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Monday
Jun292009

« I thought Id seen it all

Dr. Jeffrey Parrish
WSDA Columnist

When one gets to a certain age and stage in life, one begins to assume that there are not very many more surprises out there. Sure we might have a surprisingly sunny day in Seattle or a surprise e-mail from an old friend, but Im talking about concept surprises. Boy was I really surprised recently.

We are all familiar with Priceline.com where one can search and negotiate for cheap travel rates on air, hotels, or rental cars. As William Shatner, the Priceline spokesman, urges us, bargain; go lower, Namby Pamby! You can name a price that youre willing to pay and see if any airline, rental car company or hotel is willing to accept your offer.

Anyone who has used Priceline knows that sometimes that cheap airfare you found includes four stops between here and there and departure time is 0 dark 30; in other words, the leftovers. But it sure was cheap!

And can you be sure about that hotel's amenities or even cleanliness until you actually check in? I suppose the rental Chevy is the same as any other similar Chevy . . . maybe just not vacuumed before you get it.

Can you believe this same pricing concept is here in healthcare? I cant, but it is available. I am so appalled that I hesitate even giving you the Internet address www.pricedoc.com. Im positive Im going to offend those of you who advertise there. Would someone please respond and take me to task, or at least explain how you think this works in a professional manner? (And I remind you who advertise there, state law requires the name of the dentist in the ads; some of you have not provided it.)

The site includes not only dentists but physicians, optometrists, cosmetic surgeons, medispas, chiropractors and all kinds of allied health providers. One selects the procedure desired, your zip code and BOOM, heres a list of providers who will perform it, some with fees quoted. I checked to see who would augment my butt (my staff has told me I need it badly!) and one guy in Redmond popped up, but he doesnt tell me a price. So thats my only potential butt aug referral from Pricedoc.com. He does, however, quote $10,000 for a facelift. Are all facelifts the same? It appears to me that some folks need lots more work than others.

But lets say I want something called Invisalign. Fifteen dental offices pop up; six of them advertise prices ranging from $4,500 to $6,000. Some of those who quote a price indicate there are conditions (like diagnosis perhaps?), but others have no conditions. Several of them have the Make Offer option. Dont like my quoted price? Make me an offer. Have we deteriorated to the point that we can have one price for something called Invisalign? Whats the CDT code for Invisalign? Does it not vary depending on the diagnosis? Does one size truly fit all? And one office even quotes $5000 for braces with no conditions. What type of malocclusion, doctor? Trust me, with the butt augmentation I want the X cup or the bootylicous version if Im going to do this! Will that cost me more because I need more silicone or saline or whatever theyre going to put in there? Is my butt the same as every other butt that wants/needs augmenting?

Lets check out bridges. Prices vary from $1,265- $2,400 with no conditions (like, maybe, numbers of units - horseshoe for that price, doctor?) while others advertise a per unit price which makes their fees look comparatively very low. All metal? Gold, semi, or base? Porcelain-faced? All ceramic? Difficult to tell when its just bridges. How about surgical extractions? Everyone quotes a single, per tooth price with no conditions. Partial bony? Full bony? Mesially inclined lower third? Veneers - one dentist says his price is only for cash payers? So my price is different if I have insurance? Watch the ethics here.

Lets think this whole thing through just a little bit more, folks. While I have no problem with advertising per se, this approach seems to me to be extreme, especially the bargaining option. Do you really want patients who price shop this way? Can you really tell a patient (not a potential airline passenger), sight unseen, that you can complete a given procedure for $X? Are you willing to perform an isolated procedure just because someone offered a price you might accept without even having completed an exam? And are you willing to offer a refund to anyone who paid more than the lowest bidder like Orbitz.com does? Or is this entire exercise just to get (augmented or non-augmented) butts in the seats? If so, its bordering on deception. Personally, this advertising approach is something I'd stay far away from - even if it required a discounted Priceline ticket purchase.