Happy belated Valentine’s Day. I took my wife out to dinner and a movie last night. We saw Contraband with Mark Walberg. It was okay, nothing great. This is the kind of movie I would put in the back of my mind for Netflix, but she likes action movies. She really wanted to see Mission Impossible IV, but it is not showing anymore. Anyway, I hope you all are doing well. And I hope you are enjoying the blog. We are consistently getting over 1,000 readers a week. I remember a couple of years ago we were thrilled with getting 300 readers every week. It just keeps reinforcing to us that dentists need other dentists. Like a quote from the Bible about "iron sharpening iron." That is what we are trying to do here.
Today’s topic is something that I have been talking about for the last year or so, but it happened again and I want to talk about it. I am sure that, like me, you are losing patients to "the guy on my insurance." I am okay with this because I understand that it is hard out there for my patients. If they have to go discount dentist to get their teeth cleaned, I am okay with this. How bad could it be for them? That is my stumbling block: how bad is it?
I had a dad come up to me at church on Sunday and say, "My son needs to come see you. His dentist told him he needs a root canal." The dad comes to me and the mom and kids go to the local corporate dentists. The kid is 20 years old. When I asked him, he said the tooth didn’t hurt.
I told the dad that his son probably has a cavity that needs to be filled, but that if it doesn't hurt, there is a very small chance he is going to need a root canal. I told him that the corporate dentists have a knack for over-treating (if you are a corporate dentist and want to talk, email me at jgammichia@aol.com). They have a CEO and CFO that want them to meet a quota for the day, and sometimes their judgment gets clouded by "the man."
I told him to make an appointment and I will look at it. The dentists that say they are going to save money would have cost them a root canal, post and core and crown, when the kid probably just needs a filling. That is $240 at my office and it would be about $2,000 out of pocket. Coming to me could save them $1,760. Hmmm.
A 55-year-old woman with a lot of decay came to me for a second opinion. She knew about the decay and wanted a treatment plan. She had a tooth that was in bad shape but it could be saved. She had an $8,500 treatment plan full of extractions and bridges and a bunch of crowns. I looked around and things were bad, but not that bad. I could do a bunch of fillings and a couple of crowns, nothing crazy. Her discount dentist was going to pull out the tough ones and do bridges and then do crowns on everything else. (I don't know about you, but I don't do too many bridges for an extracted tooth any more. I do implants. I think they use bridges for the quick buck.) This patient would be saving about $3,000 by coming to me, and I am supposed to be the EXPENSIVE one!?!
How do high-quality, fair, relational dentists, like us, get this message across to the public? This is what I have decided to do. We have these community magazines. You get them in the mail, thumb through them (I do, too), then throw them away. I never thought anyone noticed these magazines until I was at a "Taste of the Town" event and they put my picture in the magazine. I had so many people email me and stop me and tell me that they saw me in that magazine. I am going to buy space in this magazine and write an article telling the above story.
I am going to buy space in the local newspaper (not the Orlando Sentinel) and write these stories. I have got to tell people. I don't care that they see me. I just don't want them to see the discount dentist, the wolf in sheep’s clothing. I feel like I have some responsibility to people and to my profession.
What do you think? You think I am nuts, don't you? Is this happening to you? Don't you just want to shake people and say, "Why are you going there?!"
This is my soapbox and you can't make me get off.
Have a great rest of the week.
john
7 comments:
Age old problem, no easy answer. . .I practice in an area easily accesssible to Florence, SC where a "denture mill" has existed for years. Patients could walk in the front door in the morning and have all their teeth extracted and walk out with a denture in the same day. I had not been in practice for long when I treated an older lady who became a very satisfied patient. She remarked to me that her late husband had been to Florence 4 different times to get dentures. None of them fit, and when he died they looked in his drawer to try to find which "upper went with which lower" for the undertaker.(sidebar: Why??? Have you ever seen a corpse smiling at a viewing?) Anyway, she remarked that he could have come to me and spent the same amount of money (4X cheap denture)and had a set of teeth that he could have worn.
My grandad would have said "We are too soon old and too late Schmart!"
Everyone is different. As for the first case you mentioned, did you see a radiograph? How do know it does not need a RCT?
First, let me say that I think your blog is great dentists both young and old. But I find your latest post a bit disturbing. I have worked for a group practice and private and if you are naive enough to think that over treating is just occurring in the multiple-doctor practices then you are sadly mistaken. I like you agree that far to often than we'd like we see patient coming in for second opinions with what can only be described as "aggressive" treatments. But I feel safe in saying that just because a private practice doesn't have a "CFO" managing daily production doesn't mean that they don't have daily financial goals. I feel it does it disservice to the dental profession to group "all" the dentists that practice a group setting as over treating and just-concerned-about-the-money people. It would be equivalent to saying after one bad experience to McDonalds that "all" McDonalds have bad service. To make a generalized statement about group practices is simply unfair. Again, let me state that I agree with you concern over dentists that over treat. But please be more conscious about generalizing all group practices and consequently all dentists that work in a group practice in the same boat.
We had an "Aspen" open about 2 years ago in our small community. I can honestly say that we have gained more patients from this practice then lost. The discount practice tends to be more of an entry level dental office for many. When patients come to us after first trying the discount practice, we are careful not to "Throw the clinic dentist under the bus". We do what we do, and they do what they do. Fear not many of the patients that leave for the discount venue will be back.
I tell the patients we are not the most expensive and we are not the cheapest but some where in the middle. People do what they want for their own reasons, price just happens to be major reason these days.
Just write a very honest piece about how to find a good dentist, what the different treatments are and what questions to ask- don't try to bring others down, it will only make you look sour. If you have clear evidence of malpractice, then you have an obligation to notify the Dental Board.
It is important to many individuals to have a gentle dentist, especially when a sensitive mouth is involved. Then there is that strange fear of the dentist because the mouth is a sensitive place. The mouth is so sensitive that sometimes activities such as flossing can make the gums bleed or inflict pain. We are more comfortable with having control over our toothbrushes rather than having someone else place strange objects into our mouths. However, the key to good oral hygiene is seeing a dentist twice per year.
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