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Did you haggle with the doctor?

She never thought she could bargain at a hospital. Fatima, 43, least expected her visit to the dentist would give her the stress of a hard bargain.

"I went to the dentist for a routine tooth extraction, but he quoted a very high fee. I decided to try another dentist in the same hospital," she says.

She was immediately dangled a lower price. But she had already decided to scout for a cheaper option.

"When the second dentist looked at my file and was told I had already seen a dentist in the hospital, he was upset and told me they had fixed fees. I retorted this was indeed not the case since I had just been offered a lower fee by his colleague. Somewhat embarrassed, he muttered apologies, saying there must have been a mistake."

Unperturbed, Fatima went to a third doctor in the same hospital, and ended up paying only half of what she was initially asked to pay.

In many private healthcare facilities around the country, doctors are not only given a commission based on the income they generate, but are also awarded salary hikes based on how much money they have helped the hospital rake in.

According to some physicians, this can result in the doctors charging higher fees.

This is not the only problem. An 'income-focused' doctor may recommend unnecessary diagnostic procedures so as to make more money. It may also lead to hurried consultations in an effort to see as many patients a day as possible.

Dental services are most prone to price discrepancies, thanks to the fact that they are not covered by most insurance plans. Patients, who have to pay out of their own pockets, bargain with dentists for cheaper fees.

Currently, the Ministry of Health (MoH) does not specify the amounts to be paid for health services at private facilities. It doesn't regulate the fee doctors charge from their patients either.

However, the ministry does require all healthcare facilities to display a list of essential services in their reception area, which should include physician consultations and common procedures.

Speaking to Khaleej Times on the condition of anonymity, some of the dentists said that "over-pricing of services" is the quickest way to make more money.

One of the dentists who spoke to KT, has worked at two different private hospitals in Abu Dhabi. He says both hospitals encouraged him to quote exaggerated prices to certain patients.

"At the first private clinic I worked in, my employer told me to observe the patient, and try to figure out his/her ability to pay. He specifically told me to charge UAE nationals and Western expatriates more than others," he reveals.

He says he has also observed other unethical practices among physicians scrambling to make the extra buck.

"The doctors who are paid commissions are extremely tense and do rush jobs, something which detrimentally affects their performance. They seldom educate patients about how to maintain dental health nor do they provide basic guidelines such as avoiding hot liquids after some dental procedures. In addition, futile dental procedures are carried out when the best option is tooth extraction," he explains.

"What is most frustrating is that dentists get rewarded for this type of behaviour. The more income you generate for the hospital, the more likely you are to get a salary increase and to be favourably rated by your supervisor," he reveals.

Dr Ikram Al Shakrachi, Oral Hygienist at Dental Design Clinic in Abu Dhabi, agrees that over-pricing is rampant in private healthcare facilities, especially dental clinics, where most patients pay in cash.

"Although we strictly enforce standardised prices in our clinic, in many places people are charged based on their nationalities. The focus should be treating a sick person," she says.

After the implementation of 'Thiqa', a Health Authority-Abu Dhabi (HAAD) insurance plan for UAE nationals which came into effect on June 1 this year, a significant number of nationals are now frequenting private healthcare facilities. The plan, which includes comprehensive dental coverage, has become a substantial source of income at some private hospitals.

One of the dentists KT spoke to, said that patients with insurance plans covering dental care are almost always charged more than those who have to pay out of their pockets. "In fact, Thiqa insurance holders are sometimes charged as much as four times higher than other patients," he reveals.

Dr Jad Aoun, Director of Third Party Administration at the National Health Insurance Company (Daman), said that although physicians who have their own clinics have the right to set their own fee, charging higher fees from Thiqa card holders is illegal because it represents an abuse of government funds. Although insurance companies can reject medical claims or refuse to work with certain facilities altogether, Dr Aoun said that Daman often negotiates with doctors to get a more reasonable price.

Meanwhile, an informed source at the MoH said that although all hospitals have statistics of the number of patients they see in a day, there is currently no centre that uses these statistics to evaluate the quality of care being provided at the facilities.

asmahamid@khaleejtimes.com

• UAE