Tuesday, 15 August 2017

MyDentist - Don't Expect Them To Stick Up For The Patient (White Fillings)

I think they need to fix the opening hours page
on their website (image from 2017-08-18)

We all hate going to the dentists. Inconvenience. Confusing terms. Pain. High costs. But at least they have your best interests at heart, right? Not always. Here's one tale about MyDentist which we came across. Or, as their stupid branding claims, {my}dentist - yep, jumping on the ridiculous iPad/Wii/WindowsMe type of falsely egocentric bandwagon, but made even worse by using non-standard punctuation. The use of {} makes it difficult (or impossible) to search for them on some mobile devices, and a pain even on a normal keyboard. They couldn't make their name more user-unfriendly if they tried. They used to be called Denticare, which was more sensible. Wonder how much they paid for that rebrand?

Interesting side note - when Denticare rebranded as MyDentist they spent money consultants and the rebranding. Many would see this as a total waste, especially since perfectly good chairs were thrown out and replaced when the company's brand colour changed to a slightly different blue, just so the chairs could match - very wasteful of money and resources.

Their current cheesy crap slogan is "helping the nation to smile", but it seems like they are just as likely to make you frown, curse and grumble, going off this story.

We've confirmed as much of this as possible. We'll call the patient Mr Ouch.

In December 2016, Mr Ouch was told by MyDentist that he needed a small filling in the side of a tooth. A really small one. He made an appointment to have the work done.

Modern dentistry. You'd expect advanced and painless techniques, invisible procedures. The 1950s were long ago, after all. You'd expect all small fillings to be white. That's what Mr Ouch assumed. And MyDentists didn't say anything to counteract that.

But MyDentist had no intention of using white fillings. They intended to drill a hole big enough for metal (amalgam, containing toxic mercury). More loss of healthy tooth, and a slab of conspicuous metal squashed into the hole like something from a Marilyn Manson video. Or the 1950s...

When Mr Ouch eventually found out their plans (no thanks to MyDentist), he was told he would have to pay a lot more money for a white filling. They insisted they would only do white fillings as private treatments (which they can obviously charge a lot more for). Mr Ouch couldn't afford it - on his low income it would have cost more than he'd made in the previous few months. He certainly didn't want the extra drilling that metal fillings require, having a phobia of dentists that required medication before treatment (something the dentists knew because they were the ones who had suggested he get sedatives prescribed by his doctor; sedatives used with their co-operation at a future MyDentist treatment). So he cancelled the appointment and wrote a letter to his dentist explaining why.

MyDentist did not bother to reply. Instead MyDentist just made a new appointment for the same treatment, without consulting him at all.

He cancelled that one too, and explained why - again. In a second and very polite letter that clearly explained the financial circumstances.

Maybe he assumed that would lead to a phone call, or help, or a third option. No, it just led to a bill for the checkup (which should have been included in the cost of the fillings if MyDentist had organised it as the patient requested). So he was forced to pay money he couldn't afford for treatment he wouldn't get, just to be told again that there were problems he couldn't afford to get treated unless he put up with extra drilling and loss of healthy tooth, and medieval metal parts being put in his mouth - extra drilling he couldn't face because of a phobia of dentists. There was no way out, and now no money left towards any treatment options. Mr Ouch was very unhappy at how all this had been managed, and he'd been left worse off than before, both financially and in terms of worsening cavities, with no immediate hope of MyDentist doing anything other than ignore his letters, and charging him money to tell him things he already knew. So much for caring for patients.

Shortly after, they asked him to fill in a satisfaction survey. He did so, and included all the information from his letters for a third time. Surely the practice manager would respond this time? Third time lucky, eh? No. Total silence. None of the letters were even acknowledged. This all added to the stress Mr Ouch was under.

Meanwhile, Mr Ouch's best friend went to a different NHS dentist and received white fillings as an NHS treatment, despite MyDentist saying that wasn't possible. The friend paid £43, but was able to deduct the £14 for their last check up last time, so they only had to pay £29 for the two small white fillings. Obviously that's a good dentist who looks at what is clinically best and what the patient wants and needs. Whereas MyDentist absolutely refused, and would only allow the option that made them most money - charging c.£140 to do it as a private treatment (£140 is the figure Mr Ouch was given by MyDentist for white fillings, which he quoted in all three communications without any contradiction - or reply - from MyDentist).

But this proved that what he'd asked for originally was possible. MyDentist had been stringing him along, and he'd had months of stress as a result, while lack of treatment made the cavities worse.

At this point Mr Ouch posted publicly on MyDentist's Facebook page. Aha! Suddenly, when other people could see it, they responded. This was the first time they had paid any attention. They could not even be bothered to reply to his letters up until that point, but of course they want to seem caring publicly.

Meanwhile, Mr Ouch did more research, and clarified that it is at the dentist's/practice's discretion as to whether some white fillings can be done on the NHS. White fillings require less drilling and can strengthen, rather than weaken, the surrounding tooth. For a small filling in the side of a tooth the best clinical option is often a white one, for those reasons. Generally the NHS favours white for front teeth, but there are valid health and clinical reasons for white being applied instead of amalgam - e.g. "The advantage of white fillings is their ability to seal and bond to the tooth structure. As a result of this seal or bond, these white fillings can be more resistant to recurrent decay. A second advantage of white fillings is that they are more insulative than silver fillings. As a result of this property, white fillings can be less sensitive to cold air, fluids, and foods. An obvious third advantage of white fillings is that they appear much more natural."

MyDentist confirmed in a public Facebook message that Mr Ouch was correct. "As per NHS guidelines, White fillings may be provided on the NHS as a band 2 where clinically appropriate [...] If the dentist agrees that the white filling is not clinically necessary then they will only offer one as a private treatment."

"Clinically appropriate" = at the dentist's discretion. In many cases "clinically appropriate" can be justified for very small fillings where minimal drilling is desirable, or the tooth wants bonding. So it is down to the dentist and the practice. In this case MyDentist was unwilling to do what would be best for the patient - and they were only willing to do it if they could charge private fees, which he could not afford, and should not have been necessary when it could be justified clinically as an NHS treatment. They were unwilling to do so.

As a result of this public discussion someone from MyDentist rang Mr Ouch on Wednesday 12th July. However, they cut off their conversation part-way through with no explanation. They later left a message asking him to ring back; he did so but there was no answer, so he left a message explaining all this on 15th July, including his phone number again, and asking for the practice to ring him back. They did not. Deafening silence. And the saga had been stretched out over seven months by that point, in which Mr Ouch had been unable to get a definitive answer from MyDentist despite multiple communications, and during which his cavity had got worse. By this point, even if MyDentist agreed to the treatment, it will have taken seven months and a lot of wasted time on his part, plus stress and worry, and cost him £13.50 extra unnecessarily. It's no wonder the whole situation had been frustrating.

Obviously, when it was not public, MyDentist would not do anything, as the ignored letters and messages proved.

Anyway, Mr Ouch posted on their Facebook page again, ever the optimist, on the hopes that MyDentist would look into it this time. He reiterated that in many cases white fillings require less drilling, and they bond to the tooth better for small cavities. There are good justifications for using them, and the NHS issues guidance but supports dentists in their clinical decision. The final say is with the dentist and practice. He asked if there was there even one dentist in the MyDentist practice who would agree to white fillings in this case, or whether the practice always over-rules the clinical judgements of the individual dentists. He ended with: "I think I've been quite patient over the last seven months, despite often getting no response from the practice. But I would like a definitive answer, please, so that I can avoid the situation dragging on forever. Thank you."

We agree. All of this should have been sorted out during the initial consultation seven months earlier. That it could drag on for so long is ridiculous; that MyDentist should seem to be so rude and stubborn and ignoring of patient concerns is even more worrying.

On 25th a MyDentist "patient support officer" rang Mr Ouch to see what she could do. She spoke to the practice and rang Mr Ouch back the next day. At which point things got even worse.

The patient support officer said they understood Mr Ouch was scared of drilling, but told him that there would be MORE drilling for a white filling than an amalgam one.

Wow. That seems to be an actual and blatant lie, unless their dentists are just misinformed, but we'll get back to that.

He was also told that MyDentist had not recorded any information about his need for sedation. It is worrying that they are so shoddy with patient records and recording important information, especially when it was their own dentist that gave Mr Ouch advice on it and treated him while on sedation. So they make errors in recording information. But that is maybe not surprising with such a high turnover of dentists (Mr Ouch says he has had around four different MyDentist dentists in the few years he had been with them).

Further, the MyDentist "patient support officer" on the phone kept reversing her position. One minute she said MyDentist only follow NHS guidelines; then when Mr Ouch pointed out that the NHS allows them flexibility for clinical reasons, and that all it requires is a dentist to agree that it is clinically necessary and justify it, she said okay, maybe there is, but they stick to their policy. So the excuse of the NHS melted away to "we do this and won't change". They chose the option that removes patient choice. She refused to accept it, and the points evidencing it had to be repeated again. It went in circles, since they won't allow patients the appropriate treatment options; it's as if they are from the dark ages.

The MyDentist "patient support officer" kept pointing to a page on NHS Choices that was aimed at giving a bit of information to patients, but she acted like it was the totality of guidance that exists in the world, some kind of holy law with no exceptions - probably because it was all the information she could find on the subject, because she was not a dentist but just someone paid to speak to angry patients. She absolutely refused to acknowledge any of the points made. And guess what NHS Choices says? This:

NHS Choices website, last checked August 2017 - "Your dentist will offer the most appropriate type of filling according to your clinical needs" - not if you are with MyDentist, they won't. In that case they'll refuse you the most appropriate type and lie about it.
 
The MyDentist "patient support officer" kept saying "I'm sorry, but ..." However, there is no point saying "I'm sorry, but ..." Sorrow means you admit you have not acted in the best way, and requires change for the future. Without that it is a lie to say you are sorry. Likewise it is a lie to say "I understand" when you then willfully misunderstand, and flat-out deny what is being said, even when it is backed up by evidence. Mr Ouch said that instead of MyDentist's "patient support officer" making him feel better, or listened to, he actually felt talked-down to, lied to, and ignored to the point of frustration. Seven months of being ignored had led to this, with no resolution in sight. So much for "helping the nation to smile".

Let's come back to that point about "white fillings require more drilling than amalgam" - the statement made by MyDentist to try and get Mr Ouch to stop complaining and to accept the  old-fashioned and less-appropriate amalgam fillings they wanted to give him. Let us see what real dentists and dental companies say: ones with up-to-date clinical knowledge and respected reputations. We will also see if there are clinical advantages to white fillings that justify their use.

"Disadvantages of Amalgam. The cavity preparation (the "pocket" in your tooth) developed by your dentist requires undercuts or ledges to keep the filling in place. Your dentist may have to remove more of the tooth to create a secure pocket.
Advantages of Composite (white): Composite fillings can bond directly to the tooth. This makes the tooth stronger than it would be with an amalgam filling. Less drilling is involved than with amalgam fillings. That's because your dentist does not have to shape the space as much to hold the filling securely. The bonding process holds the composite resin in the tooth."
Source: Colgate

"Composite fillings [...] may also be a good choice for people who are afraid of dental work, since a composite can be bonded in place, which means less drilling."
Source: WebMD

"Preparing: As composites chemically bond to tooth structure, they can help hold weak parts of the tooth together. They also require less drilling away of tooth structure in many circumstances. Preservation of tooth structure has become central to many dentists work, and white fillings can help in this ‘minimally invasive’ dentistry. Amalgam vs composite winner here? Composite."
Source: Dental Care Matters

"Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes. Composites often allow a dentist to prepare a cavity much smaller than can be achieved with gold, porcelain or silver amalgam fillings. Making a smaller filling is very important to the strength of a tooth and for increasing the amount of time a filling will wear."
Source: Abbadent

"The treatment of choice for a very small single surface cavity, according to Pickard, is a composite restoration and that should be the starting point for the NHS. It is not just “cost” but clinical effectiveness as well"
Source: UK's Chief Dental Officer Dr Barry Cockcroft

"In 2015, after leaving the post at the DoH, Dr Cockcroft became a non-executive director at UK Corporate dental provider 'MyDentist (Formally Integrated Dental Holdings) [6] One of the largest providers of NHS and private dentistry in the country."
Source: Wikipedia

Mmm. Barry Cockroft became a director of MyDentist! Yet MyDentist ignored his guidance and chose a policy of favouring Amalgam for the NHS treatments, and charging more for white fillings. Very strange.

Quality dentists are in agreement that white fillings require less drilling, not more; this is the opposite of what MyDentist had tried to claim on the phone. Again, they were either lying to shut a patient up, or dangerously misinformed. And it is strange that MyDentist has a policy which prevents their dentists from using white fillings on the NHS except for front teeth. There are good medical reasons to use them for small fillings on the sides of back teeth too.

Also, MyDentist claims that the NHS doesn't ever cover white fillings on back teeth. We know it is a lie because this is done every day when clinically necessary, as Mr Ouch's friend showed. Further information that might be of interest:

"NHS Choices says about what is available: ‘All the treatment that your dentist believes is necessary to achieve and maintain good oral health is available on the NHS.’"
Source: Dentistry UK

"The latest directive from Mr Barry Cockcroft, the Chief Dental Officer for England - states that for small holes in back teeth, the evidence now supports the use of composite, (white filling) as the best way to restore these teeth. That means it should be available on the NHS, as it's no longer the 'cosmetic' option, but the best functional option!"
Barry Cockcroft "says clearly that the appropriate restorative material for a small single surface caries lesion is a composite restoration, and that is what the NHS would expect people to provide in these circumstances."

Source: MoneySavingExpert
As we saw above, Barry Cockroft - who argued strongly that white fillings were fully justified on the NHS - became a director of MyDentist! So it is bizarre that MyDentist is then so misinformed on this topic.

"Q Can I get them [white fillings] on the NHS?
A The National Health Service will not usually allow white fillings on the biting surfaces of back teeth. However, this does not apply to the sides of back teeth or to any front teeth."
Source: Elgin Dental Care
Note - "usually" is not the same as "never". It shows that it is possible, with justification.
Secondly: Mr Ouch's fillings were on the sides of back teeth, meaning white fillings on the NHS would be fully justified. MyDentist totally ignored this.

"Composite [white] filling: On the NHS, you’re more likely to get them on front teeth, but your dentist decides what you need."
Source: Which

"The NHS does not specify the material used. It is the dentist's own choice to use an appropriate material."
Source: Cosmetic Dentistry Guide

So MyDentist seems to be lying about policy on this as well.

What happened next, after that disastrous phone call? In a move of startling cynicism, also showing a lack of understanding of the "social" part of social media, MyDentist then rushed to delete all the Facebook posts on their page from the patient, and all the evidence that one of their patients was unhappy (but they left up far older comments from other people, proving it was a selective cull). They only want it to look like everyone is satisfied with their service, and brush everything else under the carpet and hope it will go away. That is a vile and dishonest tactic. Of course, Mr Ouch already had the URLs and threads saved as evidence, but now the URLs just led to this screen:

MyDentist deleting genuine comments from unhappy customers
in order to give a false and misleading impression.
The information will be reshared, screenshotted, and the date of upload and deletion recorded.

Mr Ouch said he was made even more angry by that. After all the stress and worry he'd suffered at the hands of MyDentist, it was the final insult to try and silence him, and prevent him sharing his experiences in order to help other patients. No doubt they have chosen to delete any recorded phone conversations that might cast them in a bad light too (or would just claim they did not record them - which would seem unlikely when nearly all "customer care" centres record calls for legal reasons, though defended as for "quality-control purposes" - yeah, right.) Of course, there are two parties to a conversation, so it doesn't depend on only one of them recording things as evidence.

On that fateful phone call MyDentist were informed by the patient how unhappy he was, and that he intended to let people know what they thought of the service. The MyDentist response was pretty much "Do your worst, we don't care". They absolutely refused to budge on the issue to the point of breathtaking stubbornness and outright lying. So be it. They'd rather have bad reviews than go out of their way to resolve issues and provide good customer service. It is crazy that they have a patient so angry about this, backed up by research; yet rather than back down or compromise, they would rather have unending bad reviews and complaints. It never ceases to surprise us how short-sighted many companies are on things like this, and they'd rather have their reputation publicly (and correctly) criticised than be helpful. It is a disappointingly short-sighted approach. Let's hope they don't start running an optician's service too.

The information here has also gone on to all major service review sites including Which?, and been passed on to the Care Quality Commission (the independent regulator of health and social care in England) and the NHS. Also the ROSPA Awards (health and safety), since MyDentist "take pride in providing clinically excellent, safe and welcoming dentistry to all our patients, and we’re pleased to receive recognition for these efforts" - well, ROSPA should know about the things MyDentist keep quiet. Other sites include the main discussion fora and UK dental organisations and regulatory bodies, such as the Parliamentary and Health Service Ombudsman (PHSO). Note - MyDentist only have 3.9/10 on TrustPilot, which is pretty rubbish.

They use sugary biscuits for better service? Surely that increases the need for fillings? Only kidding. It's another example of a website that lies.
There is no need for cookies when you are just browsing pages.
What the cookies really do is track you.
That's nothing to do with "providing a better service", but has everything to do with profiling you, whether you agree or not.

Saturday, 2 January 2016

Dell Laptop Drama - Buyer Beware


I just wanted to list my experience with a new Dell laptop.

I decided to replace a laptop with a brand-name one. It seemed like it would be the best option for future-proofing things, and giving reliable quality for peace of mind. So I bought a brand new Dell Vostro Core i3 laptop a couple of weeks ago, as a present for my girlfriend.

The second time I used it there was an error message, something like "Your system will operate slower and the battery will not charge. Please connect a Dell AC adapter for best system operation." It was a Dell power adapter, the brand new one that came with the laptop! Then the laptop rebooted, got caught in an endless cycle of tests and screen flashing and incredibly loud beeping. We had to quit out of that. Later we risked the power adapter again and it was fine. But it got me really worried about the new laptop. Should I return it? Then she'd be without a laptop for who knows how long.

I started looking into it, and why a Dell laptop might be bothered about who made the PSU it was connected to, and how it would even know that. I was irritated by what I discovered. I find out that Dell add chips and a fragile pin to their PSUs, so if it isn't a DELL PSU the laptop knows. Why? So that if you aren't using a Dell PSU their laptop actually disables battery charging, and slows the PC down significantly. Incredibly mean-spirited, forcing you to keep buying their own PSUs if you don't want the laptop to work at a fraction of its potential. And the power adapter cable has a thin pin in the centre. I'd never seen a power cable like that before. It certainly didn't seem as sturdy as the ones I was used to, that were just a thick, unbreakable tube. And I was right. Online comments showed that the pins bend and break easily. They, in conjunction with the adapter's identifying chip, are a weak point, a designed failure point. It is something I abhor - inbuilt obsolescence - designing things so they are prone to breaking, forcing you to buy more premium-priced replacement PSUs, increasing a company's profits at the expense of product quality and the environment. Or the pin can break off inside the laptop power connector, meaning a very expensive repair. Comment boards show all sorts of problems with Dell PSUs, often ruining the laptop. I didn't know any of this beforehand, or I'd have never bought a Dell laptop. It was only after the error appeared that I Googled it and found pages and pages of unhappy customers. Some took to the level of removing a chip from a Dell PSU and soldering it to the laptop motherboard to try and get round at least some of this attempt by Dell to cripple their laptops. It is wasteful, dishonest, unethical behaviour and I am really disappointed in Dell. I had thought a branded laptop meant quality, but it is actually just greed.

Thursday, 30 July 2015

HTC Wasteful Phones

Today I contacted HTC (a previous disappointment) to ask about getting one of their phones repaired.
Chat Transcript
Please wait while we find an agent to assist you...
You have been connected to Zan.
Zan:  Hi , thank you for contacting HTC Support, I am looking in to your query now.
Guest:  Thanks. Here's the summary: I have a HTC phone, the model I put in the summary. The touchscreen is not working on some areas, so needs fixing. It is out of warranty - how do I get it fixed? Who are the recommended HTC repairers?
Zan:  I'm sorry the line has ended we cannot repair it anymore.
Zan:  We no longer make parts and attempt of repair would cost more that the phone is worth.

Guest:  So HTC know of no-one that can repair their phones, and actually recommend adding old ones to the mountains of e-waste that pollute the environment?
Zan:  I can't arrange a repair for you sorry.
Guest:  That's not quite what I'm asking. HTC know of no-one that can repair their phones, no other company offering this service? Have set up no relationships with third party repairers? HTC just said: "No, throw it away, add to the world's waste problems"?
Zan:  How may I help you?
Guest:  Ideally by answering my questions.
Guest:  I can break them down into Yes/No questions if that is easier.
Guest:  Does HTC know any other company/person/service that can repair their phones? [Yes/No]
Thank you for using InstantService. You may now close this window.
Thank you for contacting us. To allow HTC to continue to improve our service can I ask that you complete a very short satisfaction survey by clicking here.
I never got to ask if HTC even take old phones back for recycling. Their approach is just to make new lines, expect you to throw the old ones away and buy new. Planned obsolescence in action right there. And if you query it they just ignore you and go offline. I'll put up with a wonky screen and see if I really need a smartphone any more - if I do then I'll avoid HTC and the like, and consider a Fairphone next time.

HTC current score:

Friday, 31 October 2014

More Royal Fail


Ah, Royal Fail.

I sent a parcel to a friend. A novel, some DVDs, a magazine, and a 16 GB USB stick with photos on. As usual I took a photo of it all in the packaging before posting, since I've experienced Royal Mail items going missing in the past. This is as much as I can do. Total value to replace: £20-30, them postage (another fiver?)

The items sent

The parcel never reached my friend. I then had to go through the clunky reporting process with Royal Mail (10th October). It takes so much time that it probably cost me an hour of my time, let's say another £6. We'll say Royal Mail has cost me £40 so far.

They state: "For all compensation claims for the contents of a letter or parcel you must provide:
Original proof posting
Original proof value (This evidence must show what it cost the claimant to acquire, purchase or manufacture the original item or repair in the case damaged)"

I included the original proof of posting. I didn't have the original receipts for the items - who does? I imagine most people don't have receipts for 99% of what is in their homes. However, the prices for these items were easy to find. I included printouts as examples of how much they cost, and assumed they would contact me for more information if required.

Today they sent me 6 piddling stamps (which don't even cover the postage costs), and claimed that I hadn't included enough information. I had included everything it was possible to include! They had never got in touch requesting further information or to ask questions, despite having my contact details. So they cost me £40 and wasted my time. That's what I call crappy service.

Oh, they don't include an email address on the letter they send, so there is no easy way to follow this up. They did point out that I could have paid even more money (maybe half the cost of the parcel!) to send it Special Delivery Guaranteed. Of course, according to them I still wouldn't have had enough evidence to get anything back when they lost it. What's more, my friend has a job, so is not there to sign for parcels. They then go back to the depot which is a pain for him to get to (especially in places like mine, where Royal Mail closed their in-town depots, and now people have to go to remote industrial estates). What a bunch of clowns.

---

11th November 2014: Another letter off Royal Mail after I queried their crappy response. They still refused my claim for a parcel they lost. They based the refusal on two things.

1. “we need our customers to provide us with an original certificate of posting” – I included that.
2. “and documented evidence of value” – I did that to the best degree possible. Unless something is brand new then no-one will have the receipt for each book and CD a year or so down the line. 99% of things in our homes no longer have receipts. So requiring original receipts is obviously ridiculous. I did the next best thing. I included photos of the items in the parcel (next to the addressed envelope); I included printouts of how much the items cost to buy, for anything over a few pounds; and for the lower-priced items it is easy to check the price on eBay, or I would have done that if asked.

Royal Mail is being obtuse and uncooperative, as usual.

9th December 2014: My continued complaints bore fruit - I was refunded the £20 parcel contents today. Great, a good outcome there, but it's a shame you have to work so hard, and RM still insisted (their get-out clause) that they will only refund with the receipts for each item, even though no-one keeps the original receipts after the first few weeks.

Tuesday, 14 August 2012

Sunday, 29 July 2012

Too much optimism


Typical! We had looked forward to something being done about all the junkmail crap posted through our letterboxes. However, things have been delayed. Even if they do get off the ground, it is still an arse-about-tit system - junkmail should be opt-in only. That would make administering the system a doddle, cut waste, and mean that we don't have to go out of our way to stop advertising crap from invading our homes.

The good news is that we came across some connected sites that are worth visiting if this is a topic which you're interested in:

Diary of a Junk Mail Campaigner is about how self-regulation by the junk mail industry is failing.
Royal Junk Mail shows the kind of crap that Royal Mail shove through your letterbox.
Stop Junk Mail has some useful advice.
Junk Buster - further advice on stopping junkmail.
Information Commisioner's Office - a form you can fill in if you get unwanted marketing calls.

Saturday, 7 July 2012

Chemist Direct

Or 'chemist indirectly confusing and purposefully making things awkward for potential customers'?

I only ever buy from websites that don't require creating an account with a password. It is nice to be offered the option for that, but all quality sites enable 'guest' purchases, i.e. just like a shop - you buy what you want with minimal fuss. Recently I went to the Chemist Direct site. It offered a quick checkout/guest option, so I spent some time putting together an order of over £60.

When I went to pay the option for a guest account had disappeared. I then spent over an hour in contact with their customer support people trying to work out what had gone wrong. I tested different browsers and sent screenshots; looked at URL formation and so on. In all that time I had to leave my PC on even when I went out, since the order would otherwise have been lost. I had hoped we could resolve it and I could go on with the order.

Now you see it (a guest purchase option when basket is empty)...

...now you don't! It disappeared once products were added to the basket.