, I called Doctor 2 to have my x-rays forwarded to a periodontist who was "in-network" to minimize my out-of-pocket expenses...

Turns out Dr. 2 left the practice, and turned over all her patients to Dr. 3, who was now part of my insurance network. Easy enough. I had him price out the work and my part was something like $800 by forgoing the $6000 in high-tech implants for extracted teeth. I still had Dr. 2's price sheet was astounded that all his costs were exactly half of hers.

At my three-month check-in I was told that I had beaten periodontal disease (apparently caused by my childhood braces)and that my gums were extremely healthy. This was great news. A couple of months ago, I made an appointment in what I thought was complications of the root plane & scaling, but by the time I actually got in the chair, I'd decided it was something worse. Much worse: A cavity.

As it turns out I was right - something they "missed" on the x-ray five months earlier. Its so bad, in fact, that the root is exposed. This explains all the pain. The periodontist decided to send me to his general dentist, Doctor 4, as this is not the periodontists specialty. Another "consultation" and a choice: root canal & crown at $1500 out-of-pocket for a "best guess" that it'll "take" (whatever that means), or have it pulled. But because it was a molar, and sunk into my sinus cavity, he needed an oral surgeon to do that, so referred me to Doctor 5.

This is where it gets complicated, but only because not only am I not a dentist. I am also not an insurance specialist - the difficulty being of course I don't know which questions to ask whom. Also, as it turns out, there is apparently zero dynamic in the relationship amongst these dentists, so if something needed to get done, it was up to me to facilitate it which, as stated above, is difficult when you don't know what it is you're supposed to facilitate. Hrumph!

I call to make the appointment with Doctor 5. Despite the fact that I've had four consultations thus far, this doctor requires his own. At some point my insurance is going to stop paying for these. I will admit that so far my costs have been just about zero through all of this, bite-wing x-rays and all. Doctor 5, however will require a panoramic x-ray. I'm pretty sure I already have one of these, but they require one within the last 12-months or they'll have to take another. I call my insurance to see if I'm eligible. They only cover panoramics every three-years, and didn't seem to either understand or care, how that policy was at odds with the dentists needs. Good news though, they showed I had a panoramic taken in March of this year!

I call Doctor 3 to get the panoramic sent to Doctor 5. "Its not a panoramic. Its an FMX; Full-Mouth Series." Its explained to me how they differ and why the periodontist uses one and the oral surgeon uses the other. This makes crystal clear sense to me. I call the insurance again. "You told me I had a panoramic, but that's not what was taken," I start. The insurance agent finishes for me, "Correct, its an FMX; Full-Mouth Series." I start to frustrate a little, and explain that Doctor 5 can't use an FMX and why a panoramic is needed. The agent explains that you get either one, or the other, every three years, and I'd had the FMX.

I call Doctor 5 and through gritted teeth ask how much a complete panoramic is, out-of-pocket cost and get what is probably the second best news I could've received - its only $80. *Whew* My next task is to get some Vicodin for my aching exposed root. Here's where things get really, really fun. Allergists have a number which represent "extremely high" for pollen count and fungus. The Dallas/Fort Worth Metroplex is double those numbers - currently the highest in the nation. If you recall, the tooth with the exposed nerve is sunk into my sinus cavity, which up until recently, was manageable pain. But no longer. No longer by a long shot.

I call Doctor 4 and ask if he prescribes medication. The answer is no. Since I haven't yet seen Doctor 5, there's no way I'm going to get anything from him, so I contact Doctor 3. Who needs to see me (for a consultation) before he'll prescribe anything. I explain that there has been "no change" in my condition since he saw me last. "But its been over a month," I'm told. I explain very patiently the irrelevance of how long its been since he's seen me BECAUSE HE ENTRUSTED MY CARE TO ANOTHER DENTIST OF HIS CHOOSING. Remember the part about these referrals having no real dynamic to the relationship?

I call Doctor 4 again, and he's not happy I haven't yet been to see Doctor 5, but prescribes me Vicodin nonetheless. I rode that wave for seven hours last night, and while it didn't allow me to sleep, it did allow me to lay in bed without pain.

I haven't slept in three days.
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