$125 for an initial consultation - WHOA!

[margarets]

So I'm shopping for an ortho. My case is pretty straightforward - just shifting some teeth a few mm back to where they were when my braces came off in the 1980s.

First consult was free, with an VERY well-known ortho who teaches at two university dental schools and invented one of the braces systems currently on the market (which allows him to offer that system at a considerable discount). However, he just looked at my teeth, took some measurements, made some notes and quoted me some costs and timeframes.

Second consult was $50, but more thorough. He took a bunch of photos and will send them to me along with a letter outlining his recommendations and so on. He was more cautious about timeframes and costs, saying that until he has my records etc and can study everything properly, he can only ballpark it.

Today I called up an ortho for my third consultation. I gotta say I didn't like the vibe I got over the phone. The receptionist wanted to know if I'd already had a consultation and how many, and if I had insurance. I said yes, and she wanted to know more details about it but I put her off saying I didn't have them with me (I actually have them memorized). Then she told me the consultation is 1.5 hours during which time I will see a "treatment coordinator" and the ortho, and it costs $125. That strikes me as pretty steep. I'm also guessing I'd see more of the coordinator than the ortho. Honestly I got the vibe that they want to squeeze the maximum $$ out of the situation, which is why they wanted my insurance details before I even showed up.

I have no problem paying for a consultation. An ortho's time is money. I'm surprised any of them do it for free. But it's interesting that the big-shot ortho charged nothing, and the downtown (i.e. very high overhead costs) ortho charged $50, but this guy needs $125?

So it's back to the drawing board finding that third ortho. What do you guys think of that price?

[sirwired]

It's not unreasonable. During the time he's having extensive chats with you, he's not seeing patients that are actually paying him money. Maybe he found that too much of his time was being wasted with "window shoppers."

Now, it may be too high for you (and for other patients he's scaring off) but it's just a business decision on his part, and not particularly sleazy.

That said... you were correct in not even mentioning what insurance you had; it doesn't matter at all until it's time for you to make payment arrangements. I wouldn't have answered either.

[margarets]

I feel like I'm being criticized for something I never said. Like "sleazy".

Being called a "window shopper" also seems unduly negative. How else can I check out various orthos and choose the one that is right for me?

I've found another ortho who charges $75 for a consultation. If they all charged over $100 I would accept that as the going rate, but since 1 out of 4 does, not so much. I don't object to paying; I object to being gouged.

I also didn't care for being asked how many consultations I've already had, like I was being sussed out as a prospect. (None of the other offices asked about that.) That, plus the questions about my insurance.... yeah, off-putting. Already I don't trust them.

[sirwired]

Whoa, slow down there... When I talked about "window shopping" I don't view that as a bad thing. Of course it is reasonable and proper to see multiple orthodontists (some of which charge a fee, some of which don't), before making a treatment decision. I never said it wasn't.

I wasn't criticizing you at all, I was merely saying that the ortho has made a reasonable business decision in charging for a consult. Whether or not you pay his fee is of course up to you.

(My remark about "sleazy" came from asking for a consult fee which didn't cross the line, asking for insurance info before even showing up which did.)

[tinkc]

Do you know anyone that has had braces or friends/co-workers with kids in braces that you could go to for a 3rd consult? I think $150 is outrageous for only a consultation. I guess if it's 1.5 hours then that makes sense but why on earth is a consultation 1.5 hours? I went to 3 ortho consults but each consultation was maybe 15 minutes? More like 10 minutes or less of actual consultation with the orthodontist, the other time was the assistant telling me about the different types of braces and their pros/cons. If you feel comfortable with making a decision between the 2 you've already seen then a 3rd isn't really necessary, in my opinion.

[Robot Teeth]

At the dental college I go to for my treatment, the consultation was $20. At the private practice orthodontist I went to for a second option, the consult was free (which is a surprise, since they wanted almost $2000 more for treatment). In both cases, the orthodontist spent about ten minutes with me, precluded by an assistant for about ten minutes.

Maybe if you live in a REALLY upscale neighborhood, like Beverly Hills or Manhattan or something, the price might be justifiable, but $150 for an initial consult sounds like an orthodontist who thinks their time is pure gold, and I can't go for that for a few different reasons.

[LoveOrtho]

I went to 2 consultations and the first was $75 and the second I think was around $60 so a total of $135. Which I think isn't a lot because you really want to look until you find an ortho that you are comfortable with. With that said, $125 for 1 consultation seems a bit much. If you can find another ortho that you really like or go to another consultation with another ortho, maybe you can save that money towards your actual braces...

~LoveOrtho

[vincent168]

Tbh, you should worry about the consultation costs but more about the treatment costs. If the consultation is completely free but they over charge for the braces, who cares?
In short, the bulk of the money is going into the treatment, so focus on that more.

[ArchWired28]

I have personally consulted 2 orthos (the 2nd one is my current ortho), and talked over the phone with the offices of two more, and all of them offered free consultations. This is however NOT a rule and every office decides for themselves whether they want to offer it free (complimentary) or charge for it. Of course if everyone else in the area offers it for free and you want to charge a fee, you will have no patients But in the remote areas where there's not many orthos, or in the very upscale places, perhaps they can charge for it and still stay competitive.

I am reading a professional ortho forum from time to time, and this question has been raised by a junior orthodontist. The responces he got pretty much said that if he wants to attract patients, he should do it for free. Of course it's a hassle and a waste of time as not all patients will stay for treatment, but it does pay off eventually. Otherwise, there would not have been so many orthos who offer it complimentary.

To pay or not to pay, is of course solely up to you, margarets. Knowing how much the treatment costs these days, I don't think the fee of $125 is unreasonable; however, if I could get it for free, there's no way on Earth I would have paid that fee, unless I definitely want this ortho to treat me (as I understand, this is not the case with you). In any case, good luck with your search!

[margarets]

Thanks for the replies everyone.

Surprisingly, the big-shot (free consult) ortho is so far the cheapest. He was very specific about the costs:

$450 for records
$1100 to put on the braces (top only, self-ligating, non-ceramic, good old metal ones)
$179 per appointment x 5 appointments = $895
(If I need six appts there's no extra charge, it's no biggie)
$550 (approx) for retainer stuff, depending on what I choose
Total: $2995

Second ortho ballparked it at $4000, but the true price is TBD after records.

I do live in a high-cost city, but all of these orthos are in similarly expensive areas, three are within walking distance of each other. Curious, isn't it?

My gut tells me to go with the first guy, but you know how you feel you should look around anyway, just to be sure? That's where I'm at.

[ArchWired28]

margarets
the consultations may be for a fee, but your treatment estimates seem very low to me. While 4K is somewhere near the lowest end of the spectrum, the $2990 is simply unheard of, at least in my area. Is it prior to the insurance and all of that? I think you should be very happy with the 1st guy, at least I would have been. Plus you've said he's a professor at the dental school? This is definitely a big plus in my eyes.

Oh, I missed that it is top only. Well, 3K still feels reasonable to me.

[vincent168]

On the topic of shopping for an ortho, what makes the ortho a 'good' one?
The cheapest?
The nicest?
The one that suggests the use of most appliances?

[zcenteno]

as far a i know, dentists and orthodontists consultation fee is actually for FREE. the rule that they have is, they cant charge you with anything unless they already have done something with you. Like the first Doc did, he just looked at your teeth but didnt take impressions and photograph, and charged you nothing. Now if the Doc started taking impressions, pictures, xrays and stuff, thats the time they would be charging you because of the technical expenses, but as i stated earlier the consultation itself, the "...measurements, made some notes and quoted me some costs and timeframes" is for FREE.

Dentists/orthodontists do not have consultation fee, if they did they would've had uniform cost for it. notice that every dentist/orthodontist you go to have different consultation fee? thats because they base it on the technical stuff they do to ya like impressions, pictures and xrays.


and plus if i were you, id go to the first doc, well first because he's honest,2nd he's a pro compared to the others you went to .

[margarets]

I can only assume that in my area orthos can charge what they want for a consultation. Today's consultation will cost $75, but this time I want them to print out the pictures they will take (so I can post them here!).

The second ortho ($50 consultation) sent his letter and it was a bit of a letdown. It just summarized the issues we discussed, so no new info there, and there was no mention of costs. I can see that he just won't get specific until I've already sunk $450 with him for records, at which point I'll be less likely to switch if his treatment plan turns out to be really expensive.

I've pretty much decided to go with the first ortho. Today's consult is just for my own due diligence, so it's just as well that I'm paying since otherwise it's a waste of the ortho's time. This one has a "treatment coordinator" too. Interesting how the big-time professor-inventor ortho doesn't have one, he just did it all himself!

I think a 'good' ortho is one you feel comfortable with, so you can ask all the questions you need, and who is using reasonably up-to-date methods and materials.

[margarets]

WELL, I spoke too soon about today's ortho. It was worth the $75 because I feel like I got more insights into my situation and options.

In addition to noticing my overbite, crossbite and spacing issues, she also addressed a cosmetic issue that always bugged me (I never mentioned it, she brought it up). My two front teeth are kind of long in relation to the ones next to it. It gives me a kind of rabbity look. Her idea is to bring the two long ones up a bit and the others down a bit, to give a more balanced look. I didn't even know that was an option! I like that option!

She also thinks that all I need are six braces on the top teeth. The others are all in a good line and she sees no reason to fiddle with them. She strongly suggested that I get a bottom retainer too, since I've been very lucky to keep the bottoms straight since 1985 with zero retention, so best to keep them that way. Also she recommended a bonded retainer for the top front teeth since they clearly want to move.

I also like that she gave me a statement re: costs. With the others it was all verbal, which makes me a little nervous. (E.g. after my records are done, they might change their tune and say I "need" a bunch of more stuff done.)

She quoted me $3200 all in. Records, clear braces (non-self-ligating though), appointments and retainers.

So, I'm going to sleep on it, check in with insurance company and then decide. But I think the third ortho is the one.