Second opinion - my Orthodontist just fired me!

[DoctoraBella]

My orthodontist told me I was not the best Invisalign candidate so I got banded with Damon 3s last December + acceledent. There were plenty of roadblocks with my treatment these past 7 months and I thought my treatment was moving slower than anticipated but what do I know... Once elastic a went on I decided to go see an ortho in my area who is top 1% Invisalign to get a second opinion. I had mild crowding with mild overjet so not a complex case and as a professional I am struggling with braces and taking care of patients directly. I got an estimate for transferring to him for Invisalign and proceeded to ask my current ortho what the refund would be for me if I transfer at 7 months in. It turns out I'd be out another $2k (she says I'm 50% done which I seriously doubt) so I have a lot to think about, but in fact it seems she made my decision for me and says since our communication is at an "impasse" that I should go elsewhere! Shouldn't this be my decision? It seems she is offended or something. But now I am in such a bad position! Either forced to pay and switch or go back to an ortho who thinks I don't trust her judgment. Do I have any recourse?

[Candyland]

That's terrible, I'm very sorry. I feel I may be in a similar situation soon. I am going to see a second Ortho next week to see if the problems I have can be corrected as my first Ortho doesn't seem to be able/doesn't want to correct them. My treatment is completely paid for already so I don't know what, if anything, I may be able to get back as a refund if I decide to change offices. I work as a nurse in a medical office and I know firsthand that some physicians don't handle criticism well, she probably did get offended that you wanted to change Orthos and is being less than professional about it. Unfortunately this happens a lot in the medical field. Good luck with everything.

[djspeece]

Interesting. Are you a physician? I noted that you see patients, so I am just curious about your profession, and if you have had any similar situations from any of your patients.

I don't know all the details of course, but you have done a nice job of presenting your side of things. My first thought was that if your treatment is proceeding too slowly with braces and powerchains, I am not certain invisalign would be quicker. But I am an RN and not a DDS much less an orthodontist. My second thought involves the contract that you likely signed -- does it give the orthodontist the option to terminate treatment; and under what conditions can you the patient terminate treatment and with what financial implications? But probably, as you likely know, a serious heart-to-heart conversation is on order to sort out the "roadblocks" you mention, and your consideration of invisalign at this point in your treatment. As the other nurse mentioned, some physicians can be sensitive to these sorts of things but in general, in my experience, they want the patient to make an informed decision and if they want to change the therapeutic approach and are aware of the likely consequences -- then they usually wish the patient well and both can move on. I have not seen a physician terminate treatment because a patient sought another opinion and was considering another approach.
It would appear by your account though, that the relationship has soured and/or your orthodontist is sensitive to perceived criticism. In any event, I hope you can sort things out and do what is best for you. That is what is important in the final analysis. Just make sure that invisalign is the real answer for you.

[sirwired]

Are your braces really an obstacle to seeing your current patients? I work in a field primarily populated by people older than me (For the first 15 years of my career, at no point was I NOT the youngest person in my department.), and my braces were not an issue. (Even problems speaking while wearing my palatal brace after surgery weren't a problem.)

That said, if you feel Invisilign is better for you, that's your choice. But a 50% refund, no matter how far you are in to your treatment, is not out of the question. (Refunds for partial treatment are usually spelled out in the initial contract.) Most of the costs to the ortho are "front-loaded"; by the time you walk out the door with your shiny new braces, there's a lot of things that had to be paid for: Marketing (including consults with patients who did not sign), x-rays, impressions, measurements, photos, treatment planning, chair and tech time for bracketing day, etc.

Lastly, a case that may look "simple" to you may be anything but. As far as I, layperson, could tell, my case was simple, and maybe doable with Invisilign. Imagine my surprise when my ortho told me, during my consult, that my case was quite complex and that he couldn't even think about a treatment plan without full records, and probably several hours staring at my models and x-rays to figure out the best way to fix my issues.

I'm not saying your case is or isn't simple, just that it's not really possible for a non-ortho to tell.

[metalliKa]

Hi, sorry your treatment is not going as you had expected. I don't know for sure, but there seems to be a lack of communication between you and your ortho. Did you convey your dissatisfaction with how the treatment is going before seeking another opinion? I know you're not obligated in anyway to let her know if you were seeking a second opinion, but that when you surprised her wanting to terminate further treatment, she may have taken offense to that. She takes that as you undermining her expertise. If you are truly wanting to go forward with Invisalign, I'd suggest you go over your signed contract carefully just to make sure there isn't any snags that can catch up with you later. And just a matter of my personal opinion, having traditional braces or Invisalign does not have any direct influence/impact on your job performance or you as a professional. Rather, it'll probably draw out the curiosity in your patients. I have had people tell me that they wish they have the courage to get braces.

Sorry I wasn't much help and hope you will get the issue resolved in your favor.

[DoctoraBella]

Hi everyone, thanks for your answers!

I agree that the communication has gone awry between me and my original Ortho, and it happened quickly. In the end, she had sent my refund check immediately before even having a conversation with me about it, and it was really unexpected. I panicked and called the Ortho I got the second opinion from and asked for help, and forwarded him all the correspondence from her, including the letter where she says I should go elsewhere because or communication is at an "impasse." Since the original estimate from the new Ortho for Invisalign was so much higher than I could afford to pay, I even asked him if he would finish up my current Damon treatment. After reviewing everything, he revised his estimate for treatment and actually the difference between the original refund and the new treatment is not very much and it is something I can actually afford without hardship. It was very kind of him to revise the estimate and I am thankful. However, he says it has to be invisalign, because he thinks it will make for a better result. Granted, he is a top 1% Invisalign provider. I know I'm in good hands and this is originally what I wanted, but my fickle self is now questioning what it will be like to adjust to yet another treatment modality now that I am used to braces, and was even coming to terms with the "awful" elastics. I was reading on AW and became very concerned about the posterior open bite issues, and am curious how my treatment will be affected now that my bite is all over the place from being in the midst of treatment. I will address these questions to my new Ortho this week (!!!) when I have my deband appointment! Eek!

In the end, I've run the gamut of emotions. I did not call my current ortho this past week when she told me she would be available (it was one of three hour-long blocks she suggested as possible times, only after I told her assistant I wanted to talk). I don't have much else to say to her at this time. I am thankful for her work but don't think I could go back to the office and be "that lady," nor trust my teeth to someone I have angered. I just hope this journey will be worthwhile, and the adjustment to invisalign is smooth. I feel like there is a new world of potential issues to tackle, and it seems overwhelming all of a sudden.

Regarding my job, I am a physician. I just felt very self conscious once the elastics went on and I felt like my mouth was so tight and having to talk through it. But I guess with invisalign I will deal with a lisp... and bad breath... etc and so on. This is so hard!

[Candyland]

Sounds like everything is working out for the best for! Good luck with the new Ortho!

[DoctoraBella]

Thanks Candy! I am nervous and somewhat sad (what!!?) about tomorrow. These things have been my second skin for 7 months and I thought when they came off I'd be done! Not doing what I'm doing now! I'll be in a retainer for a few weeks which I'm afraid might be worse than being in braces! I have tons of regrets and I cannot believe how fickle I am about it. My hand was forced though, so it is the only way.