Making a mountain of problems out of a mole

A coworker recently had one of the worst customer service experiences I’ve ever heard about. No, it wasn’t that some big-box store refused to accept a return. And, no, it wasn’t an online retailer failing to issue a refund on a defective product. The situation is actually much more serious, because it pertains to her health.

She has what looked to her physician to be a precancerous mole that needs to be removed. The physician referred her to a dermatologist. In the dermatologist’s office, she’s asked to fill out the usual paperwork, including a form to collect her preferred method, days, and times for the dermatologist’s office to contact her. She wrote in her times and specified Thursdays and Fridays—her days off from work.

Returning the completed paperwork to the front desk, she asked, “How much will my visit cost today?” One of the staff members answers with a non-answer: “Don’t worry. We’ll bill your insurance.”

When it was her turn, she headed back to the exam room and spent about five minutes with a plastic surgeon. He saw the biopsy report and confirmed that the mole should come off via an outpatient procedure.

She returned to the front desk to figure out what needs to happen next. Hoping for some idea about the cost of the suggested outpatient procedure, she asked, “What will this procedure cost me?” This time they reply, “We don’t know.”

She explained that she needs to be able to plan for expenses like this. She asked, “Can you print out some kind of estimate?”

“No. Maybe schedule the appointment, and then we’ll have that information for you later,” they say.

A little frustrated, she left without scheduling the procedure.

Adding insult to injury, they called her Monday morning—at work!—to schedule her procedure.
They called again on Tuesday. And Wednesday!

She returned the call on Thursday—her day off and, incidentally, one of the preferred days she had listed on the dermatologist’s intake forms. The first thing they said to her on the phone? “Wow! You’re kind of hard to get ahold of!”


OK. Deep breath. She does need to have this mole removed, after all. They wanted her to schedule the appointment. She reiterated that she really needed to know what it will cost before she schedules a procedure.

The answers finally came. A grand total of $6,000 with at least $2,000 out-of-pocket. That’s a lot of cash to come up with, so she said she needed a few days to think about it.

When Monday rolled around, the calls began again. They called her on Monday, Tuesday, and Wednesday, despite the fact that she told them—via their own form!—that Thursdays and Fridays were the only days when she can take personal calls. They wanted to schedule her procedure. (Never mind that she told them she needed to think about it.)

The nail in the coffin? She got a bill in the mail for the five minutes spent with the plastic surgeon. She owes $400—after insurance. She called to say she can pay them $200 over the phone and she’ll be able to pay the remaining $200 in a couple of days.

Their reply? “Well, you didn’t discuss a payment plan with us!”


By now, she’s so frustrated and upset that she’s decided not to return to that particular practice. Meanwhile, she’s walking around with a precancerous mole that, left alone, could exact a much higher and more ominous price.

Her story troubles me on many levels. Whether you’re in dermatology, dentistry, or some other healthcare profession, ensuring that the financial side of your practice is handled every bit as professionally as the procedural side of your craft is paramount. That means having members of your staff who can confidently, ethically, and transparently manage your patients’ financial expectations. Failing to do this keeps patients in the dark about procedural costs and, essentially, leaves them in a state of powerlessness.

Practitioners should also think twice about the patient information they bother to collect. For instance, the dermatology office asked my coworker on which days they should contact her—and then they promptly ignored her input. By doing so, they simultaneously wasted her time and disrespected her wishes.

Ignoring that patient input also wasted staff/call center time. (Perhaps it’s time for that particular practice to audit its intake forms. Let’s say their call center is only operable on Mondays, Tuesdays, and Wednesdays. If that’s the case, shouldn’t their forms reflect that?)

It may not be immediate, but practices with these kinds of shortcomings are headed for trouble. They don’t inspire confidence in potential patients, who, sooner or later, may go well out of their way just to be treated with competence, transparency, and respect.