To Pay or Not to Pay

Post from DSN User:

“Ok. True safe place moment:

I place a #30 Implant and patient has it restored. Screw comes loose and he doesn’t tell anyone. GP finds it’s loose during a Hygiene visit and re-tightens screw. It comes loose again. GP remakes crown. Comes loose again. GP refers to pros who adjusts occlusion and replaces screw. Comes loose…because it’s fractured! GP asks me to “fix” it all for free. I do. Remove implant, graft and replace implant. Now GP is asking me to cover the lab bill for the crown now.

This was caused by the patient not telling anyone the screw was loose and had likely nothing to do with my work.

Do I pay the bill just to save face?”


Sometimes we’re placed in unfortunate situations where you have to either swallow your pride or stand your ground. Does this User pay the bill and have it seem like she is at fault or does she not pay it and potentially ruin her relationship with the GP?


  • “I always see the big picture. If this is an isolated issue with the GP office, then I would cover it and move on. You will lose here. IMO it’s the price to pay to play this game of dentistry”

———–> Reply from Original Poster:  “I think I have to pay it so the relationship is not damaged with any of the parties. Referrals and Google reviews run everything.”

———–> Reply from Original Commentator: “Unfortunately, I agree with you. I had a guy two weeks ago get hurt by my assistants suction. He praised me and expressed his affection for me, but does not want to come back to my office. Figure that out..? He said he wants all his money credited to his black AMEX or he will take it further…whatever that means. I am returning $6k after all that work and aggravation. It really sucks, but I just don’t need the stress if attorneys and such.”

  • In my opinion a refund is an omission of guilt. I would have an open and honest conversation with the GP and pros. Then send them both gift cards thanking them for working with you. The implant process is just as much the surgeon who places responsibility as it is the restorative docs. I don’t see why you owe the money. But an act of goodwill with a gift card would be nice.”
  • “My instinct is hell no don’t pay the bill…..butttt, how important is this referral source? If it is a big source of patients, I would pay it, but try to make your case about it somehow. Unless you think it will burn a bridge with the referring doctor. I just don’t see how you can be responsible to pay for it though…That’s a crappy position to be in. You already replaced the implant and all? Maybe express that you did your part as a gesture of good will/faith etc. Sorry if the above was already said, I’m sure it was kinda TLDR tbh”

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It seems as though this DSN User is going to choose to bite the bullet and pay the bill in order to maintain the relationship with her GP. It’s a tough pill to swallow when you know the scenario shouldn’t have played out this way but because there are other factors that can affect the future you do what you have to do. This DSN User received a considerable amount of feedback. Some say ‘HECK NO!’ while others say ‘do it for good measure’. In the long run it’s a learning experience that will help to implement new policies to later avoid other cases like this.  Maybe the biggest take-away as a specialist is that referrals drive your business…and you have to do extraordinary things sometimes to keep referral sources happy. 

Thankfully this DSN User had a place to vent. A place she could go to express her frustrations and hear what others had to say about the deplorable position she’s in. If you’re looking for more actionable information like this, join DSN!