Will managed care overrun dentistry?

[Alpha13]

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Saw this posted in pre-allo and thought it was worthy of discussion:

Dentistry is only temporarily unaffected by managed care. If you are not worried about managed care moving in on dentistry, or think they have the power to prevent it because of this cavalier attitude that all dentists intrinsically have, then you are being naive.

Do you guys agree? I'd hate to see dentistry go the way of medicine. I think in the long term it may be inevitable though.

 

[aphistis]

Saw this posted in pre-allo and thought it was worthy of discussion:



Do you guys agree? I'd hate to see dentistry go the way of medicine. I think in the long term it may be inevitable though.

99.8% of the people in pre-allo don't even know what's really going on in their *own* profession, much less anybody else's. It must be that cavalier attitude that all wannabe physicians intrinsically have. 😉

Nobody has a crystal ball to know for sure what the future holds, but the prospects for dentistry right now look as promising as they ever have, for as far into the future as anybody seems interested in speculating.

Infiltration by managed care is always a concern, but a lot of dentists put a lot of effort into rebuffing it, and to be fair, a lot of what dentistry has collectively learned about resisting managed care came directly from observing the methods HMOs employed to become such a dominant force among physicians. Those doctors' pain has, unfortunately, become our gain.

 

[HermeytheElf]

I doubt very much that most of the people who are now considering dentistry as a profession would be as enthusiastic about it if they did indeed consider managed care to be a major threat. In my opinion, dentistry has withstood and will continue to withstand the insurance companies...the only real threat is of government intervention which may be inevitable when a large enough percentage of americans can no longer afford health insurance. If healthcare comes under government control, its a good bet that dentistry will get thrown in as well. But until then, enjoy the autonomy that dentistry as a profession affords you.

 

[adamlc18]

The lack of managed care was one of the big draws for me from medicine. That being said, I think dentists may end up shooting themselves in the foot by touting how oral health is essential to your overall health. Most of the public sees dentistry as necessary but elective if that makes any sense at all. I think if there is such a big push about how oral health, especially perio can cause heart disease, there may be more of a push for dental insurance. That being said, I think dentists in general will fight tooth and nail to resist most blatant attempts for HMO's for the majority of the population.

 

[I'mFillingFine]

sorry, comp froze and made a dupe 🙁

 

[I'mFillingFine]

Also, I think the very fact that dentists have such autonomy (and from reading SDN, this seems to be a big factor in all our decisions) can keep their heads above water in taking a stand against insurance factories. So many run their own business or have a small team practice that it'd be much harder to pull said wool over said eyes. A lot of med school residency grads are just so eager to get into the business, that they can get swept into a big institutional hospital or distracted with all the managed care CRAP.



....But we're certainly all sounding quite optimistic! Any seasoned dentists or office managers out there to tell us how medical economy really works once we're out there?

 

[Sprgrover]

Saw this posted in pre-allo and thought it was worthy of discussion:



Do you guys agree? I'd hate to see dentistry go the way of medicine. I think in the long term it may be inevitable though.

No. What that guest overlooks, or is completely unaware of, is that a huge chunk of what dentists do is deemed cosmetic and elective by insurance companies. Verneers, implants, and tooth whitening are service many people are willing to pay for but are far from necessary to sustain life. Dental insurance doesn't exist in the same sense as medical insurance - what is out there are dental spending accounts. Furthermore, dentists are able to operate on a cash only basis (and many do) and many are small business owners. Conversely physicians rarely are their own bosses (they are a part of a hospital, for example), their services are rarely considered elective, and you'll be hard pressed to find any physician that is able to operate without accepting insurance. These are some of the many things that have snared their profession in politics. In addition, dentists have kept their profession largely self regulated and continue to fight for this. 80% of dentists are members of the ADA (which goes a long way when the the ADA is lobbying in Washington) versus the AMA which can only claim it represents ~20% of the doctors in America. In short, claiming that dentistry will fall prey to managed care is like saying an apple will morph into an orange.

 

[Ankylosed]

No. Conversely physicians rarely are their own bosses (they are a part of a hospital, for example), their services are rarely considered elective, and you'll be hard pressed to find any physician that is able to operate without accepting insurance. These are some of the many things that have snared their profession in politics.

I disagree with this statement. The largest percentage of physicians are their own bosses, even though they may part of a larger group of physicians. Most physicians are independent contractors to the hospital, but are not actually part of or employed by the hospital. The hospital merely provides a place for the physician to do his work. Also, there are a greater amount of elective cases done in the OR than non-elective cases on any given day. It would be a real mess if the majority of cases were nonelective.
Many times it really comes down to whether the patient can tolerate the pain of their affliction or not, but this doesn't shift the case from an elective to a nonelective case. I don't disagree with you about the dental situation, but I think you need to straighten up your facts about the medical part.

 

[DcS]

Saw this posted in pre-allo and thought it was worthy of discussion:



Do you guys agree? I'd hate to see dentistry go the way of medicine. I think in the long term it may be inevitable though.

The ironic part about what that person said is that it is the fact that dentists are not cavalier. I don't have to go into detail becaus Sprgrover hit the nail on the head.

"In addition, dentists have kept their profession largely self regulated and continue to fight for this. 80% of dentists are members of the ADA (which goes a long way when the the ADA is lobbying in Washington) versus the AMA which can only claim it represents ~20% of the doctors in America. In short, claiming that dentistry will fall prey to managed care is like saying an apple will morph into an orange."

That is the reason managed care has not infiltrated dentistry. It's because of the strength of the ADA and the lobbying power they have. It's the very opposite...MDs are too cavalier to feel a need to join the AMA...which is what cost them the opportunity to fight managed care in the way dentists have.

Just proves the ignorance of the original statement.

 

[Legacy]

80% of dentists are members of the ADA (which goes a long way when the the ADA is lobbying in Washington) versus the AMA which can only claim it represents ~20% of the doctors in America. In short, claiming that dentistry will fall prey to managed care is like saying an apple will morph into an orange.

I've heard we're all probably "safe" for the rest of this decade. Anyone starting their dental doctoral program next year should be out before any rampantly widespread and serious managed dental care trends develop. But if it happens then it will be a McDonaldized trend just like medicine. Accordingly, all the ADA lobbyists in Washington may not be enough.

When I say 'safe' I don't mean I have a jihad going against all the McCastle Dentals out there. Still, giving affordable care in a private practice is a trademark of the profession of our fathers, grandfathers, and great-grandfathers (also mothers, grandmothers, etc.). How can you make your prices fair to all "your" patients when you have agreed to allow someone to jack up your prices relative to all patients period? Dentistry is expensive regardless and there can be no systematic extra value meal for dental pricing procedures that lets dentists co-learn, co-gatekeep, and co-operate as they have done for the past century. The bad side we have to realize --> every existing managed care business out there currently sends every private practice mailed literature trying to convince even the oldest veteran dentists that they are wrong "as-is" because they are not caught up "with competitive and organized business practices." The horror, the horror! But do their economic philosophies of competition and organization agree with my own philosophies on fair pricing and flexibility? That is the question that must currently be keeping the wolves at bay.

This is also where being your own boss becomes not some selfish personal vendetta against every minimum wage overseer-martinet who has made you miserable. You can get what you give and not have to feel a guilt-trip about how your own business serves others and serves itself. I'm not going to mention managed care in my interview if I can help it because unfortunately in any kind of discussion the rhetoric seems to always funnel its way down to someone else's humility-instilling and outright vindictive perception concerning the ambition of wanting to become one's own boss. In short, a trap for those lacking in outspokenness. Relative to what managed care 'could' do to my pricing schema and scheduling flexibility, I know that being my own boss would be best both for me and my patients.