Patient or Customer? Analyzing the Medical Upsell


By E. Eugene Webb PhD, from Bay Post Internet


Have you had the experience of going to a dentist, eye doctor, chiropractor or other medical provider and been given a reasonable looking estimate of the cost of the procedure you need or are interested in only to have that cost rise dramatically as the process begins?

There are a lot of names for this type of business practice: bait and switch, entice and transfer, trade up, up sell, move up more; or as I like to call it “lie and cheat.”

Now, there are certainly times that a medical, dental or eye procedure may require additional services, but what I am talking about is a deliberate attempt to lure you in and get you in a position where you have little option but continue with escalating costs.

My wife and I have recently experienced this process, me with a dentist and her with a Lasik process.

In my case, a large dental practice with multiple locations in the bay area that I had been using for years recommended I have an implant where a tooth had been removed.

I agreed and was referred to their traveling oral surgeon.

What started out as an estimate of about $1000 for the implant quickly ballooned into a nearly $6000 process of deep cleaning, periodontal process, oral gum surgery, tooth extraction (the tooth was on the other side of my mouth) and finally an implant.

Fortunately, they provided estimates prior to any work being performed and I have called a halt to the process.

In my wife’s case one of the larger Lasik/eye centers you see advertised in the Bay area examined my wife, who already knew she needed eye surgery but was looking for services closer to our new home.

Following the examination, she was taken to a “scheduling room”, where a non-medical professional recommended a more expensive lens and other services that “your insurance will not cover.” The cost rose to levels considerably higher than her original Lasik procedure in her other eye. She has decided to go back to her original provider even though the drive will be much longer.

The point of all of this is simply when you walk into a specialty medical facility that looks like a cross between a medieval castle and a new car dealership remember someone has to pay for all of that and that someone is you. The primary reason they don’t accept your medical insurance is that if they do, in many cases the insurance provider sets the procedure rates and that limits revenue.

It used to be you could trust your doctor to be fair and honest, and I believe that is still true in many cases. But large practices are often owned by medical businesses and run by non-medical professionals. Their objectives are revenue and return on investment.

So, if you find yourself in a closing room as opposed to an examination room being hustled for expensive procedures and add ons, especially those “your insurance” doesn’t cover, it may be time for you to do some shopping around.

These days caveat emptor (buyer beware) is just as applicable in the medical clinic, vision center or dental practice as it is at the car dealership.

These days you are more of a customer than a patient.


E. Eugene Webb PhD is the author of  In Search of Robin, So You Want to Blog.

Comments are closed.