花生 Peanut

$50 Peanut Principle

Just when I thought I was safely out of Hougang, away from the alamaks …

Never did I expect Hougang to come looking for me. Yes, this couple from Hougang Ave 9. I’ve never met them in my 17 years in Hougang. Now that I’m in Orchard, they just happened to be shopping around Lucky Plaza and decided to let me take a look at Mrs Hougang’s teeth.

I didn’t see what went on at the reception area, but I don’t think my staff told them anything about consultation being free. What they probably heard was: “Consultation charges may be waived if treatment is done.” They probably didn’t stress that conversely, consultation charges will apply if they seek consultation only.

After a 10-minute consultation, the couple stepped out and my staff told them that consultation charges would be $50. They suddenly got furious. First, Mr Hougang insisted that my staff told them that consultation was free. Apparently, many alamak Singaporeans (not necessarily from Hougang) assume that “just see only” equals free consultation.

“$50 is peanuts to me. It’s just a matter of principle.” Mr Hougang claimed. “If my English is lousy, you can say that I misunderstood you. But I speak Queen’s Engrish (sic). You are not giving me free consultation like you promised.”

I explained that my staff have quite clearly informed them that consultation charges may be waived if treatment is done. Nobody said that consultation is free.

“We were just passing by. We’ve got no time for treatment. We planned to have treatment on another day. For today, we wanted to see only.” said Mr Hougang.

So does that mean he did understand that he had to pay for consultation since he was seeking consultation only? Why couldn’t he pay us some peanuts today and then let me deduct it from his treatment cost if and when his wife returns for treatment?

Still no deal. It’s the principle, not the money. He changed his argument and protested that I didn’t even put on my mask on and do a “proper” check on his wife. Wow, now we’ve got an expert who can tell me what is proper. He said that he just wanted to ask me whether his wife’s teeth could be done up nicely. He claimed that he just wanted to know “yes” or “no”. He claimed that I took less than 5 minutes, just told him “yes” and charged him a ridiculous $50. So what actually happened during consultation that made it such a rip off like Mr Hougang claimed?

The Hougang couple happily came in and the lady allowed me to examine her teeth. Her complained that her lower front teeth were almost ground to nothing. On examination, I discovered that practically all her teeth were worn out on the biting surfaces. This is likely due to bruxism, or the unconscious grinding of one’s teeth during sleep. Very often, these cases would require what we call full mouth reconstruction. It is as frightening as it sounds. All the teeth in the patient’s mouth are prepared and turned into crowns.

Mrs Hougang’s case didn’t seem that bad. Her complaint was purely cosmetic. Even though the cusps of her back teeth were all flat, she didn’t lose that much vertical height. Furthermore, her lower front teeth had a gum level that was higher than that of her lower back teeth.

This made it an ideal case for crown lengthening. I proposed root canal treatment for her 4 lower front teeth followed by crown lengthening gum surgery. This will not only bring the gum level to one that matches the back teeth, it will also provide more crown height for the proper retention of crowns. The patient’s bite need not be raised, so the other teeth need not be crowned. If tooth mobility becomes an issue after crown lengthening, we could splint the teeth in twos by joining them with crowns.

I told the couple about the different types of crowns that could be done. Conventional PFMs or full ceramics. I also explored the advantages and disadvantages of extraction followed by implants.

I didn’t take very long, probably 10 to 15 minutes, but I thought I did a very decent examination, diagnosis and prescription for her cosmetic problem and deserve to be paid $50. But no. And Mr Hougang’s last words to my staff were: “You say something wrong I can sue you.”

What a case of 恶人先告状. All because of a $50 Peanut Principle

I don’t know what it’s going to take to wake people up and stop throwing freebies like free dental checkups at patients who aren’t very motivated. It’s not that they can’t afford it. They have plans for long holidays and gigantic HDTVs. These pampered folks may not dare refuse to pay consultation charges at government clinics, but they don’t take private practitioners that seriously. As important as educating them about dental health, those who speak “Queen’s Engrish” should be taught that “just see only” is not equals to free consultation.