ONE of the largest dental chains in Singapore is charging its patients an extra fee of $7, which has led to queries from some of them.
Private dental group Q&M Dental Surgery, which has 35 clinics, started charging for 'consumables' in August.
These are items a dentist uses in treatment, such as plastic cups for gargling, which have to be disposed of after one-time use for hygiene reasons.
Signs put up at its clinics said the group had been absorbing such charges in the past. 'However, with the recent increase in costs, we have no choice but to pass the additional charges for consumables to patients.'
The 12-year-old group previously absorbed such costs in its fee, said its general manager, Miss S.J. Foo. But it decided to tack on the extra charge because of inflation and rising costs, she added.
Rather than factor consumables into its treatment fees and raise those, it decided to itemise consumables separately 'for transparency's sake', she said.
But the extra charge is not sitting well with some of its patients.
Mr Nicklaus Goh, whose mother was charged the fee at a Q&M branch in Bukit Batok last month, said: 'Whenever we go to the dentist, we expect it to be clean. Why should we pay more for sterilisation? Does that mean I'll get dirty equipment if I don't pay the $7?'
Undergraduate Jason Hau, 23, who visited a Q&M-affiliated clinic in Boon Lay recently but said he might stop because of the new charges, said: 'It's unfair for them to use transparency as an excuse to raise charges.'
Some others felt that while it was fair to charge patients for consumables, the fee was too high. Ms Lilian Lee, 70, said: 'It's okay because infection control is important, but it's kind of expensive.'
Mr James Ong, 66, suggested it be waived for retirees like him.
A check with 11 dental clinics and groups found that some, especially the bigger ones, also charge for consumables.
NTUC Denticare, which has 13 outlets, started charging consumable fees of $2 for non-surgical and $5 for surgical procedures in 2003, after the deadly Sars outbreak raised greater awareness of infection control.
Its chief operating officer, Mr Wong Tuck Wah, said: 'Other practices may choose to put the charge (for infection-control consumables) on the whole bill, but we choose to be transparent.'
Dentigiene's two outlets have been charging a fee of $5 since April.
The National Dental Centre has also been charging consumable fees of $8 for outpatients and $42.50 for dental operations, and has levied the charge from as far back as 10 years ago.
The fee started appearing in bills from April 1, when all clinics were required by the Health Ministry to provide patients with bills itemising separate charges.
Trainee teacher Myra Khoo, 22, who received treatment at the National Dental Centre, felt the charge was steep but small compared with her orthodontic procedures, which cost about $1,000.
Dental charges islandwide range from about $30 for a simple consultation to more than $4,000 for orthodontic treatment.
The clinics that do not impose consumables fees are mainly the smaller and the public ones.
The five National Healthcare Group polyclinics and four SingHealth polyclinics that provide dental services still factor consumables into their treatment costs, while six small clinics The Straits Times contacted said they absorbed this cost.
Dr Eugene Quek, from Ascension Dental Clinic in Jurong, said $7 'sounds like a lot' to pay for consumables. He estimates that these expenses, which his clinic absorbs, come up to less than $5 per patient.
Dr Chen Chok Mang, from Mandarin Dental Clinic in Bukit Timah, said: 'We consider (consumables) a business overhead - in every business, there are always overheads you have to bear.'
But Denticare's Mr Wong said: 'Patients can pay $500 to $600 for a procedure and gripe over a $2 charge.'
The Singapore Dental Association does not have guidelines on whether clinics should charge for consumables.
Its ethics committee chairman, Dr Raymond Ang, said: 'If a clinic practises adequate infection control procedures, it is their business decision whether to factor the costs incurred inside their treatment fees or to pass the costs on as a consumable charge.'
caiwj@sph.com.sg
KNOW WHAT YOU'RE PAYING FOR
CHARGES for 'consumables' by dentists may have come to patients' attention only because of a recent Health Ministry rule about itemised bills.
From April 1, all medical and dental clinics have had to give a breakdown of bills. They also
have to display screening and consultation charges prominently at their premises. This is to make medical charges more transparent.
The national dentists' union, the Singapore Dental Association, said such transparency is important, especially after it removed dental fee guidelines from its website last year for competitive reasons.
Then, the Singapore Medical Association, Singapore Dental Council and other professional regulatory bodies scrapped fee guidelines to avoid breaching the Competition Act, which came into effect in January 2006. The Act does not allow professional bodies to impose fee guidelines, as this could be seen as price-fixing.
This story was first published in The Straits Times on Oct 6, 2008.
