Sunday, February 07, 2016
Is a dentist obligated to refund money after patient's death?
A reader who is a dentist in Ohio writes that he's faced an ethical dilemma several times that has him wondering about the right thing to do.
After providing dentures or bridgework for an elderly patient and then performing following up adjustments, his patients are typically fine. But occasionally, a few weeks or months later, the patient dies. Months later, the dentist receives a call or letter from the executor of the former patient's estate saying that while reviewing the deceased's financial records he or she noticed the money that was spent on new teeth shortly before the patient's death. The executor then asks for all or part of the dentist's fee to be refunded since the patient did not live long enough to use the new teeth.
The Ohio dentist writes that while some opticians will buy-back new eyeglasses in such situations, lenses and frames can be refitted for other patients. "Dentures should never be recycled," he writes, "except in rare cases like when marooned on a small island or life boat." He asks if a tattoo artist would be expected to refund fees if a customer dies soon after purchasing a new tattoo, "assuming he didn't die from ink poisoning."
"Dentures usually require multiple office visits and significant laboratory costs," he writes. "Good will notwithstanding, many ethical dentists deny refund requests in this situation?"
Normally, the Ohio dentist refuses requests for post-mortem refunds. Although, he has on occasion forgiven a balance owed by a patient making installment payments. "Dental insurance usually pays around one-half of the denture fee," he writes. "I ask for a down payment at the start, with the balance due after the insurance check is received."
On one occasion, a patient had just retired and wanted to replace his dentures to more fully enjoy his retirement years. Three weeks after the dentures were placed, the Ohio dentist received the insurance check and mailed an invoice for the balance. His widow received it the day after he died unexpectedly. When the dentist found out he offered his condolences, and asked her to disregard the invoice. "She said he really liked his new teeth, and would be happy to pay, but I said the pleasure of knowing him was payment enough. He was exceptionally pleasant and easy to work with."
But while he occasionally forgives the balance due, he normally refuses requests for post-mortem refunds. "The amount of effort a dentist expends is the same whether a patient goes on to live 10 weeks or 20 years."
If the family of the deceased patient had an issue with the quality of the dentures, they can petition for a review of the work. But that's not what the Columbus dentist is talking about here. Here he wonders if it's ethical to refuse to refund money spent on dentures for a patient who dies shortly after the work was done.
The right thing is for the dentist to make clear what his payment policy is up front. If any patient, regardless of age, happens to die shortly after the dental work is done, that may be tragic, but it doesn't lessen the time and work that the dentist committed to the patient.
Jeffrey L. Seglin, author of The Simple Art of Business Etiquette: How to Rise to the Top by Playing Nice, is a lecturer in public policy and director of the communications program at Harvard's Kennedy School. He is also the administrator of www.jeffreyseglin.com, a blog focused on ethical issues.
Do you have ethical questions that you need answered? Send them to firstname.lastname@example.org.
Follow him on Twitter: @jseglin
(c) 2015 JEFFREY L. SEGLIN. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.