Re: TMJ/TMD Clinic

Dear Colleague:

As the above service to Eastern Canada has grown, I would like to take this opportunity to inform you what I do, how I do it and potential fees so that this information can be clearly relayed to patients in need of this service.

• Initial consultation: The fee for this service is $185, which includes a panoramic radiograph (a copy of which is sent to the GDP). For patients who have been involved in a motor vehicle accident, suffered other trauma and/or are under litigation a more comprehensive initial consult is required at a charge of $385. This includes a very detailed computer-analyzed anamnestic report.

• Therapies: I provide all routine therapies (eg: bite plates, medications) as well as the following in-house therapies:

- Several physical treatment modalities including but not limited to: ultrasound, iontophoresis, infrared laser, acupressure, TENS and MicroStim as well as pulsed radiofrequency.
- Massage therapy provided by a competent, highly-trained registered massage therapist.
- Injection therapy using depo-medrol/ marcaine, therapeutic Botox and synthetic joint fluid as well as prolotherapy (regenerative).
- Multidisciplinary occlusal correction when required/requested.

• Fees: we will accept direct payment from third party carriers and assist with expediting this. We can also arrange payment for funds involved in settlements from legal cases. We never accept direct payment from WCB, Indian Affairs or MSI but will assist in expediting payment directly to the patient from these organizations. It is the patient’s full responsibility to gain funding from these authorities, however, we will cooperate with this. It is essential that patients are aware that they themselves are responsible for fees related to services provided on their behalf. MSI does not “cover” detailed and comprehensive therapies for such conditions and does not dictate our standard of care. We also provide the “PatientLink” credit service to our patients.

• Legal reports: Rapid provision and total familiarity with reports for attorneys and insurance carriers is the norm as is familiarity with expert witness court appearances. Please see www.aacfp.org for expert witness code of ethics.

• Surgery: My goal is to avoid or minimize surgery whenever possible. Experience and literature indicate that less than 10% of TMJ patients are suitable candidates for surgery, even when the total range of surgical procedures is considered (not only the only limited number of surgical procedures “covered” by MSI). Nearly always, surgical patients require significant adjunctive therapy (eg: bite plate of specific design and purpose) if the surgical results are to provide maximum prognosis and efficacy.

• Emergencies: If patients are in dire pain we are able to see them within approximately 48 hours (if normal business hours).

If patients delay initiation of the totality of the treatment beyond the 6-9 month mark, it is likely that they would enter an upper quarter body chronic pain situation. Unfortunately, these patients often have major and multiple issues regarding pain control and limited prognosis for improvement (eg: fibromyalgia, Barré and Lieou Syndrome). My goal is to prevent this situation occurring with rapid delivery of therapy. If delay has occurred and patients are already in this state, they would (in my view) be better served by a referral to Dr. Stacie Saunders whose practice is limited to TMD and Orofacial pain and who is more adept at dealing with complex and chronic orofacial pain pathologies.

I do feel, however, that practicing in a multi-specialist clinic and working closely with other associated health care professionals educated (validated) in this area leaves me in the unique position to provide the multi-disciplinary team approach required to assist these unfortunate patients.

Please feel free to contact me if I can provide any further information or clarification.

Yours collegially,

Dr. Andrew Thompson
(Additional TMJ/TMD related qualifications include but are not limited to: Fellowship Eligible American Academy of Craniofacial Pain; Member - American Headache Society; Member - American Academy of Pain Medicine)

Please note that any views/opinions expressed above are those of Dr. Thompson exclusively.