The line between fraud and hustling?

[homunculusus]

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I scour the dental forum every now and then and always read how some dentists claim to work only 20 hours per week and pull in $800k or some outrageous numbers. I'm in medicine but I hear similar statements from some family doctors "I only work 30 hours" or "so and so only works 30 hours and pulls in $700k". I understand averages and national surveys don't take into account private practice or paint the whole picture but some of the figures I hear on here are 4-5x and make it seem as if anyone can do it. In medicine, the MGMA survey is generally pretty close salary-wise and region-wise to someone working regular hours.

King of crowns: Wisconsin dentist convicted of breaking patients’ teeth to submit $4.2 million in bogus insurance claims

Dr. Scott Charmoli was charged with selling patients unnecessary crown procedures and then cracking their teeth with a drill to justify insurance claims.

www.marketwatch.com

Came across this article. How many dentists are actually hustling vs doing things like this? I've had to report a dentist on behalf of a family member (medicaid/ins said it likely won't be investigated since the resources required to investigate outweigh the potential fraud), and I also know doctors who got busted after decades of "hustling" and "flexing" expensive materialistic items and created an image that they were the cream of the crop when in reality they were running pill mills

 

[DrJeff]

I scour the dental forum every now and then and always read how some dentists claim to work only 20 hours per week and pull in $800k or some outrageous numbers. I'm in medicine but I hear similar statements from some family doctors "I only work 30 hours" or "so and so only works 30 hours and pulls in $700k". I understand averages and national surveys don't take into account private practice or paint the whole picture but some of the figures I hear on here are 4-5x and make it seem as if anyone can do it. In medicine, the MGMA survey is generally pretty close salary-wise and region-wise to someone working regular hours.

King of crowns: Wisconsin dentist convicted of breaking patients’ teeth to submit $4.2 million in bogus insurance claims

Dr. Scott Charmoli was charged with selling patients unnecessary crown procedures and then cracking their teeth with a drill to justify insurance claims.

www.marketwatch.com

Came across this article. How many dentists are actually hustling vs doing things like this? I've had to report a dentist on behalf of a family member (medicaid/ins said it likely won't be investigated since the resources required to investigate outweigh the potential fraud), and I also know doctors who got busted after decades of "hustling" and "flexing" expensive materialistic items and created an image that they were the cream of the crop when in reality they were running pill mills

Always an interesting topic to discuss. And often one where having been in practice, in the same location, long enough to see how what your initial assessement and treatment to a patient may have either succeeded or "failed" (and "failed" maybe not because of poor patient compliance/hygiene but because of your initial treatment plan maybe being too conservative) functions in your patients mouths over time.

Personally in the now nearing 25 years of practicing general dentistry, I am doing more crowns, and often in situations where say 15-20 years ago, my gut instinct was to go "more conservative" with say a fractured off cusp or a Class IV anterior where I used to be more inclined to go with a direct composite restoration as my initial treatment planning instinct. And its not because my skills have decreased (atleast I sure don't think they have😉 ) but because I have seen those larger direct restorations "fail" both sooner and at a higher rate than I have seen indirect restorations fail in similiar treatment planning situations, and often when they fail, there may end up being subsequent endodontic needs as well. When you see things like that happen many, many, many times over decades, and across all demographics of my patients, while we always want to preserve as much healthy enamel and dentin as possible, you start to see that sometimes, you may end up choosing too conservative a treatment course, which then ends up requiring the removal of more healthy enamel or dentin than you may of had to do if you went more aggressive in your treatment planning initially.

So I think that one needs to also consider in this topic, if dentist A is doing more crowns today than dentist B, but in 10 years, dentist B has had to go back and do a crown on a tooth they initially did a direct restoration on and ends up over say 10 years doing a similar percentage of crowns on their respective patient pools, is dentist A initially doing "too many" crowns or is dentist B not doing enough crowns? And obviously this is making the assumption that both dentist A and dentist B are practicing from an ethical standpoint.