Monday, July 21, 2014

It's Just a Tooth - Remove It

I really want to share with you all the awesomeness that was #AGD2014 Annual Meeting & Exhibits in Detroit! But alas, you’ll have to wait to see in it next month's AGD Impact. But I can tell you firsthand that, it was GREAT! I’m looking forward to the Golden Opportunity awaiting me in San Francisco!

Today, I had what Oprah calls an “Ah-ha moment.” That is to say, I was walking along with a friend during my hometown parade and I sarcastically said I should have brought business cards because I saw a lot of people IN NEED! As we continued to walk and talk, my friend questioned me about whether or not I accept the adult dental Medicaid plan provided under the Affordable Care Act. I simply said, “Yes, I do. But it’s VERY limited.”

Before anyone ostracizes me for taking PPOs, children's Medicaid and “insurance” at all, hear me out. My partner and I work really hard and although we do hate seeing the end-of-day adjustments, there are a significant number of patients that we HELP! We get them (with the plans’ help) into the office and present treatment to restore their oral health. Some find a way to pay the additional needs and some work within the confinements of their plan. For many in my area, this is the only way they can receive ANY necessary treatment. Also, we get a chance to educate and inform them.

Now, would I love to do 100% resin/porcelain? Of course. But, OMG, wait for it… I place amalgam! I know! (I feel like I just shared the dirtiest tale ever!) I believe there is always a time and place. If my patient can’t do the appropriate full coverage and I know I can’t appropriately isolate and restore in resin, then amalgam it is.

It isn’t always about reimbursement. We have been placing posterior composites at a downgraded fee for years in order to provide minimally-invasive, appropriate dental care to our patients.

While thinking about the limited plans, I feel that patients were given a bait and switch. Having been without benefits for many years, they were handed Willy Wonka’s Golden Ticket. They walk into the office beaming saying, “I’ve got dental insurance now and I am ready to have my work done!”

Unfortunately, then, you haveto sit them down (or, if you’re lucky like me, the treatment coordinator breaks the bad news) and explain that yes, although they have dental benefits, those benefits are limited. Sadly, breaking the news that a tooth is infected and needs an RCT is usually met with, “Does my insurance cover that?” When the answer is no, most will choose to have it pulled because “it’s only a tooth.”

It saddens me that in my young career I am already experiencing the frustrations of the red tape politics that is dental benefits.

Colleen B. DeLacy, DDS, FAGD


Burgett said...

Nice article and excellent take on the current state of "insurance". Glad to hear that you care about your patients first and foremost but of course, I already knew that.

Burgett said...

Nice article and excellent take on the current state of "insurance". Glad to hear that you care about your patients first and foremost but of course, I already knew that.

David Tecosky DMD MAGD said...

I like your honesty in discussing your take and your actions regarding patient's insurance plans. In the last few years I have reduced the number and breadth of plans I take and have changed the way I introduce myself and my practice to patients. I am up front immediately about our mission which is to preserve our patients' teeth for life and we discuss how much a patient knows or needs to know about their insurance and what is covered and who is responsible for the decisions. Patients are often taken aback that I even stop to have this conversation with them. They don't usually hear a direct explanation to the issues, and usually expect us just to sell them something. I wonder if that is the message that the increase in dental advertising and jaded reporting by the media is getting
Dave Tecosky Editor, PAGD Keystone Explorer

bob oro said...

We too loved Detroit AGD!! Got to dance to Motown sounds in Motown.
Loved your post's honesty.
Alloys still have a place in our practice and we are assistance/insurance free practice.
Hi Dave! We do not use the words dental insurance anymore. As I explained at our seminar AGD annual Philly, dental insurance stopped in 1983. Since then it has only been assistance.
Enjoy the Journey,
Bob and Debbie


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