How do you handle a patient who can not afford the treatments you recommend?

If I really believe that a patient can't afford my fees and they need extensive treatment I often refer them to another more affordable dental provider. Treatment by a qualified but inexpensive provider for these patients is preferable to no treatment.  For example, for the last several years I have been referring patients to Montefiore Dental Clinic in the Bronx if they need multiple implants and can't afford to have them done by my regular implant surgeons. My patients who have gone there have had decent results. Once they have completed their implant treatment they often return for their regular re care visits to my office.

Some patients do claim they can't afford my treatment, but I believe they actually can afford it. What they actually mean is" I they would like to find a less expensive dental provider". That is also is OK  with me. Although sometimes I personally believe that "cheap can be expensive" in the long run, all of us need to decide how to best budget our own finances.

It can be more difficult when what  a patient really wants have me perform their treatments and not be referred to another dentist. Sometimes, the solution is  they need help planning their treatments so that they can better handle the finances involved. For some  patients staging their treatments is the answer. Staging treatments involves taking care of the most urgent procedures first, and then planning for some of their more expensive procedures later. For example, lets consider a patient needing  two crowns, an extraction , several fillings and a root canal. Stage one treatment would involve cleaning out all moderate to large cavities, and if possible having their root canal completed. If teeth will require crowns then long term interim restorations need to be placed to help keep the condition of he teeth stable. In stage II treatment, crowns or implants maybe placed. Extractions of non infected, but non restorable teeth can often wait until patients finances will allow an implant placement. This sort of treatment staging  can work out well for some patients who need managing their dental finances

Many patients will ask for a discount when they need extensive treatment. This poses problems for  dentists. Although some dentists do extend  financial consideration to patients who need extensive dental treatment, it should be pointed out that it costs money to deliver dental care. Generally dental overheads run from 60-70% of a dental bill. Also, complicated treatment plans often require a dentist spend additional time planning and managing a patients treatments.

When extending a discount, a dentist should be aware of the time and costs involved in providing treatment. Sometimes, when a dentist provides a large fee reduction for a case he can end up either with little profit or even find that providing the patients treatment ended up costing the practice money. Either circumstance is alright if a dentist's intention was  to perform a charitable action, but it often it occurs because  the dentist fails to accurately calculate the costs of completing a patient's treatment.