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What is wrong, when it comes to professional services and fees payable, much misunderstanding arises from patients and providers. Why does this happen? Maxillofacial and cosmetically targeted surgeries involves techniques, comfort and facility, all of which are made available for the public. Choosing to be a patient and accepting professional advice and health, particularly dental health, is a number one priority in life. Those who prefer to spend funds, time and resources on hedonistic pleasures should re-examine their values. What can be done about it? To alleviate this some strategies, derived from previous publications [1,2] which help enormously are laid out below.

Coping strategies: Three initial fundamental principles:

• WAHUM TOMYO (What Arrangements Have You Made To Meet Your Obligations?)

• IPP (Immediate Payment)

• BTP (Big Toe Philosophy)

WAHUM TOMYO (What Arrangements Have You Made To Meet Your Obligations?)

This question sifts out those people who are not committed to paying. Beware of folk who dismiss an up-front quote, or “do not care about the amount involved”. Those who wish to obtain “bang for their buck” will volunteer information about how to pay. Be ready to discuss payment arrangement; a written treatment plan and ‘guestimate’ of fees is assembled (IPP). The omission of this question in practice leads to much misunderstanding of obligations stresses the patient and becomes a recrudescent source of distress to all.

IPP (Immediate Payment Practice)

Many anxieties arise in practice when it comes to collecting fees for services rendered. Whenever any work is planned, it is imperative that the entire treatment plan is written out and costs indicated. This should be provided to the patient before any therapy is initiated. Assumption is the mother of all foul-ups. This treatment planning eliminates all confusion about what was said, faulty recollections, and accurately indicates expected fees to be charged. This offer of service with acceptance constitutes a legal contract. Once provided, a clear statement saying “This is an Immediate Payment Practice (IPP). Fees are payable on completion of service”. Co-payments and immediate settlement by insurers should be clarified before treatment.

BTP (Big Toe Philosophy)

Too many dentists allow their own feelings to influence application of IPP. This must not be allowed; as suggested above with IPP, when therapy is completed, as the patient exits the chair, the first thing they do is put their foot on the floor. Now the dentist must invoke BTP. As the patients big toe of the foot (usually covered by socks, stockings and shoes) touches the floor, a gentle reminder that the practice functions on IPP. “Kindly attend to your obligations with the receptionist before leaving.” After which the patient will settle their finances before leaving.

People who expect spectacular dentistry must expect to pay spectacular prices.