Dentists Are Pushing Medical Credit Cards on Patients

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I wonder if the doctors receive a finders fee?

Though the dentist’s office had told Zhao he was signing up for a payment plan with no interest, he says, in fact he had signed up for what’s known as a deferred-interest credit card, which charges no interest on payments during a promotional period, but imposes hefty fees on top of the original payments if the user doesn’t pay off the entire balance within that time. Zhao says he had to take out a chunk of his savings to pay off the card so he wouldn’t be charged 26.99% in deferred interest

Zhao’s experience is not just the story of a bad encounter with a medical provider. It highlights the way medical credit cards are increasingly pushed on patients across America as the costs of health, dental, and veterinary procedures rise. CareCredit had 12 million cardholders and 270,000 participating providers in 2024, up from 4.4 million cardholders and 177,000 participating providers a decade prior, according to a May 2023 report by the Consumer Financial Protection Bureau (CFPB). “The growing promotion and use of medical cards and installment loans,” the CFPB wrote, “can increase the financial burden on patients who may pay more than they otherwise would pay and may compromise medical outcomes.”

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Well, of course, offering patients/ clients multiple options for paying their bills sure sounds much more sinister when presented like this.

As a dentist who offered Care Credit along with cash, check, and the Holy Trinity (Visa, Mastercard and American Express)…along with different options for handling their dental problems wherever possible…this account is very misleading. Sure the company offered “90 days interest free”…just like PC Richards used to at the time (yep, I know I’m dating myself but Care Credit was available back when this store was still in business)…but the very high interest rate after that wasn’t hidden.

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Years ago I had a dentist offer financing to me for a $3,000 procedure I determined to be of little utility.

I explained to him that paying 12% interest only made it that much more expensive, and then decamped to getting my dental work done at the OHSU dental school.

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Certainly, but remember that surveys indicate a large percentage of the population can’t handle more than $400-500 in unexpected expenses.

DB2

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The “correct cost” of the $3,000 procedure was $300 or less. So absent the obscene level of price gouging, the average person would have been better able to afford it.

And this kind of thing is happening in every corner of health care, dentistry, artificial limbs, eye glasses, hearing aids, etc. every day. It’s just patriotic capitalism and lack of price competition.

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How do you know this? You went round price shopping for a quote on the exact same procedure(s)?

I note upstream that you’d determined the proposed treatment to be of little utility. That could certainly be the case, depending on what the proposed treatment was and its value to you (expensive restoration of, say, badly decayed upper incisors is a waste of money for someone who doesn’t care what they look like…regardless of how cheap the price quoted is). There is no “correct cost” however…no matter how resentful you might be of a quoted fee. A big chunk of my fees were earmarked for fixed overheads and, although not usually included under that accounting heading, that to my mind meant providing a meaningful compensation package for my employees, including…but not limited to…a bounce free paycheck. I know, it’s a shocker, right? That there are folk out there in the workforce, toiling away for a “JC” who don’t want to work for less than they think they’re worth.

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Of course. You should know better than even asking the question by now. {{ LOL }}

The dentist wanted $3,000 for an acrylic night guard. As an engineer, I have some familiarity with the cost of manufacturing a 3 ounce piece of plastic that looked suspiciously like the plastic mouthpiece I could purchase at the sporting goods store for $1.99 that is typically used by football players and boxers.

The dentist complained that the sports mouthpieces were made out of soft plastic that I’d chew through in short order. The $3,000 device was being specially-crafted for my dental bite and then custom fitted to ensure that there weren’t any high spots or stress points that could damage my teeth under the lion or tiger like forces being developed by the human bite.

I wasn’t buying it, and told him I could likely buy a whole case of the $1.99 model for $100 and swap them out weekly if I was destroying them at a rapid pace.

When I got to the OHSU Dental School, they confirmed that the acrylic night guard was likely a good idea for me, and they could provide a de rigueur, custom-fitted model made of rich, Corinthian acrylic for the princely sum of $225. I’ve had 3 such devices made by OHSU over the past 15 years. I believe the last one was about 4 years ago and cost $345.

I’ve got a hilarious anecdote from the dental chair for you.

When I had the last night guard fitted 4 years ago, my Dental student Don had it set perfectly fine and had the Professor come over to inspect the job.

She started making adjustments to the appliance that were making the fit worse, and I quickly detected that the problem was that she was just press-fitting the night guard to my teeth with her fingers and wasn’t letting me bite down on it to make sure that it was firmly seated in the same place with each successive adjustment she was doing. And as the fit got worse and worse, I complained more firmly that she really needed to let me bite down on the appliance to make sure it was in the same position with each adjustment. After about 20 minutes of frustration, the bell rung for the end of student clinic hours, all activity stopped, and my night guard wasn’t in any shape to let me leave the building with it. I’d have to make another 30 minute drive back and forth to Portland for a second try at a later date. I said to her, “You know, Don pretty much had this thing perfect before you got your fingers on it.”

When I returned, Don had a different Professor supervising the operation.

And the lesson of the story? In both Medicine and Dentistry, you really need to listen to the patient – especially when they know what they’re talking about. {{ LOL }}

Anyway, after seeing this done 3 or 4 times, I’m pretty sure I could a bang-up, American Dental Society-approved job of fitting the device on my own with the red and black marking tape and the Dremel drill I have at home. If they raise prices much more, I may try to manufacture my own. {{ LOL }}

https://www.dremel.com/images/dremel-4000-512s-sanding-wood-tools-tip3--03d36291cf584492a5d2e2eca01d0b5a.jpg?imgWidth=720&imgHeight=404&scale=1

Of course, I’d be using a much smaller burr than the one in the picture.

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Oh you were perfectly right…the nightguard was likely of little utility. At $3000, $300 … and whatever the bargain price charged for your student fitted job. Was never able to see the point of them except for some modest protection for sports (my daughter had a whole line upbof custom fitted mouthguards in funky colours and patterns). That was a bit of misleading bait and switch, though…these plastic toys aren’t really dentistry. I thought you meant actual treatment.

Of course, I did have “success” with one antisnoring playthings. We had a delivery of some free blanks and instructions for manufacture. As I was about to pitch them in the recycling bin, my office manager asked if I’d make one up for her husband, so he dropped by for me to make some impressions and study models and I produced a masterpiece (I had a vacuum former for bleaching trays/fluoride trays etc) that was very comfy. Duly fitted it. A few days later, a very happy office manager…the gizmo definitely worked!!! No snoring. However, the mechanism was questionable. Having the device in his mouth actually stopped the husband from falling asleep. No snoring, but the constant tossing and turning kept her awake just the same. I’d been right in the first place, the gizmo belonged in the garbage…and I didn’t have to pay a dime for the knowledge gained. My sort of continuing education course.

I do thank you for your service, though. To this day, I’m grateful to those patients who were generous with their time and forbearance in allowing me and my classmates to make our mistakes under guidance before being let out unsupervised on the general public. In truth, I didn’t make many mistakes…I was probably more of a Don than, say, a Phil (one of my classmates who, despite our extensive practise in restorative dentistry and remedial work for him, never passed his licensing exam). However patients had no choice of student and students no choice of supervisor…which can actually be an equally dodgy proposition. One reason I decided it was a better idea to make sure there was minimal need for any restorative work in the future. Dental treatment is fine…for other people.

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Mine is for teeth grinding, not snoring and I believe it’s helping to prevent additional damage – otherwise I wouldn’t have purchased four to date. Just glad that I was able to prevent myself from getting screwed on the price of the first one.

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Phil worked on me the first year. He’d spend the first two hours of the 3-hour clinic period futzing around with the plaster cast they’d made of my mouth and his paperwork, then a professor would come over to the chair and tell Phil to pick up the handpiece and do something – you don’t want to keep the patient in the chair forever. He disappeared before the end of the term and other students more expertly completed the treatment plan. I doubt he graduated, let alone took the licensing exam.

When the time came to fit the night guard, the professor was very demanding that I not leave the chair without a perfect fit and set the student back to adjust one thing or another over the full 3-hour period. So I was at least grateful for that.

The next term I got assigned the Class Valedictorian who appeared to be doing expert work in a timely fashion with little supervision. I had her replace two molars that were more silver amalgam filling than tooth with crowns as long as I had her working on my case. She apparently joined the Navy when they promised her a Dental Pathology residency along with paying off her student loans. The Navy is lucky to have her if she’s still there.

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This is the gadget I use. It’s thermoset plastic. Put the thing in a pot of boiling water for a few minutes, then bite on it, to form it to your teeth.

Screenshot 2025-01-16 at 09-47-04 DenTek Professional-Fit Dental Guard for Nighttime Teeth Grinding 1 ct Meijer
Screenshot 2025-01-16 at 09-47-04 DenTek Professional-Fit Dental Guard for Nighttime Teeth Grinding 1 ct Meijer1228×580 229 KB

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Hey, that’s exactly how I would form the mouth guards for my kids who chose to play certain sports that require a mouth guard. Every year or so we would get new ones, boil them up briefly, and then fit them into the mouth.

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you get my vote for best post of the year so far. Thanks, this is very helpful

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The $1.99 football mouthpieces I used worked the same way, but they’re soft plastic that allows you to continue to chew at night.

The $300 acrylic devices I’ve been using for 15+ years are hard plastic that you can’t chew, so you end up just biting down on it without grinding. That’s why they last 4 to 5 years.

I noticed that there a now a lot of labs that sell them for $130 to $200, but you have to fit them yourself and grind down the high spots properly. I’m confident I could that that myself after having seen it done 3 or 4 times. But a person new to this would likely spend a lot of time in trial and error to get it right.

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