why must we help people in poor regions?

[mrlantern]

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You know, I really hate it when dental educators and the media talk of how important it is to get dentists treating patients in poor neighborhoods.

Being poor is one thing, and it's not my business to intrude. But the problem is, with this population, the patients are really awful. They argue with you all the way, yell at you when they don't see desired outcomes, and they come in with the worst children ever for dentistry. > 90% of them are afraid of the dentists anyway and they don't care about their health. And many of them have had prior criminal records and are hiv/hep c positive.

The worst aspect isn't how they neglect their teeth and general health. I feel like these patients are always bitter. They always act as if they're fully entitled, namely to your money, and they are willing to be tough and look for trouble to get them.

I personally don't think the people in question deserve any kind of help or investment in their ghetto neighborhoods. Alot of decent people are perfectly fine with never having to deal with ghetto people. With the exception of Jesus, why would anyone intentionally want to treat them?

So why do so many dental schools talk of the importance in getting providers to treat this patient pool? This issue is always perplexing to me and I need to know if there is something that I'm not quite understanding.

 

[Quattro DMD]

You know, I really hate it when dental educators and the media talk of how important it is to get dentists treating patients in poor neighborhoods.

Being poor is one thing, and it's not my business to intrude. But the problem is, with this population, the patients are really awful. They argue with you all the way, yell at you when they don't see desired outcomes, and they come in with the worst children ever for dentistry. > 90% of them are afraid of the dentists anyway and they don't care about their health. And many of them have had prior criminal records and are hiv/hep c positive.


The worst aspect isn't how they neglect their teeth and general health. I feel like these patients are always bitter. They always act as if they're fully entitled, namely to your money, and they are willing to be tough and look for trouble to get them.

I personally don't think the people in question deserve any kind of help or investment in their ghetto neighborhoods. Alot of decent people are perfectly fine with never having to deal with ghetto people. With the exception of Jesus, why would anyone intentionally want to treat them?

So why do so many dental schools talk of the importance in getting providers to treat this patient pool? This issue is always perplexing to me and I need to know if there is something that I'm not quite understanding.

I am not familiar with the specifics of your experiences within the community health setting, however I did notice a few general issues with some of your statements. First off, you're passing judgments on "these people". As a dental care provider it is not your place to pass judgment on your patients, you're there to deliver high quality care, not look down upon them. Secondly, you're making vast generalizations about poor/urban population pools based on the actions of a few....I believe that's called stereotyping. Lastly, dental educators prompt students to work in poor/rural/urban areas because there is huge disparity in access to care. Just because this is not your ideal working situation does not mean you can completely disregard oral health care for the poor.

 

[pietrodds]

the challenge is not to get dentists to treat these 'people', it's getting someone who has dedicated 8+ years of their lives to work for free because there is no money to pay a professional to treat them. Unless someone has paid your way through school, as a dentist you have lots of bills to pay and those bills are going to pay themselves. However, with that in mind, if you are not a compassionate person, there is no salary that would allow you to get over yourself to treat this population. If you need your ego stroked with monetary gradification or even just verbal appreciation then you will be disappointed treating these patients. I have found that I enjoy donating my time at the free clinic to be beneficial so that I can appreciate what I have not so much that I feel like I'm being appreciated. Many of these folks don't have the ability to appreciate what they have as their thought patterns are stuck in negative patterns of victimization, emotional pain, etc. They live in a constant state of living in the mindset of scarcity. Poverty is as my a state of mind as it is state of finances so don't take it personally when they're not conscious enough to say thank you.

 

[bigstix808]

well, this is turning out to be a better thread than expected. continue...please.

and to the post above mine...well said.

 

[Masseter]

How many time have you offered service to « these people ».

We are a few at our dental school that go to a health center that only treats hiv positive people. Most of them have no work. no house. not even a social security number. They are drug addicts, street workers (we've seen some children (14-15yr old) street workers).

Most of the time we do amalgams/extraction. Sometime a root canal. We do it for free. If they don't feel you judge them, they will thank you. They come to us. We do not force them.

It offers a good feeling of accomplishment to relieve them from the pain they have.

We know that they might throw the toothbrush and toothpaste we give them. We have to deal with this, but nonetheless we do our job. If we give them floss, they will use it to sew their clothes (yes we saw this many times hehe!). But whatever!

I do plan to offer some free service for them if they ever come to my clinic. We are all human, yet we can live in a whole different world.

 

[TedyBearSuicide]

You still haven't moved out of NYC yet, have you???

 

[americanpierg]

I want to perform dental procedures on your mouth.

 

[KinKs]

If by "these people" you mean economically disadvantaged, immigrant, minority, stuggling, hungry, laid-off, in need of support, systematically oppressed, judged or scapegoated - you speak of me and many people I know.

In the moment it took me to read your sweeping generalizations, I had an epiphany. Your very existence and those like you make it quite necessary for this country to have mid-level providers. Evidently, you are too high to treat us. Maybe mid-level providers will.

I hope you will never see the day when you need help from someone and he/she refuses, not because they are incapable but because it is not their business to intrude.

Regards

 

[Demeter]

Just Let them Eat Cake & let their teeth rot out.

 

[laundry]

I just hope that "helping people" wasn't anywhere near a 1 mile radius of your application.

 

[mrlantern]

I just hope that "helping people" wasn't anywhere near a 1 mile radius of your application.

Uhhh.................................

Last week, I had a patient escorted out by the police, a kid asking me if he can sue his other dentist for at least $25k, a lovely young lady who keeps blaming me for the temp filling that came off #19 and has over 15 broken appts, etc, etc.... And a good number of them are just angry people and they make your job 10x harder. Apparently it's not just about the money. You can be miserable working in this environment.

Any comments? Am I still a monster? Does anyone want to apologize to me for their replies?

 

[mrlantern]

If by "these people" you mean economically disadvantaged, immigrant, minority, stuggling, hungry, laid-off, in need of support, systematically oppressed, judged or scapegoated - you speak of me and many people I know.

In the moment it took me to read your sweeping generalizations, I had an epiphany. Your very existence and those like you make it quite necessary for this country to have mid-level providers. Evidently, you are too high to treat us. Maybe mid-level providers will.

I hope you will never see the day when you need help from someone and he/she refuses, not because they are incapable but because it is not their business to intrude.

Regards

You assume way too much, my friend. Please read my earlier reply to this thread and be kind enough to retract your comments. I didn't blindly make up the original post; they were from my experience.

And be careful what you wish you for. If dentists can't treat the psycho patient who keeps screaming in your ears and has to be dragged out of the chair because he doesn't understand that a flipper needs lab fabrication, I don't think anyone can. Mid level providers would probably cry at the first sight.

 

[Eggs n Coffee]

mrlantern's post was not in great taste...

But he does have a point.

We have this idea that healthcare workers are somehow the exception to this capitalist system we're running. We think they should be self sacrificing, benevolent, give up their time to help the poor. But dentists and doctors are human. You cannot expect them to act like they're not a part of the system. Socioeconomic status has a huge impact on your quality of life, so you cannot expect a dentist or doctor to forego that just so they can "serve others." Especially after years of intense schooling, training, and competition. In addition, most dentists and doctors come out with a six figure debt that's gotta get paid.

So when people talk about needing more healthcare workers in rural areas, they can't talk ideals. They have to talk incentives. What incentives are there to bring more doctors and dentists into rural areas? Obviously not enough incentives.

 

[KinKs]

Uhhh.................................



Any comments? Am I still a monster? Does anyone want to apologize to me for their replies?

Ahhhhh...... how about NO

 

[mrlantern]

So when people talk about needing more healthcare workers in rural areas, they can't talk ideals. They have to talk incentives. What incentives are there to bring more doctors and dentists into rural areas? Obviously not enough incentives.

I never signed up to treat Medicaid and low income patients for the hope of making a lot of money. And I'm making significantly less than six figures. I also don't earn any benefits like 401k. Believe it or not, I never had health insurance since almost two years ago. My financial situation isn't good at all but that is not the relevant topic here.

My point is how difficult this patient pool is.

 

[mrlantern]

Ahhhhh...... how about NO

how very nice of you.

 

[MTD52]

Well it's a good thing you're excited about helping other people. At least that's a plus.

 

[omaralt]

i love how most of the replies are coming from pre-dents and dental students. Wait till you get out into the real world.. while i probably would have worded mrlantern's post differently i definitely see his point. it's usually the people that you bend over backwards trying to help and provide free/discounted dentistry that end up stabbing you in the back. many of these people are just looking to make a quick payday, and will sue whoever they think has deep pockets (even though most of us dont have those yet 🙂). its hilarious when i see billboards on my way to work everyday for www.whocanisue.com. that is the society we live in.. i dont mind providing work to under-privilaged peoples, but i do it under my control. i would be more apt to do pro bono work on a hard working, struggling, single mother who comes into my office in pain, but cant afford the rct, core b/u and crown vs doing it on a single mother of 5, who lives in the projects, on welfare, foodstamps, and thinks obama is going to buy her a house.. and feels entitled to all that! instead of being thankful that we're supporting her lazy ass, she feels like she's entitled to even more... anyways, the moral of the story is that i will be providing free/discounted dental care once i finish my residency, but only to people that i feel truly deserve it.

 

[mike3kgt]

its hilarious when i see billboards on my way to work everyday for www.whocanisue.com. that is the society we live in.. i dont mind providing work to under-privilaged peoples, but i do it under my control.

I remember when I first drove by that billboard. It made me want to spontaneous eviscerate my internal organs. Then again, I felt almost the same way when I first saw a dentist advertising on a billboard on I-95. It is almost sad what some people are trying to do for $.

I can say with no hesitation that they are some truly disadvantaged people out there who desperately need help getting back on their feet. I have treated the truly poor and destitute and the very wealthy and advantaged. I can say unequivocally that it feels really good to help out those who truly need help and to give them A+ care. These patients are appreciative of your efforts, cause minimal problems, and are a pleasure to treat.

I can also state without reservation that there are those out there who look to use the system by any means and feel entitled to it. These patients are miserable and are incredibly risky to treat from both a medico-legal and physical means. These patients are unappreciative or have no feelings of your care, cause no to major problems, and make you want to gouge your eyes out they're so awful to treat.

It is very difficult to be able to discriminate between the two groups until it is often too late. In a private practice or community health setting, you are able to discriminate between these patients and weed them out to give care to those who truly need it. When you are attached to the government organ or under contract, such as Medicaid or DHMOs, you are legally obliged to treat everyone. If you refuse to treat these patients, you increase your risk.

-------------------------------

I am sorry mrlantern, your comments are often times accurate, we have told you many times to get out of NYC. There are wonderful places not too far from there where dentistry is relaxing, fun, and profitable while at the same time giving back to the community.

It certainly is concerning the prospect of more government control of dentistry. It is even more concerning the prospect of mid-level dental providers.

Where is the ADA? GKAS... maybe? Or how about supporting increased government control (i.e. federal mandates to states of adult dental medicaid benefits)? Or how about giving in to midlevel providers (Glick)? I still pay my dues but I am not happy about it.

 

[The Hammer]

You know, I really hate it when dental educators and the media talk of how important it is to get dentists treating patients in poor neighborhoods.

Being poor is one thing, and it's not my business to intrude. But the problem is, with this population, the patients are really awful. They argue with you all the way, yell at you when they don't see desired outcomes, and they come in with the worst children ever for dentistry. > 90% of them are afraid of the dentists anyway and they don't care about their health. And many of them have had prior criminal records and are hiv/hep c positive.

The worst aspect isn't how they neglect their teeth and general health. I feel like these patients are always bitter. They always act as if they're fully entitled, namely to your money, and they are willing to be tough and look for trouble to get them.

I personally don't think the people in question deserve any kind of help or investment in their ghetto neighborhoods. Alot of decent people are perfectly fine with never having to deal with ghetto people. With the exception of Jesus, why would anyone intentionally want to treat them?

So why do so many dental schools talk of the importance in getting providers to treat this patient pool? This issue is always perplexing to me and I need to know if there is something that I'm not quite understanding.

Umm because DDS shouldn't stand for Dentist, Douchebag, S H I T heel ?

 

[Saddleshoes]

Being poor is one thing, and it's not my business to intrude. But the problem is, with this population, the patients are really awful. They argue with you all the way, yell at you when they don't see desired outcomes, and they come in with the worst children ever for dentistry. > 90% of them are afraid of the dentists anyway and they don't care about their health. And many of them have had prior criminal records and are hiv/hep c positive.

The worst aspect isn't how they neglect their teeth and general health. I feel like these patients are always bitter. They always act as if they're fully entitled, namely to your money, and they are willing to be tough and look for trouble to get them.

I'm sorry to hear about your bad experience.

I have devoted the lion's share of my career taking care of exactly the folks you are talking about. I have found my patients to be extremely grateful for the care they have gotten. I have also found my patients to be very receptive to ways to improve not only their oral heath but their life style as well. I have not experienced any of the behaviors you are describing.

Maybe I have been lucky, but I have had a very rewarding career, to date, both financially and personally taking care of the very people are talking about.

 

[zeldadds]

'these people' = me.

i am a dental student, a minority, rely on public aid, disadvantaged.

watch what you say in life... because you are no better than me nor any of 'those people' that you've mentioned. We are all human beings and we all have different circumstances, priorities and **** that we go through. Just because you have not experienced those..doesn't mean you are better off. If you think you are, then i strongly suggest that dentistry is not for you..because in the end..it's about you giving an opportunity for 'those people' to smile again when they leave your office...even if its for a second.. that's your job and my job my friend.

please be a little bit more considerate with your words before you spit them out in public just because you were going through a ****ing ****ty day....

 

[Dr.Millisevert]

So when people talk about needing more healthcare workers in rural areas, they can't talk ideals. They have to talk incentives. What incentives are there to bring more doctors and dentists into rural areas? Obviously not enough incentives.

Offer every dental graduate loan repayment (= 25% of principal and yr interest for every year worked in rural/area of need). That would equate to 4 years for full repayment.. which is the same deal as you'd get in the US armed forces. Sounds fair to me. That is the only way I can see these people attracting graduates.

 

[setdoc7]

Not getting it. I work in a public health setting (HHC Hospital) in NYC. We treat a variety of patients including those who are underserved, financially unable to afford care elsewhere, HIV+, medically compromised, etc. Our HIV patients receive top quality care under Ryan-White. We provide excellent care to all of our patients, and rarely run into the issues described in this thread. Our staff dentists and residents all have health care. There is a great 401K as well as other perks (CE, vacation, sick leave, maternity, etc). Think mrlantern needs to look for another job, with better benefits. Oh, and by the way, we are a designated dental shortage area and staff dentists are able to get loan repayment while working here.
We have figured out a way to make it work for everyone. It's a big world and there has to be room for everyone. I do not think anyone should be denied proper care.

 

[Dr.Millisevert]

Not getting it. I work in a public health setting (HHC Hospital) in NYC. We treat a variety of patients including those who are underserved, financially unable to afford care elsewhere, HIV+, medically compromised, etc. Our HIV patients receive top quality care under Ryan-White. We provide excellent care to all of our patients, and rarely run into the issues described in this thread. Our staff dentists and residents all have health care. There is a great 401K as well as other perks (CE, vacation, sick leave, maternity, etc). Think mrlantern needs to look for another job, with better benefits. Oh, and by the way, we are a designated dental shortage area and staff dentists are able to get loan repayment while working here.
We have figured out a way to make it work for everyone. It's a big world and there has to be room for everyone. I do not think anyone should be denied proper care.

Thanks set doc.. Good to know there are at a few reasonable options out there for some applicants.

 

[fxteef]

I do not think anyone should be denied proper care.

This, along with the term "access to care", are part of what I don't quite understand about a lot of the healthcare debate. Nobody IS denied proper care, and everyone HAS access to care. Just because people choose not to use their money on their teeth doesn't mean they don't have access to care. When I lived below poverty in undergrad (ate and paid rent on ~ $4000/yr), I chose to spend some of my scarce money on insurance, toothpaste, and foods that provide nutrition. I didn't always have the luxury of buying potato chips or fast food. Nor did I have the luxury of fixing my wrecked car. That doesn't mean I didn't have access to a mechanic, I just couldn't afford the treatment for my car. With a temporary reshuffling of my spending/earning, I saved enough to fix the problem. The same should hold true for someone who needs dental tx, right?

 

[Quattro DMD]

This, along with the term "access to care", are part of what I don't quite understand about a lot of the healthcare debate. Nobody IS denied proper care, and everyone HAS access to care. Just because people choose not to use their money on their teeth doesn't mean they don't have access to care. When I lived below poverty in undergrad (ate and paid rent on ~ $4000/yr), I chose to spend some of my scarce money on insurance, toothpaste, and foods that provide nutrition. I didn't always have the luxury of buying potato chips or fast food. Nor did I have the luxury of fixing my wrecked car. That doesn't mean I didn't have access to a mechanic, I just couldn't afford the treatment for my car. With a temporary reshuffling of my spending/earning, I saved enough to fix the problem. The same should hold true for someone who needs dental tx, right?

Access to care refers to whether or not a person can obtain needed care. In dental care, it involves the following:

-Is there a dental office physically available within a reasonable distance and open at reasonable times?
-Is there transportation to this dental office?
-Does the person have the financial resources, either on his own or through insurance, to pay for dental treatment?
-Can the person take the time to go to the dentist without jeopardizing his job?

If the answer to these four questions is not "yes," then the person has access to dental care that is restricted, at least to some degree.

(Burt, Brian A.. Dentistry, Dental Practice, and the Community, 6th Edition. Saunders Book Company, 032005. 4.3.3.1).
<vbk:0-7216-0515-X#outline(4.3.3.1)>

And while I agree that people should shuffle their money around to pay for things they need, like dental care, it's not always that simple. Parents for example (well most parents), put their child's needs before their own. If the child needs clothes, food, medicine, they'll handle it. What happens if mom or dad needs a root canal? Well they can't afford it because their son has severe asthma, and the purchase of his name brand medications required all the extra money. What are they suppose to do then?

 

[omaralt]

seems like the best way to get free dental care is to either get HIV or to go to prison..

 

[Dr.Millisevert]

Access to care What happens if mom or dad needs a root canal? Well they can't afford it because their son has severe asthma, and the purchase of his name brand medications required all the extra money. What are they suppose to do then?

As long as this same hypothetical woman's kids aren't sitting around the office playing on their PSP and iPhones.... Or talking about their next vacation or luxuray car.

Otherwise I agree with you

 

[pietrodds]

As long as this same hypothetical woman's kids aren't sitting around the office playing on their PSP and iPhones.... Or talking about their next vacation or luxuray car.

Otherwise I agree with you

A pack a day cigarette smoking habit costs $1500-2000 a year... throw in a case of beer a week and you're looking at another $1000 a year. Drugs are even more expensive!!

A dentist can do a lot of nice dentistry for 3K a year... much of it is the lack of access is an issue of perception/relativity and not reality.

 

[mike3kgt]

A pack a day cigarette smoking habit costs $1500-2000 a year... throw in a case of beer a week and you're looking at another $1000 a year. Drugs are even more expensive!!

A dentist can do a lot of nice dentistry for 3K a year... much of it is the lack of access is an issue of perception/relativity and not reality.

This is the truth and I could not agree more. I cannot tell you how many times people would come into my office when I was working with government plans or even private dental plans who would state that they cannot afford to have anything done because "dentistry is too expensive." But yet these same patients (more often than not... yes this seems like I'm painting a broad brush, but it is the truth) smoke a pack a day every day and have been doing so for the past 15 years.

Cost of a pack of cigs in Ohio = ~ $5.00 x 365 = $1,825 / year x 15 years = $27,375.

From strictly an economic perspective, that's a lot of dental (and medical!!) bills that could have been paid with this waste of money. Add in the physical factors of increased risk due to smoking related disease and the true economic costs are astronomical.

Yet, for me to ask that same patient to pay the front desk $100.00 to have an extraction done is unacceptable. Then this same patient complains about access to dental care.

I know, broad brush, but unless you have been apart of this type of environment, you don't necessarily know the difference between ideal and real.

 

[Moose A Moose]

I can completely empathize with what you're saying. The frustration and difficulty involved with treating those in need stems from their lack of education in the medical process, and what needs to be done to stay healthy. This is a problem faced by all facets of the health industry (dental, opt, med, etc).

I can understand why those in positions of authority and power want to continue this sort of treatment on morale and philosophical grounds. In fact, for the most part I agree with them. However, helping these people- let's say in the lesser areas of the world- is actually hurting more than helping. We heal [and feed] those in areas of the world that have no education, and no further means of self-help. Hence, all they can do is continue to populate an area that already lacks ample means to hold their community. It's a degenerative cycle that only drains funds from other nations. I don't know if any of you are familiar with the 'Ishmael' books by Daniel Quinn, but he greatly touches on these topics with interesting points- hits a lot of ways to solve problems in the world which may seem a little 'off the wall' to most contemporary thinkiners.

..yikes, sorry for that metaphysical tangent. Sometimes these fingers get out of control.

 

[VCUDDS]

ok so to fend off any negative comments about my post...please forgive me if i sound harsh. I will try not to generalize or offend any segment of our society (mainly pt with managed care).

-I have worked in an office that sees 80-90% managed care pt's with age group as young as 2.5yrs old and as old as 85. while it's absolutely true that you cant generlize any hypothesis about the "quality" of pts with managed care a lot of what have been said saddly is true. Now don't get me wrong you do see the few pt's that really need the care, and who really appreciate the fact your providing them with what they need.
-the problem is when you have people going around the system, they come in and they want everything done the same way as if they are paying cash (i dont mean the quality but procedure wise)so you tell'em kindly that veneers are not covered procedure......and they start cursing the system for not taking care of them.....people like that, and even if you only see one/day...will make your day very miserable!.

 

[Gunner McGee]

You know, I really hate it when dental educators and the media talk of how important it is to get dentists treating patients in poor neighborhoods.

Being poor is one thing, and it's not my business to intrude. But the problem is, with this population, the patients are really awful. They argue with you all the way, yell at you when they don't see desired outcomes, and they come in with the worst children ever for dentistry. > 90% of them are afraid of the dentists anyway and they don't care about their health. And many of them have had prior criminal records and are hiv/hep c positive.

The worst aspect isn't how they neglect their teeth and general health. I feel like these patients are always bitter. They always act as if they're fully entitled, namely to your money, and they are willing to be tough and look for trouble to get them.

I personally don't think the people in question deserve any kind of help or investment in their ghetto neighborhoods. Alot of decent people are perfectly fine with never having to deal with ghetto people. With the exception of Jesus, why would anyone intentionally want to treat them?

So why do so many dental schools talk of the importance in getting providers to treat this patient pool? This issue is always perplexing to me and I need to know if there is something that I'm not quite understanding.

Have you thought about switching professions and becoming a stock broker? I read somewhere that the average goldman-sacks trader makes like 700gs a year and they don't have to help anyone out. Dentistry may be too altruistic of profession for someone like you.

 

[Gunner McGee]

http://www.nytimes.com/2009/07/15/b...&scp=1&sq=goldman sachs average salary&st=cse

 

[Dr.Millisevert]

However, helping these people- let's say in the lesser areas of the world- is actually hurting more than helping. We heal [and feed] those in areas of the world that have no education, and no further means of self-help. Hence, all they can do is continue to populate an area that already lacks ample means to hold their community. It's a degenerative cycle that only drains funds from other nations.

..yikes, sorry for that metaphysical tangent. Sometimes these fingers get out of control.

wow... Not like hitler exactly because you're not suggesting taking an active role in killing people.. But it does sound like you are suggesting that the world would be a better place if we do nothing and let the worlds poor and uneducated kill them selves and each other.

Hmmm... Wow

 

[mrlantern]

http://www.nytimes.com/2009/07/15/b...&scp=1&sq=goldman sachs average salary&st=cse

You know it's pointless to mention that, right?

It's harder to become an analyst at Goldman Sachs than it is to get accepted into the most competitive medical/dental school or residency. It'll be next to impossible for a relatively old fart with only a DDS and zero corporate experience, for which they'd rather hire a young buck.

 

[mrlantern]

'these people' = me.

i am a dental student, a minority, rely on public aid, disadvantaged.

watch what you say in life... because you are no better than me nor any of 'those people' that you've mentioned. We are all human beings and we all have different circumstances, priorities and **** that we go through. Just because you have not experienced those..doesn't mean you are better off. If you think you are, then i strongly suggest that dentistry is not for you..because in the end..it's about you giving an opportunity for 'those people' to smile again when they leave your office...even if its for a second.. that's your job and my job my friend.

please be a little bit more considerate with your words before you spit them out in public just because you were going through a ****ing ****ty day....

I don't have medical/dental/vision/etc. insurance either. I've been without insurance for a few years. I'm not in the best of health too. So I know firsthand the importance of the right to medical and dental care. But this was never my point. And I accepted this part-time low-paying job for $275/day because I thought I would be "helping" people and not have to put my financial needs before their dental needs because this is a community clinic.

It's about how the specified patient pool resembles a very difficult group of people to deal with. I don't know why they are very confrontational, loud, and uncooperative. Not all of them are like this but a lot of them are. I have lots of stories to tell but I will not bother talking about them to this audience.

I'm very confused when you mentioned I'm not better off just because I haven't gone through similar circumstances. Are you telling me that these behaviors are acceptable ?

 

[Gunner McGee]

You know it's pointless to mention that, right?

It's harder to become an analyst at Goldman Sachs than it is to get accepted into the most competitive medical/dental school or residency. It'll be next to impossible for a relatively old fart with only a DDS and zero corporate experience, for which they'd rather hire a young buck.

Wow there buddy don't take yourself too seriously. I have a couple of buddies in finance and let me tell you, although they don't work for goldman sachs, they make a ton of money. My point is that in dentistry is essentially an altruistic*profession, and if you have a problem with helping people you might want to look into a career where you don't have to help anyone, make a bunch of money, and hide all of it in the cayman islands so it doesn't go to helping anyone out.

 

[Gunner McGee]

Oh yeah and I forgot to add, 770,000 per year is the average goldman-sachs EMPLOYEE salary, not analyst. And they have like 20,000 employees. How many oral surgeons are there in the US?

 

[Visceral]

Some of you guys need to be a little less quick to jump on Lantern.

It sounds like he's in a really tough situation. 19/20 of the patients I see are great, but there's always that one that sounds like the people Lantern describes. It's hard, it's really hard.

You try to channel all the altruism that you can and think of how you are helping a patient, but when they complain about the cost of implant supported dentures which are 30% of the cost of the normal fee guide, or they try to convince you the PA you took last week was responsible for them needing to go on antibiotics from their MD (not the decay leading to the pulp on several teeth), it becomes rough. It becomes easy to pigeon hole these patients at this point and run with whatever stereotypes may exist. I'm not saying it's right, but when people are stressed and angered it's easy to resort to having such thoughts.

I am lucky in that 95% of my patients are great so it more than makes up for it, but having to see many of these difficult patients can really be draining and can suck the altruism out of the best person.

I'm not saying it's alright to stereotype whole groups of people and judge them, but understand patients like that do exist and can be a drain on you, so in the same light try not to judge Lantern too hard.

Anyways Lantern, sorry things are not working out for you and best of luck. The advice I would give would just be what other people have told you prior.

 

[mrlantern]

Wow there buddy don't take yourself too seriously. I have a couple of buddies in finance and let me tell you, although they don't work for goldman sachs, they make a ton of money. My point is that in dentistry is essentially an altruistic*profession, and if you have a problem with helping people you might want to look into a career where you don't have to help anyone, make a bunch of money, and hide all of it in the cayman islands so it doesn't go to helping anyone out.

.....all written with the logic of a third grader. 🙄

I don't know who raised you but, if I were you, I think I would understand the point of this thread before replying.

 

[Gunner McGee]

.....all written with the logic of a third grader. 🙄

I don't know who raised you but, if I were you, I think I would understand the point of this thread before replying.

You can call me all the names you want but it doesn't invalidate my argument. I believe thats a ad hominem fallacy? And I don't care what the tread is about my goal here is to make you feel bad about yourself.....

 

[armorshell]

.....all written with the logic of a third grader. 🙄

I don't know who raised you but, if I were you, I think I would understand the point of this thread before replying.

Hey man, you may say he has the logic of a 3rd grader, but suggesting you go into finance makes a little more sense (to me at least) than, I dunno, opening up a Burger King franchise.

*coughcough*

I live and work in NYC as a dentist. Apparently NYC is practically an insurance-driven market for dentists. Many workers here are unionized and fall under low-cost health insurances. No patients want to pay anything out of pocket and there are dentists on almost each and every block in the city. It's difficult to not accept as many insurances you can, despite the decline in reimbursements from many dental plans. Add to that the costs of liability insurance ( highly pro-rated premiums in this area. ), unrealistic patient expectations, and a general lack of respect from the public.

The technical aspect of providing quality dentistry is difficult to do, amidst the high overhead from purchases and maintenance of dental supplies and equipment. Many dentists in the area can only afford to rely on low-cost laboratories for fixed prosthetics, which will fit and be easy to adjust only as much as you paid for them. And then there's the costs of maintaining active licensure and taking regular continuing dental education courses.

Apparently the difficulty of this job doesn't justify the earnings.

I want out of this profession. I still have student loans but I'm thinking of tacking on more debt for opening a Burger King franchise. In NYC, even in bad economic times, with the exception of upscale restaurants, people freely spend money on food. With menus from Burger King, the business speaks for itself. ( I honestly think it's less of a business to sell Whopper sandwiches than it is to sell dental services. It's far easier to deal with PITA customers than PITA patients. And the work seems easier than dentistry ) I've done my math. A BK shop that is near reliable foot traffic and regularly has customers appear to NET around a $1000 per day. ( show me an average NYC dentist or physician who NETs $1000/day ) So I'm now thinking, Burger King, here I come !

Any comments? Is this a rational idea?

 

[omaralt]

i hate this argument "if you want to make money go into finance. i have buddies pulling in 1million +/yr, etc, etc". thats a ******ed argument; ya you dont go into dentistry only for the money, but what other profession can you go into that guarantees you a steady 6 figure income? what percentage of dentists go on to make 6 figures? 90%+ i would say. How many business grads go on to make 6 figures? probably less than 10%.. those guys at goldman sachs are the exception, not the norm. a dentist pulling in 6 figures is the norm, not the exception

 

[dentwannabe]

i hate this argument "if you want to make money go into finance. i have buddies pulling in 1million +/yr, etc, etc". thats a ******ed argument; ya you dont go into dentistry only for the money, but what other profession can you go into that guarantees you a steady 6 figure income? what percentage of dentists go on to make 6 figures? 90%+ i would say. How many business grads go on to make 6 figures? probably less than 10%.. those guys at goldman sachs are the exception, not the norm. a dentist pulling in 6 figures is the norm, not the exception

You know, dentistry and medicine (not the cosmetic parts of both) are different from other businesses in that there is a care-taker aspect to it where you help one to improve their health. Their body's wellness is at stake. Few other professions are like that. We're not a hair salon or barber shop. Caries is an oral disease process. Therefore, as a mighty world superpower it makes perfect sense that the government should assist those in need to improve their health, oral and overall. No one is perfect -- There will always be 10,000 excuses not to help someone. "They're buying PSPs, or driving fancy cars". Guess what -- those are not the majority of people. The majority of people simply can't afford care and have a hard time making ends meet. Some will always abuse the system, we have to minimize that but that aspect will be in everything. Even in our modern day tax system, we have hypocritical dentists that cheat on their taxes and then rip on poor people for cheating the government also.

Now I'm not saying this current government healthcare bill is the solution, but we do need a reform which gives some sort of service to all the uninsured.

 

[mrlantern]

? And I don't care what the tread is about my goal here is to make you feel bad about yourself.....

Why would you try making me feel bad about myself if you don't know what the thread is about????

I never said anywhere that my main goal was to become rich. I once complained somewhere else about being poor and having lots of debt but I never talked of how uppity I wanted to be. No one treats poor patients with the idea of being rich. I never wanted thanks either. I just wanted to do good work in the best interests of the patients. But is it too much to ask for them to be cooperative, civic, knowledgable about their Medicaids, and stop causing verbal fights in the operatories? Maybe you're also one of these people and that's why you're becoming offended.

 

[mrlantern]

Hey man, you may say he has the logic of a 3rd grader, but suggesting you go into finance makes a little more sense (to me at least) than, I dunno, opening up a Burger King franchise.

I disagree. He keeps saying finance but I don't know what he's talking about. Finance could mean anything. I think he means investment banking but it's foolhardy to think an older applicant with no business experience could get into something so competitive. The BK franchise is the more logical option ( or so it seems but I can't trust myself on this completely either because I don't know how the business is run ), and would be immediately attainable if it weren't for my student loans that can take more than 15 years to pay off.

And stop stalking my old posts !

 

[junkemails44]

Well, here is another perspective. If dentists are not doing their jobs, then the government might step in start dictating.

 

[mike3kgt]

Even in our modern day tax system, we have hypocritical dentists that cheat on their taxes and then rip on poor people for cheating the government also.

What about politicians cheating on their taxes? What about an Obama nominee who would possibly be instrumental to health-care reform "cheating" on taxes??

"Obama HHS nominee Kathy Sebelius informed the Senate Finance Committee yesterday that she paid nearly $8,000 in back taxes and interest due to "unintentional errors" in her 2005, 2006, and 2007 tax returns."

I don't see anything wrong about writing off CE education, building expenses, and practice improvements. Who can blame any of us (democrats included) for wanting to give the government less of our hard earned $$ to a system that plans on squandering it anyways!! Medicaid is called "entitlement" and those who plan on abusing it view it as entitled to them even though they didn't necessarily have to actually work for the benefits.

I [dentists] on the other hand don't view tax-write offs as "entitlement", but I certainly feel as if I am entitled to my own hard-earned $$ especially after 8+ hours of delicate surgical procedures on human beings and the 8+ years of higher education that went into learning and perfecting the skills necessary to perform those skills!