Annoying experience at the dentist’s office today, where I was pushed hard about an in-home sleep study. (No worries - my insurance company will pay for it!) Why does the dentist suddenly care how I’m sleeping? Turns out my insurance will also pay for the appliance he’d make for me to wear at night if I have sleep apnea.
The questionnaire/screening tool was clearly designed to elicit scores pointing to the need for a sleep study: a dozen questions with values of 4, 6, or 8 points for each “yes” answer. Anything more than 8 points and you need a sleep study. Before you get “carried out in a box,” as my dentist actually said.
The questions included: have you gained weight you find difficult to take off? (I suggest that 80 percent of the people reading this would say yes. I don’t think 6 pounds puts you in a box.) Do you wake up more often than once a night? (Yes. To pee.) Do you sometimes wake up not feeling well-rested? (Yes. There are things I worry about that occasionally keep me up. Sleep apnea is not one of them.)
Sounds like a sweet deal for the sleep study company - how many people can’t rack up 8 points with questions like those? I only wound up with 4 points (I fibbed), then was asked multiple times if I was “sure” of my answers. No one ever told me I snored? But I have such a high palate and small mouth! I was truly uncomfortable - it seemed such a clear upsell to me.
At my last MD’s appointment, I had to complete a questionnaire that was obviously looking for symptoms of depression - copyrighted by a pharmaceutical company that sells several antidepressants. I’m not depressed, and I’m not looking for my MD to tell me I am based on a drug company’s questionnaire.
Obviously, sleep apnea and depression are serious medical concerns - but it’s a turnoff when screenings are so obviously geared toward pushing the patient into ever more testing, medication, and treatment. No more questionnaires for me.
This is interesting. There is one major doc in my area who does the sleep studies ( he has a terrific personality). He recommends the breathing apparatus most often, and rarely, the mouth guard. He refers to one dentist, as least from my observation. It sounds like your dentist is looking for business.
I absolutely believe that sleep issues are problematic, especially for post menopausal women. Also, depressive symptoms are common. I just don’t believe that dentists are the ones to diagnose. Obviously, I’m biased, as I’ve spent 40+ years studying these issues. My intake form does not include any dental questions.
When I saw this thread title, I thought it was about annoyance with forms that make you fill out every detail of your insurance card, and then they just scan the card anyway!
This is worse. Maybe he’s sold all his tooth whitening kits and wants more $$$. The only nighttime dental appliance he should be considering is the one that people wear to prevent them from grinding their teeth.
I once had a new dentist insist I needed over $10,000 in work, including multiple fillings and crowns and a bite guard… Some of it was urgent she insisted, some could wait for my insurance to re-up. I scheduled the urgent stuff, including filling cavities she convinced me were going to have me in excruciating pain any day, then I got sick and couldn’t make it to my appointments for a few months. I realized that after all that time nothing was bothering me so I went to my kids’ family dentist for a second opinion. His diagnosis was, “You have one tooth that might require a filling some time in the future, but I don’t see anything that needs to be done now.” That was five years ago and I’ve had nothing but cleanings since then.
Yes, some dentists are VERY aggressive at trying to drum up business for themselves, often unwarranted. Each time I’ve moved and had to find a new dentist, I do ask people I know but twice I’ve gone to dentists like that and had to fire them.
“New dentist” as in just starting practice and needing to pay off huge dental school debt and debt from starting a new practice or purchasing an existing one?
I have had a dentist ask me if I snore. (nothing was said about going to a sleep study). When I asked why they wanted to know I was told that my gums were dried out, an indication of sleeping with an open mouth which in turn is tied to snoring.
I can accept that sort of questioning, a dentist concerned about dried out gums makes sense to me. I would have been turned off if I had been told to go to the sleep study and have a mouthpiece made.
My dentist offered me the opportunity to do a fancy oral cancer scan with some sort of blue light for the low, low price of $99. I declined. I’m in my 40s and have never used tobacco. The visual inspection of my mouth twice a year after the cleanings is fine, thank you very much.
My ENT and Gyn both now have signage in their offices offering facial fillers/botox.
I agree this cross-marketing has gotten out of hand. I guess I shouldn’t be surprised if I’m offered facial cosmetic procedures by the GI next year when I have my 50 year colonoscopy.
Yes, it could be that she’d put herself into debt and needed to drum up some business. She had just taken over the practice of my long-time dentist who had retired. Due to chemo I was over a year overdue for a checkup and it was possible I had damage caused by treatment, so I was surprised by the extent of what she recommended but I trusted that at least some of it need to be done. The family dentist from whom I got the second opinion asked me to forward the estimate I’d received. I think he was considering reporting her to the licensing board.
Saw an ad in a magazine for a test to diagnose adult adhd. Took the test. Might have been this one: https://www.additudemag.com/adhd-symptoms-test-adults/
Think I was having a bad week of work when I took it and to be honest I just don’t have the career work ethic that I had at 22! Anyway-Passed the tests with flying colors and the results indicated i was probably ADHD and I should head to my GP pronto. Told my GP about the test. (He was skeptical
Presumably, they make enough extra by recommending colonoscopy every decade as the primary screening for colon cancer, rather than using the much cheaper and non-invasive fecal immunochemical test (FIT) yearly as the primary screening, with colonoscopy as the secondary if FIT finds something. The expected number of colonoscopies in the latter case is about half as many as using colonoscopy as the primary (with resulting lower risk of harm from screening), but using FIT as the primary is about 90% as effective at preventing colon cancer deaths, according to the tables at the end of https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/colorectal-cancer-screening2 .
As an anesthesiologist I am overwhelmed by surgical patients with undiagnosed obstructive sleep apnea. I found that over the past 15 years of practice, the numbers of patients I encounter with OSA has exploded. It is a major risk factor for post operative respiratory failure and death. But when I discuss the need for testing and treatment, the majority of patients look at me with a dismissive stare. I don’t understand why patients are so concerned about their anesthesia care but aren’t willing to follow my genuine recommendations. I sometimes cringe to think that these patients may go home post operatively with powerful opioids for their pain which could potentially kill them.
Addressing another topic in this thread is the need for practitioners to generate revenues. As an example, I treat alcoholics in my other specialty of addiction medicine. I successfully treat these patients with a drug that cost $2500 per month with staggering positive results. So, the appointments are 30 minutes, I provide my personal cell phone number, I frequently text follow ups in between monthly appointments, I have after hour and weekend appointments. Yet, the insurance companies won’t pays me more than $70 per appointment for those services. However, they don’t blink at paying $2500 per month for a drug or $1500 per day for Hep C treatment. So, the pressure for practitioners to generate revenues impacts their ability to remain in practice. Otherwise, they have to generate income through volume (5-10 minute appointments).
These examples are the tip of the iceberg of frustrations for both health professionals and the patients.
I had to show my H a video of him sleeping, with his breath stopping for frightful periods of time, for him to agree to finally see a sleep doc. Then he had to wait 3 months for an appointment!
He had an official test for sleep apnea, but the doc told us that the best test was the testimony of a co-sleeper. I’m so glad he got it treated. I think some people just dismiss it as snoring, and not as the health threat that it is.
When I went for my annual dermatology check, I was given a survey about skin care, on an iPad while I was waiting for the doc. I didn’t know what it was and I was a sitting duck in the exam room, so of course I took it. Turns out they were looking to recommend which skin care products from the line they sell would work best for me. The Derm office is really pushing products and non-medical procedures; I get open house invites via email regularly.
When I went for my last physical in Nov 2017, I was asked to fill out a survey relating to symptoms of depression and anxiety. My dr said they had to do that now (she’s a solo practitioner part of an umbrella group). The kicker was when I was billed for the “Depression Screening”. I called the business office to complain about being billed for something I had to fill out that the dr barely looked at. It was removed from my bill, but next physical I won’t even bother to complete the survey.
When I googled the medical code for the screening, the first hit that came up was (I’m paraphrasing) “how to increase revenue”.
That said, my dentist mentioned it too, but only because he had to yell at me to take a breath during a twilight anesthesia procedure (just once, but still was being cautious). That was fine with me.