Is your dentist ripping you off?

[kov82]

What do you guys think?

http://shine.yahoo.com/event/financiallyfit/is-your-dentist-ripping-you-off-2476643/

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[dl9006]

What do you guys think?

 

[whodat4life]

What do you guys think?

http://shine.yahoo.com/event/financiallyfit/is-your-dentist-ripping-you-off-2476643/

Seems like this dentist wasn't networking with other dentists in the area. I hear patients complain about the cost of care all the time, but they don't stop and think about how much overhead a dentist has.

Student Debt Payment - ~2,500/mo
Average practice - ~3,500-4,000
Office Manager - ~4,400
Dental Assistant (x2) - ~5,800
Dental Hygienist (x3) - ~16,000
Malpractice Ins - ~1,500
Receptionist - ~3,000
Billing Specialist - ~2,800
------------------------------
***Supplies - not sure, probably varies a lot depending on specialty/need
***Electricity -
***Phone/Cable/Internet
***Water

I'm sure there are more expenses, but just including the top portion alone, that's 40k per month (480k/year) that goes out just on paying employees, student loans, and the note on the practice. This is all before the dentist makes anything at all. I think we can all agree that a dentist DESERVES to be paid a decent amount of money for his struggles to become a dentist and the sacrifices he/she has had to make to do so.

 

[whodat4life]

reading the article and some of the comments, i think this is a good reminder of how ignorant some of our future patients will be about dentistry and the cost related to it.

it's a reminder that we as future dentists should take our time to educate our patients to clear any misunderstanding and that both parties are on the same page. otherwise if something goes wrong, the patient will think he/she was cheated and go around spreading lies like this article


pretty frustrating to see that so many people hold such a bad perception of dentists



some of the comments were ridiculous:

some guy actually suggested yanking your own teeth and filling the socket with quick dry cement...

another guy's going around telling people to scrape their teeth with a sharp metal object and polish the teeth themselves..


and then you get the anti-fluoride nutjobs that came to enlighten as well

 

[Odontos2015]

Definitely good advice on Dr. Messina's part. On a side note, he was the valedictorian of my dad's dental class and has been published many times. He's written some very interesting articles on the business and practice philosophy side of dentistry that are well worth the read, if you can find them.

 

[7 Iron]

Most people who post comments to these sort of stories don't know anything at all. All they will do is complain. I used to read comments to Yahoo stories seriously, but now I only do if I want to laugh

 

[DrJeff]

Most people who post comments to these sort of stories don't know anything at all. All they will do is complain. I used to read comments to Yahoo stories seriously, but now I only do if I want to laugh

Plus, you'll rarely meet a patient who doesn't think that your fees are too high. But if you take care of your patients well, they'll keep coming back to see you (and still from time to time complain that your fees are too high )

If you don't feel comfortable charging what you feel your time and years of effort you put into your education and training are worth, then you're more than likely going to have some serious problems with the business side of dentistry (and yes it is a business, and there's nothing wrong with getting paid for the services that you provide, inspite of what some may think)

 

[kov82]

I mostly thought about the author and how she really knew what she was doing, she knows the public really hates paying for dental work, but if I bought a $90,000 benz I would hate paying for it too, getting high value items or service for free is great!

Like you guys said they dont know anything about it, and thats what annoyed me about her was that question at the end "Do you feel like your dentist’s fees are fair?" oh yea..... like 10,000 people would come on and say "I lllllloved paying $900 for that crown so I can keep doing what I've always been doing........chewing"

The fact is that people take their teeth for granted and they forget very quickly (as soon as they see the bill) the pain they were in before they saw their dentist. She was very clever to write this during bad economical times, just fanning the flames.

 

[Mackchops]

Keep in mind that to Mr. Q, everything he sees us do looks really easy. A denture is just a piece of plastic. A cavity is just a hole you drill and then you stuff some stuff in there to plug it up. An extraction is as simple as just yanking hard enough. My advice, instead of getting annoyed at your patients for not appreciating the value of your services is to educate them on a continuing basis just HOW VALUABLE your services are!

Of course there's always a screwball who won't listen to a reasonable thing you say...

I mostly thought about the author and how she really knew what she was doing, she knows the public really hates paying for dental work, but if I bought a $90,000 benz I would hate paying for it too, getting high value items or service for free is great!

Like you guys said they dont know anything about it, and thats what annoyed me about her was that question at the end "Do you feel like your dentist’s fees are fair?" oh yea..... like 10,000 people would come on and say "I lllllloved paying $900 for that crown so I can keep doing what I've always been doing........chewing"

The fact is that people take their teeth for granted and they forget very quickly (as soon as they see the bill) the pain they were in before they saw their dentist. She was very clever to write this during bad economical times, just fanning the flames.

 

[mike3kgt]

Seems like this dentist wasn't networking with other dentists in the area. I hear patients complain about the cost of care all the time, but they don't stop and think about how much overhead a dentist has.

Sorry, you will not get patients to buy into "look at how much I have to pay" rationale. They just don't care.

Where you focus your energy is the value you create by charging the fees you do. I worked in two practices my first 2 years out before going back to residency... one was a high end restorative office and the other a community health center. One charged $1,500 a crown, the other between $350-700 (depending on your reported income... sliding fee scale). Patients in both offices complained about the fees but patients in the community health center complained more and the patients who paid more complained less.

Why? Well, we created value in the $1,500 crown philosophy. We had a nice office with well versed staff that were available at any time of the day. Myself or my senior doc was also available for emergencies after hours and gave out our cell numbers to all patients. We had an official/unofficial 'stand-behind' promise that if you're not happy whatsoever within 5 years, it would be replaced at no cost. Didn't like the shade? Replaced for free. Broke 2 years later? Yep, replaced. Did we have a problem with that system? Nope. Maybe about 5k in re-dos a year...

The lower fee office was a 'clinic'. Looked like one, past the lips everything fits type of place. Don't like it? Well, sorry, it's cheap, deal with it. Little value, lots of complaints. So I stayed away from doing crowns there. Mostly fillings etc.

If you compete on price alone, I promise you will fail. Compete on service (and of course deliver) and you can grow and love this profession. If you don't have the personality or skill to deliver on these promises or expectations, well, there's always an in-network system to fall back on.

 

[DrReo]

If it's more than the iPhone bill, the suggested treatment will be way too much.

 

[DrJeff]

If it's more than the iPhone bill, the suggested treatment will be way too much.

I also give a bit of the wiggle factor in the form of the cost of a couple of mucho-grande 1/2 soy double expresso light foam, extra whipped cream drizzled with chocolate coffees from starbucks every week ontop of that monthly iphone bill patient pricing complaining point equation

 

[FutureDent020]

and then you get the anti-fluoride nutjobs that came to enlighten as well

I can't tell you how many times I stumble upon this on the internet or even here the common public discussing it. It's ridiculous. The best thing I ever heard someone say was, "Do your own research on flouride. Don't listen to what your dentist says". So I agree, it is terrible how ill-informed some patients are.

 

[CaliDent383]

At least in my shadowing experience, I think plenty of dentists do rip people off routinely in order to meet production goals. One chain office even had production goals in dollar amounts for each day in the back room, you think this doesn't pressure dentists to overtreat? I can't remember how many times I heard "blah blah blah, your insurance will cover most of it" to a clueless patient who will trustingly go along with what is said (maybe it's just ripping off the insurance companies initially, but guess who then has to pay more for insurance). Pretty sad, but only going to increase in bad economic times when it's all about the bottom line.

 

[DrJeff]

At least in my shadowing experience, I think plenty of dentists do rip people off routinely in order to meet production goals. One chain office even had production goals in dollar amounts for each day in the back room, you think this doesn't pressure dentists to overtreat? I can't remember how many times I heard "blah blah blah, your insurance will cover most of it" to a clueless patient who will trustingly go along with what is said (maybe it's just ripping off the insurance companies initially, but guess who then has to pay more for insurance). Pretty sad, but only going to increase in bad economic times when it's all about the bottom line.

Key phrase highlighted. Enough said

 

[mike3kgt]

Key phrase highlighted. Enough said

Well... I have practiced in offices like this and it was awful. Worst part was they had daily goals, certain % from different procedures, bonuses for staff included so the whole office would be pushing hard for production. Then you were the bad guy when you had to refer out that RCT on #2 on a patient who can't open wide or those bony impacted 3rds. Or you end up doing the procedure poorly and open yourself up to liability.

Then again, is this different from 'normal' offices where they have monthly production goals? or yearly? Bonus for the staff? If the office makes a certain amount, they all go to a meeting or vacation trip? Is this any worse?

 

[DrJeff]

Well... I have practiced in offices like this and it was awful. Worst part was they had daily goals, certain % from different procedures, bonuses for staff included so the whole office would be pushing hard for production. Then you were the bad guy when you had to refer out that RCT on #2 on a patient who can't open wide or those bony impacted 3rds. Or you end up doing the procedure poorly and open yourself up to liability.

Then again, is this different from 'normal' offices where they have monthly production goals? or yearly? Bonus for the staff? If the office makes a certain amount, they all go to a meeting or vacation trip? Is this any worse?

I think that its totally different. For example, in my office, sure I know what amount I need to collect on average per day to meet my part of the office's overhead, and my partner knows what amount he needs to collect per day for his part of the overhead too. If we have a day where we don't make that number, no big deal as more than likely they'll be another day that we'll exceed that number. If I need to refer out that endo on #2 or some extractions, no "guilt" at all. I just do what's in the best interest of my patient based on my abilities, the patient, and my conscience.

Sure, we have an office bonus system in place, but then again we set our bonus levels based on historical REASONABLE goals and then have a tiered structure so that if we collect above a certain amount, a second bonus kicks in and so on. It does more to help my staff keep the schedule full, which then in reality leads to increased production which hopefully means increased collection, and that's what really pays the bills, collections.

The bottomline for me is that while in a sense I do have some "pressure" on me to meet my financial obligations to my business, those don't supercede my ethics, and sometimes in a chain situation that isn't the case when the dentist has to answer to an office manager who may very well have more "power" than the dentist does

 

[charlestweed]

Sorry, you will not get patients to buy into "look at how much I have to pay" rationale. They just don't care.

Where you focus your energy is the value you create by charging the fees you do. I worked in two practices my first 2 years out before going back to residency... one was a high end restorative office and the other a community health center. One charged $1,500 a crown, the other between $350-700 (depending on your reported income... sliding fee scale). Patients in both offices complained about the fees but patients in the community health center complained more and the patients who paid more complained less.

Why? Well, we created value in the $1,500 crown philosophy. We had a nice office with well versed staff that were available at any time of the day. Myself or my senior doc was also available for emergencies after hours and gave out our cell numbers to all patients. We had an official/unofficial 'stand-behind' promise that if you're not happy whatsoever within 5 years, it would be replaced at no cost. Didn't like the shade? Replaced for free. Broke 2 years later? Yep, replaced. Did we have a problem with that system? Nope. Maybe about 5k in re-dos a year...

The lower fee office was a 'clinic'. Looked like one, past the lips everything fits type of place. Don't like it? Well, sorry, it's cheap, deal with it. Little value, lots of complaints. So I stayed away from doing crowns there. Mostly fillings etc.

If you compete on price alone, I promise you will fail. Compete on service (and of course deliver) and you can grow and love this profession. If you don't have the personality or skill to deliver on these promises or expectations, well, there's always an in-network system to fall back on.

Agreed 100%. This is why I don’t think I would have a successful practice if I were a general dentist. I can’t take the risk of spending $300-400k to set up a state-of-the art facility. I neither have the communication skills nor the patience to sit down and to spend time talking to the patients. I don’t have to do any of these and still be able to do OK as an orthodontist. I rarely have to spend more than 5 minutes for each ortho consulatation. In my opinion, not having to spend a lot of time talking to the patients makes my job more enjoyable. And I would never give my cell phone number to the patients.

 

[charlestweed]

At least in my shadowing experience, I think plenty of dentists do rip people off routinely in order to meet production goals. One chain office even had production goals in dollar amounts for each day in the back room, you think this doesn't pressure dentists to overtreat? I can't remember how many times I heard "blah blah blah, your insurance will cover most of it" to a clueless patient who will trustingly go along with what is said (maybe it's just ripping off the insurance companies initially, but guess who then has to pay more for insurance). Pretty sad, but only going to increase in bad economic times when it's all about the bottom line.

The reason people get treatment at the dental chains is dental chains accept the crappy HMO plans that most private practices don’t accept. The problem is the patients with these HMO plans think that they have the best insurance plan in the world. The patients don’t realize that their HMO plans pay the dentists zero dollar for a silver filling, $100 for a crown, $100 for a molar endo etc. Therefore, the associate dentists who work at these chains have to upgrade the treatment to composite fillings, porcelain fused to gold crowns, and they try to find some reasons to refer the RCT cases to the outside endodontists.

HMO plans ruin the quality of care in dentistry. Instead of paying for these bad HMO plans, the patient should use the money they save and get better dental treatments at a fee-for-service private practice.

 

[whodat4life]

Sorry, you will not get patients to buy into "look at how much I have to pay" rationale. They just don't care.

Where you focus your energy is the value you create by charging the fees you do. I worked in two practices my first 2 years out before going back to residency... one was a high end restorative office and the other a community health center. One charged $1,500 a crown, the other between $350-700 (depending on your reported income... sliding fee scale). Patients in both offices complained about the fees but patients in the community health center complained more and the patients who paid more complained less.

Why? Well, we created value in the $1,500 crown philosophy. We had a nice office with well versed staff that were available at any time of the day. Myself or my senior doc was also available for emergencies after hours and gave out our cell numbers to all patients. We had an official/unofficial 'stand-behind' promise that if you're not happy whatsoever within 5 years, it would be replaced at no cost. Didn't like the shade? Replaced for free. Broke 2 years later? Yep, replaced. Did we have a problem with that system? Nope. Maybe about 5k in re-dos a year...

The lower fee office was a 'clinic'. Looked like one, past the lips everything fits type of place. Don't like it? Well, sorry, it's cheap, deal with it. Little value, lots of complaints. So I stayed away from doing crowns there. Mostly fillings etc.

If you compete on price alone, I promise you will fail. Compete on service (and of course deliver) and you can grow and love this profession. If you don't have the personality or skill to deliver on these promises or expectations, well, there's always an in-network system to fall back on.

Very interesting...I can tell you sincerely care about your patients! For that money that you lost in redoing crowns that didn't work properly (or shade, etc...) you probably made more in the end. Great advice, thanks so much for that.

 

[peanutb123]

there is also a website called ripoffreport.com

search dentist a lot more of fools wills pop up.