[ACEsthetics] advice on difficult patient

This transpired on friday. I will try and be brief.

A thirteen year old girl, crowding, overclosed, set back mandible, set back maxilla

treatment plan...advance premaxilla and improve inclination of upper 7 - 10), expand arches, correct overclosure, advance lower jaw and straighten. ..about 1 year....a bargain at $8,200

treatment plan and payment plan broken up into 3 phases.  We are moving to final phase which is commensurate with removal of upper braces and fine tuning of lower jaw advancement and straightening of lower teeth.  Patient has paid 2/3 but it was a total grind to get the funds.  Father has Mazerratti and private jet (according to daughter) and lives in most posh part of my town.

The dentistry is going beyond great.  The daughter and I get along great.  Mother was told to come in with payment so that we could take off upper braces and extract primary upper cuspids.  She agreed and was scheduled.  On her appointment time(while her daughter was waiting to be seated) she said that husband wasn't in town but promised ("I'm good for it") that he would be in town on wednesday and pay then.  I removed braces on top and extracted and took an impression for an upper retainer on maxilla. I have a fixed wire on 7-10 so they aren't going anywhere but want to maintain archform with removable retainer.

Friday no payments but we are told that living in Malibu is difficult and that we are hounding them for money...etc..

I normally don't get involved in this stuff but I sent an email (from the office) stating what the agreement had been and that we hadn't received payment for the extractions, previous hygiene and xrays nor the next phase of ortho.  I politely said I wouldn't relinquish retainer without payment as agreed upon.  They love the ortho that is being done...no problems there (the mother is super friendly and complimentary)

I got this email back from the father (who wasn't home as I was told):

Dr. Perkins, 

I'm hoping I have this wrong – while I was out of the country, you removed my daughter's braces and pulled two teeth, but won't give her the retainer until I come by with more money? 

Please let me know if this is the case so I can send her elsewhere and leave appropriate reviews for you online and via word of mouth. 

I just arrived in Miami and will be flying to LA tonight, but I can send/receive email.

I sent these two emails back.....

XXX-

thanks for responding.  There was an arrangement made with XX that she would be making the commensurate payment for the next phase.  She was to make the payment by the day we did the work (removed the braces and extracted necessary teeth).  This was all discussed with XX via a letter (emailed) on August 1.  She knew that payment for the next phase was due on monday (the day of treatment) but she said that you would be back on wednesday and would make the payment at that time.  Now we are being told a lot of confusing things that don't relate to our agreement.

I have poured a lot into X's case and I am quite confident that what we are doing for X is not something that you could find elsewhere.  As XX can attest, I made every effort to get the results to the point they are now in time for X's first day of school. 

I am sure you can understand that we need to get compensation for the services provided.  It has happened too frequently in the past where we provide services without payment as agreed upon (or in the time frame established).  It becomes very difficult to procure the payment after the services have been rendered.  We have provided great value to X and we hope that is valued.

I understand your position and your threats.  If you feel like X would get better treatment elsewhere you are welcome to request X's records and find another person to treat her.  I hope you find a place that is as committed as we have been.

p.s. XX advised us to go ahead and remove the upper braces and do the extractions necessary on the grounds that payment was coming on wednesday.  We would have left the braces on had we known that the payment wasn't forthcoming by that date. 

Please let me know how you want to proceed. 

Sincerely,

XXX-

I thought of another option that you might be happier with.  If you (or XX) can come in on Monday and just make the payment for the extractions, the cleaning, and the xray we took, we will give you the retainer for X.  You will have to sign a form (that we will provide) that states that you are requesting us to discontinue X's treatment.  This way you will not have to make the balance of the payment on the treatment, except for the services completed (extractions, cleaning, xrays). 

let us know

sincerely,

Getting the initial payments had been extremely fraught with false promises and game playing.....

what would you guys do?

--
Bob S. Perkins D.D.S.
www.smilesinmalibu.com

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