Dentist charging a "behavioral fee" for ASD child?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It sounds like your kid's issues created a longer appointment than the time normally allotted. Maybe that's why the fee.

OP here--Nope--the appointment was finished within the allotted time (even though we started late, while we waited for Dr. Shin!).

I don't believe that for a second, come on OP. Getting in and out of the chair costs time. Stopping treatment to be consoled costs time.

You aren't a fit, she said as much. And I bet her schedule got delayed accommodating your kid and may have cost her some clients.

Accept and move on.

You sound insane.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP--Just to note, I asked why we were being charged a "behavioral fee," and where we had agreed to do so. After asking several questions about this extra charge, and after other parents in the office also began to take notice, I was told that we no longer had to pay the fee. But please be forewarned about this practice.

I mean, to be fair you admitted in your post that your child’s behaviors were a lot. And required extra time and accommodations, which Dr shin provided? (And did YOU give the office advanced notice that this type of extra time and accommodation would be necessary for your child?—and did they “agree” to it?) Just trying to apply your rationale for NOT paying to their rationale for charging to begin with.

The fact that it took extra time and accommodation to successfully complete this appointment was not in dispute by you. But how can they warn you in advance about a special behavioral fee (which probably took extra staff, and time they weren’t prepared for given the regular appointment time allotted) if they don’t have any clue until you get there that there are any special circumstances??

Sounds to me like they were trying to go forward with the appointment as best as possible while also being compensated fairly …and yet when you pitched a fit about it, they removed the fee just to avoid the hassle of you.
And likely wanted to just have you leave in peace.
But you were so ungrateful and resentful that you decided to come on here and trash them online anyway. Wow.

Nothing she said or did seems out of line to me. I’m sorry that you are faced with some challenges in this department, but no one owes you services.

Did you even read the thread? The appt did not take longer than allotted, even though the dr did. It start on time. They had warned ahead of time. This is ridiculous. I would report to the licensing board, and I’m glad you have warned us here.

My neurotypical children go to a dentist with open plan stations. I routinely see much more dramatic and disruptive behavior from nt children there. I take my daughter who has sensory issues to Smile Wonders in Reston even though we don’t live anywhere near there. They are amazing. We have had extra charges bc they have suggested adding more frequent appts to get my dd used to things. They’ve discussed the plan and fees ahead of time and have been more than reasonable.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think what makes me really mad on your behalf OP is that this dentist treated your kid like a burden. ALL kids deserve dental care not just the perfect ones. We SN parents get so used to our kids getting excluded due to their disability that it starts to seem like they aren’t entitled to anything. But all kids deserve health care - it should be the one place where “behaviors” don’t get your kid kicked out. That’s not to say that it may not reach a point where the medical professional has to call in more support or refer to a specialist. But you don’t just … fire your harder to treat patients!! And then try to charge them for it. SO unprofessional. She should have come up with a plan to either get more behavioral support for her office or figure out a referral.

Oh course health care providers do. How strange to think they shouldn't.

They shouldn’t. It’s unethical and unprofessional, and possibly illegal if done in violation of the ADA.

To make sure I understand, you think it is ok to force a person to treat a someone they don't have the capacity for. Hold them hostage and have no choice in the matter, like your own little slave.

Healthcare providers do have a choice and they are permitted to have free will, even if you think they are your personal property.

[Anonymous]

From an article re: dental ethics for treatment of people with disabilities:
"The code of professional conduct explains that although dentists may exercise reasonable discretion in selecting patients for their practices, they shall not refuse to accept patients into their practice or deny dental service to patients because of the patient’s race, creed, color, gender, sexual orientation, gender identity, national origin, or disability.

An advisory opinion on disability discrimination in the Code of Ethics states: As is the case with all patients, when considering the treatment of patients with a physical, intellectual or developmental disability or disabilities . . . the individual dentist should determine if they have the need of another’s skills, knowledge, equipment or expertise, and if so, consultation or referral . . . is indicated.

Dentists should welcome patients with developmental disabilities just as they would welcome all patients. If they feel unprepared to treat such patients, they should consult with a colleague who has experience with this patient population, read literature on this topic, and provide accommodations necessary to include such patients in the decision-making process, either personally or through an agent chosen by the patient.

It would be unjust for a dentist to decline to treat patients with developmental disabilities because the dentist feels uncomfortable. "


https://helenjournal.org/january-2024/xxvil80d4fswrjpqim1as5l8hdubhl

[Anonymous]

This sounds potentially illegal.

[Anonymous]

Anonymous wrote:We just took our DC to Dr. Elizabeth Shin at Bethesda Chevy Chase Dentistry. We went to her after seeing her recommended on this board. But after our awful experience today, I wanted to warn other parents on this listserv that she attempted to charge us a $120 "behavioral fee" for our ASD/ADHD child.

DC has anxiety and sensitivity to dental care. DC and got out of the dental chair several times when things got overwhelming, but was quickly able to get back in with parental support. DC needed to take breaks and spit frequently, had difficulty choosing the flavor of toothpaste, and covered ears when Dr. Shin sang a song about tooth brushing (DC has sensitivity around this). To Dr. Shin's credit, DC was able to get through the appointment with a full cleaning and fluoride treatment on time.

Yes, the visit was more challenging than with NT kids. But Dr. Shin's actions after the appointment spoke volumes--she asked me "where on the spectrum" our child was, and informed me that "while I'm sure your child is very intelligent," he was "too high on the spectrum" for her to be able to accept as a patient. When I went to check out at the registration desk, I was informed that Dr. Shin was charging us an extra $120 for a "behavioral fee."

If your child requires extra time for the appointment, it is fair for the dentist to ask you to pay for that time.

[Anonymous]

Even if you were done in the allocated time for the appointment, it might have taken more of the dentist's time than planned (vs. hygienists, assistants, etc.). It makes sense that they would charge for that time (though they should call it something else).

[Anonymous]

Anonymous wrote:

Anonymous wrote:We just took our DC to Dr. Elizabeth Shin at Bethesda Chevy Chase Dentistry. We went to her after seeing her recommended on this board. But after our awful experience today, I wanted to warn other parents on this listserv that she attempted to charge us a $120 "behavioral fee" for our ASD/ADHD child.

DC has anxiety and sensitivity to dental care. DC and got out of the dental chair several times when things got overwhelming, but was quickly able to get back in with parental support. DC needed to take breaks and spit frequently, had difficulty choosing the flavor of toothpaste, and covered ears when Dr. Shin sang a song about tooth brushing (DC has sensitivity around this). To Dr. Shin's credit, DC was able to get through the appointment with a full cleaning and fluoride treatment on time.

Yes, the visit was more challenging than with NT kids. But Dr. Shin's actions after the appointment spoke volumes--she asked me "where on the spectrum" our child was, and informed me that "while I'm sure your child is very intelligent," he was "too high on the spectrum" for her to be able to accept as a patient. When I went to check out at the registration desk, I was informed that Dr. Shin was charging us an extra $120 for a "behavioral fee."

If your child requires extra time for the appointment, it is fair for the dentist to ask you to pay for that time.

Look, another poster who can't read!

[Anonymous]

If it takes extra effort for the dentist to perform the procedure, then they can charge you for the extra service.

[Anonymous]

I don't know why everyone is bashing OP when she went to a dentist YOU ALL recommended as being good for children with special needs and she told them ahead of time what the child's diagnosis/concerns were and was told they could handle it. It would be one thing for the dentist to say at the end of the appointment: "I'm sorry but I don't think that I am the right dentist for your child" and maybe even provide a few other names, but to throw in a fake fee that OP was not previously informed of is total BS.

[Anonymous]

Yeah its all just deplorable.
You are well rid of each other.

[Anonymous]

Anonymous wrote:If it takes extra effort for the dentist to perform the procedure, then they can charge you for the extra service.

But this did not take extra time, so why are you posting this? Just to bash a special needs family?

[Anonymous]

No one should be charged a surprise fee. Offices should be transparent about all fees. If it's not on their website, OP should not have to pay it (I see that she did not have to pay it after arguing - good for you, OP).

--
That said, looking at their website, they suggest having a televisit before the main appointment if a child has anxiety - did you do that, OP?

Meet Dr. Shin before your visit
Schedule a teledentistry appointment prior to the first dental visit. Even one meeting/exposure like this can help to preempt/relieve anxiety. This is a fun way to meet Dr. Shin and ask questions prior to your visit.

Anxiety
Schedule a teledentistry appointment prior to the first dental visit. Even one meeting/exposure like this can help to preempt/relieve anxiety. Also, please consider that your child takes emotional clues from you. If you feel anxiety going to the dentist, please try to leave that at the door. Be positive, cheerful, and emphasize learning and fun. You are helping to shape the way your child feels about dental visits and their oral health and hygiene.

[Anonymous]

Jesus who are these posters intent on giving OP a rough time? This behavior by the dentist office is appalling. I don’t know if it’s illegal or not but I am glad to know so I NEVER go there. Dr. Shin should be happy about that because my kid is way worse than OPs.

OP, I go to Kids Teeth in Rockville. They were recommended to me by a friend with neurotypical children. We didn’t have a diagnosis when we started there and it turned out it’s the worst of all things to trigger my kids anxiety. The first few appointments were absolutely excruciating for me as a parent because I was so embarrassed and shocked because I had never seen behavior like that before from my child, who was counseled out of preschool not long after. It was awful. But both the dentist and the hygienist were amazing and patient and kind and put detailed notes in the file and we figured it out. It’s much better now. I have never once been charged extra or made to feel bad about my child- the dentist has always been extremely generous in describing the variety of anxiety that dentists trigger and working with us on what would help.

It wasn’t until I started bringing my younger, NT child that I realized we were being given a ton of extra time (though I would absolutely have paid extra, it definitely would be nice to be given a heads up if they were going to do that) and the dentist herself was spending extra time and care with us. There are kind people out there.

[Anonymous]

Anonymous wrote:Go to Dr Lewis at Ensor Johnson Lewis in Bethesda. Specializes in special needs dentistry.

Thanks, PP!
Not OP but I also struggle to support my DS with ASD at dental appointments. I appreciate this info!!