Question

Respond to the following case study:

The patient is a 50-year-old male seeking care for a painful tooth. The patient called the office of his primary dentist (Provider A) for an appointment. He was told that he could come in for a cleaning, but that the doctor was not available for an examination. Upon arrival at the dental office, it was obvious to the dental hygienist that the patient was in extreme pain and had at least one failing tooth. They charged the patient for an office visit and referred him to another dental practice (Provider B) for care.

The patient followed up with Provider B early the next morning. Upon arrival, he was told that to appropriately diagnose the problem, they would need to conduct a series of scans utilizing a specialized piece of equipment. Unfortunately, the procedure was not covered by insurance. The patient agreed to the cost and the scan was completed. The patient was told that he did indeed have 2 failing teeth and that Provider B “does not do tooth extractions’’. The patient paid for the scan, was given a copy of the images on a DVD, and referred to another dental practice (Provider C) for an extraction.

The patient followed up with Provider C late the next afternoon. Upon arrival, the DVD version of the scan would not open. To verify the diagnosis, another specialized scan was conducted. After it was confirmed that the patient did have 2 failing teeth, the office manager entered the room to explain costs and treatment. The patient was informed that both teeth should be removed, a bone graft completed, and the missing teeth replaced with implants. He was told that this procedure would cost $6,000 and was not covered by insurance. When the patient responded with a bit of surprise, he was informed that the practice had a relationship with a finance company and that he could apply for a loan to have the work completed. The patient requested to have 2 teeth extracted and pass on the implants. He was told that was not the best solution, but that the doctor would remove the teeth. However, he would need to pay $1000 in advance of any work. The patient agreed and the extractions were completed. He was referred to Provider A for follow up.

Upon returning to Provider A, the patient found that no records of the diagnoses and extraction had been sent from Provider B or C. Additional treatment was therefore delayed. The patient was, by now, very frustrated. He had spent approximately $1500 out-of-pocket, seen 3 providers and lived in pain for a week while these events transpired.

What could have been done to improve the patient experience as well as overall efficiency?

Answer 1

Some of the things which could have been done to improve the patient experience as well as overall efficiency are

• A proper transmission of information between the providers to ensure a continuity of care in these type of cases. The growth of technological advancements is enormous this should have been used to its fullest.
• The Provider A teams has to be provided information to the patient to make a follow up in particular period of time to assess the prognosis or detoriation of the health status which could have adversely controlled the pain experienced by the patient