Dental Care at Community Health Care Hilltop Tacoma

Dental Care at Community Health Care Hilltop Tacoma  June 5, 2019

 

I’m writing this not to pitch a bitch, but to report what happened when I went to have a tooth evaluated at Community Health Care on Martin Luther King Jr. Way in Tacoma this past week. The coordination of care there was sadly lacking. I want to document what happened to me so you can prepare ahead if you ever run into the same kind of situation.

 

The Facts

 

I’m on warfarin for life due to a blood-clotting issue.

 

I drove to Hilltop Community Health Care Dental last Thursday (May 30) to have them evaluate a molar in my lower left jaw that is giving me fits.

 

The wonderful technician and receptionist there were awesome. I have no beef with them at all.

 

I do have a beef with what happened to me.

 

After taking two x-rays, I was given the choice of extensive and expensive dental work (a root canal, cavity-filling and replacement of the crowd that is covering the tooth) on the tooth that was giving me fits, or having it extracted.  I opted for the extraction (due to my  anemic income) and said I needed it done right away because I have a crucial public presentation to give at a convention in Forks next Saturday (June 15th) and I wanted it out and healed well before then.

 

I was asked to return that same afternoon for the extraction.

 

I drove back for the extraction and was put into the dental chair at which time a lady dentist came by to say she would pull my front tooth today but she didn’t feel confident about pulling the molar that was giving me fits and she would get someone else to do that.

 

I told her I had no intention of ever having my front tooth pulled; that I would pay to have the cavity in it filled and the porcelain veneer replaced because I didn’t intend to go to Forks (or anywhere else, for that matter) with a missing front tooth.

 

She consulted with other dentists who said they couldn’t extract the molar that day because it would take longer for the molar than for a front tooth and they were too tightly scheduled. So, they rescheduled me for the next available opportunity: this morning at 7:45.

 

(Side Note: Had they been able to pull the molar that first day I was in their office, they said I would not have been charged for the extraction, as they would have considered it a single visit. My understanding, when I drove back into town for the extraction, was that it was for the only tooth I wanted extracted—the molar!)

 

They told me to get a release from the coumadin (warfarin) clinic because the removal of a molar would be at higher-risk for excessive bleeding and they wanted to be sure I was a candidate for that (that my coumadin folks would confirm that I was fine to proceed).

 

I said fine and made those arrangements.

 

The coumadin clinic told me they almost never take a patient off warfarin for dental procedures, including extractions, because it’s far riskier to take a person off blood-clotting medications than it is to mitigate against extra bleeding. They advised me what to do if the bleeding didn’t stop, and I felt confident  I’d be able to manage. They also faxed over a dental research report documenting that patients are fine to go ahead with dental extractions because dental procedures almost NEVER require coming off blood-thinners.

 

Yesterday morning I got  a call from the Hilltop dental receptionist saying that the dentist who would do the procedure had reviewed my x-rays and information that day (he had been out of the country all week) and was requiring that I get my primary care physician to sign off on the procedure, too. My primary care physician was at home, sick, so her nurse had to take extraordinary measures to get a release for me as quickly as the dental clinic required one. So, I spent all afternoon that day getting the required release from her and from the coumadin clinic, so I could show up this morning for the procedure with all my ducks in a row.

 

All release forms were prepared, signed and faxed over yesterday afternoon by 4:45; both the coumadin clinic and my primary care physician called me to confirm they had faxed their releases over. I texted Hilltop to let them know they had been faxed.

 

Crickets.

 

So, this morning, I arrived at the scheduled time to have the tooth extracted. The receptionist asked me if I had the release forms with me. I said no; that they had been faxed to the clinic the afternoon before. She checked and said they didn’t receive them. I double-checked the fax number she gave me; she confirmed it was the right one.

 

Then she told me that the dentist also insisted that I have a recent INR test result before he would do the procedure! (My last INR test was a month ago; my next one was scheduled for tomorrow.)

 

OK, are you following me? This is my THIRD trip to Hilltop to have my tooth extracted: I’m scheduled to have it taken out within minutes and they throw this new requirement at me just after telling me they didn’t receive my release forms via fax!  (Slow burn. I’m thinking, “This is rucking fidiculous!”)

 

So, I drive across town to get my INR checked.  (Thankfully, the clinic shoehorns me in so I can get it done, and talks me down from the ledge, because they can see I’m about ready to spit tacks at the ridiculousness of it all after they’ve already jumped through hoops to approve the procedure and fax the approval the night before.)

 

My INR level is PERFECT for the procedure. I get a second release form signed and dated and the coumadin clinic faxes it over again; I also get a hard copy in case the fax doesn’t go again.

 

Then I drive to my primary care physician and tell them the fax they sent didn’t arrive. They confirm that they got a confirmation page saying it had been sent the afternoon before, and they fax it again and give me a hard copy, so I have it in hand, too.

 

So, I call back Hilltop and let them know I have the required paperwork. The receptionist confirms that she has just received both via fax, too, and says, “Hold for a moment: I might be able to get you back in here at 10.”  (It’s 9 now; an hour and a half after my tooth should have been removed this morning.)

 

She comes back on and says, “I’m sorry. Because the extraction will take about an hour, we can’t schedule you in again until Saturday morning.”

 

I say, “Fine. I’ll be there. Thank you.”

 

(Even though I will be living on Tylenol non-stop for three more days in addition to the seven days I’ve already been on it between dental visits.)

 

She apologizes.

 

I say, “I understand.” (And I do, but it’s infuriating!)

 

Here’s what should have happened:

 

A written form should have been issued to me with explicit instructions about what was required so I didn’t have to jump through hoops for days, and at the  freaking last minute yesterday afternoon and this morning, making sure all the i’s were dotted and the t’s were crossed.

 

Had I known at the outset what my responsibilities were as a patient, I could have had them done a week ago when they sent me home the first time. I did do everything they told me to in plenty of time (I am not a procrastinator); they just didn’t tell me all I needed to do, so I’ve wasted a quarter tank of gas driving all over Tacoma the past two days getting my ducks in a row, and I missed my scheduled appointment because they didn’t tell me they required a current INR reading, even though the coumadin clinic says they never take people off coumadin except under the most extraordinary of circumstances (the removal of more than three problematic teeth, for example).

 

I am going to take this report to them in the morning and hope it gives them some insight into how to handle things like this in the future.

 

And now you have a heads up in case you’re on blood thinners and you have dental surgery coming up. The receptionist at the coumadin clinic says that what I experienced is not at all unusual when dealing with dentists, so this is crucial information to know.

 

Again, what happened to me wasn’t an anomaly; it’s common, AND IT SHOULDN’T BE. People fighting painful teeth should not be forced to wait and wait and wait and jump through more hoops than necessary (especially at the last possible minute!) to get something taken care of… We’re miserable enough without having to go through all this!!!