I may get into some trouble by writing this blog entry....I am looking for comments from both dentists and non-dentists.
In healthcare the sacred cow is the "Doctor - Patient Relationship". Nothing should interfere with this. Not insurance plans or policies and most certainly, not government.
I recently saw a marketing piece from a large dental insurance company here in Colorado describing various options to prospective clients. On the back cover there is a heading,
"Why buy dental insurance?"
I would like to take this opportunity to give a dentist's perspective on some of the points...
Point #1. "Your overall health could be impacted by your oral health" - true!
Point #2. "Dentists can catch potential problems early when they see you regularly" true!
Point #3. "People with dental insurance have better oral health outcomes" false! People that go to the dentist have better oral health outcomes.
Less than 50% of people with dental insurance actually go to the dentist. This implies that you can't go to the dentist without insurance. People spend more money on their cell phone bill per month than it costs to get a cleaning from the dentist every 6 months.
Point #4. "Routine exams allow your dentists to get to know you and your health history." true - great point.
We (dentists) value the relationships that we have with our patients. The relationships that I foster with my patients are what gives me the most satisfaction in my practice. Through consistent visits over the years we are able to monitor changes in the oral health. We have detailed notes to compare the present condition with past. A trusting relationship that is created over time ensures to the patient that the dentist has his/her best interest in mind.
Point #5. "You could see significant savings" true and false-
You could if you have no dental problems. If you have dental problems, you might not. The discounted rates that the participating dentists are required to charge means that the dentist must lower his cost for the work. Something will have to give from the producer side to make this work for the dentist to stay in business. Lower cost materials, lower cost lab work, work done by assistants rather than the dentist, etc. This could affect the outcome and/or quality of the work.
Point #6. "Subscribers (patients) are protected by discounted rates even for procedures that are not covered under their plan" false!
This statement bothers me. They just made the point that it is good to have a trusting relationship with your dentist. This statement creates distrust in the relationship.
Why does the insurance company feel that the patient needs protecting? Just what are they protecting the patients from?
You can buy a Kia or you can by a Lexus - both will reliably get you to places you want to go. The Lexus will have more bells and whistles than the Kia; therefore it costs more. Is there an entity that is protecting the prospective car buyers so they don't pay more for the car? No. What people are choosing to pay extra for is the experience and the confidence in the brand. If the cost of the car was more than the prospective car-buyer values, there will be no sale. The sale is market driven!
Not all cars are the same. Not all dentists are the same. Not all dental procedures are the same. Dentists that invest in continuing education are constantly raising the care that they provide to their patients. By doing this, they can provide better dentistry and the patient will have a better experience. They might charge a little more so that they can make a living and continue on their path towards mastery.
If someone values a different level of care, they should not be penalized for it. Some people value low cost, some value individualized experience. Some value life-like esthetics, some value function. That is their choice and should not be prevented to seek out what is important to them. If the fee is too high, there will be no sale!
Dental insurance companies are doing this and interfering with the sacred cow.
This self proclaimed protector (dental insurance company) has yearly revenues upwards of $100 million dollars. I don't know any dentist, anywhere, anytime that has revenues in that galaxy.
We run small businesses.
We are artisans and craftsmen, managing personalities while balancing science to make a living.
We invested at least 8 years in college and dental school. Some of us have advanced degrees in various aspects of dentistry. We learned in dental school to provide the best care for our patients based on science - not on what the insurance companies cover. The insurance company has established their own "standard of care" through propaganda such as this.
Dental insurance companies although they may be benevolent in their intent they are skimming money from the patients and interfering with the "Sacred Cow"
7. "Without Network Protection, there is no limit to what providers can charge for non-covered services." false!
This statement irritates me and just about every other dentist that I know!
The free market that we live in drives the fee. If a dentist charges too much, the patient won't buy it! This is a non-covered service, why should an insurance company set a fee for a service that it does not cover? It makes no sense.
I think that the public needs protection from the propaganda that the insurance companies are feeding them.
Last spring, a few colleagues and I had the opportunity to represent the Colorado Dental Association and the American Dental Association in Washington DC. We had several legislative experts speak to us as a group before we met with Colorado's legislators. Every expert was adamant when they told us this truth-
"Dentistry is the last free market health care system that works."
It works because we value the "Doctor - Patient Relationship" as sacred.
You can blow out a candle
But you can't blow out a fire,
Once the flames begin to catch,
The wind will blow it higher.
Peter Gabriel "Biko"
Lets get the flames to catch!
Well said! Insurance companies are in business today only because they are profitable. They are merely the "middle man" between patient and doctor.
ReplyDeleteOur patients experience the intimate bonds we create with them at our practice routinely. I have my doubts they share the same relationship with their insurance company. When a patient calls our office, we do not ask for their social security number, date of birth, or policy number. We already know who they are, we just need to know their concern.
What a dark day for the insurance companies it will be when patients realize patients are the employers of the insurance companies and not the other way around.
Great blog entry!!
-Shawn
Brett...great entry! This is a struggle that is upon us as providers and will only get more heated as the years go by.
ReplyDeleteI too strongly believe in a free market of dentistry. People will pay for services they VALUE. If there is no VALUE in what they pay for then they won't spend the money. It's a simple as people's coffee they get everyday. Why do people spend 6 bucks at Ink or Starbucks when they know they can get a cheap cup at 7/11 or brew it at home. They spend this money for the EXPERIENCE and the PRODUCT they are buying. They know it's expensive but yet, they still do it. That's the beauty of it all.
I do believe there is a place for insurance-based practices. There is a sizeable population that want the cheapest care. However, I don't believe the entire dental model needs to be modeled after the corporate insurance practice as things seem to be trending. This is why we need to keep up the fight for us private practitioners that provide the ultimate care for our patients.
Brett, this dissertation is outstanding...
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