Huge group of dentists slandered?

It is difficult to pick up any dental publication these days without encountering an advertisement for 1-800-DENTIST. Marketing-wise, this organization is on a roll. With what passes for slick advertising in the practice-management arena, 1-800-DENTIST allies itself with the fight against managed care to heighten its appeal to dentists, using a retinue of well-known gurus to hawk its wares. The most recent ads feature participating dentists and, believe it or not, their patients, listing actual

It is difficult to pick up any dental publication these days without encountering an advertisement for 1-800-DENTIST. Marketing-wise, this organization is on a roll. With what passes for slick advertising in the practice-management arena, 1-800-DENTIST allies itself with the fight against managed care to heighten its appeal to dentists, using a retinue of well-known gurus to hawk its wares. The most recent ads feature participating dentists and, believe it or not, their patients, listing actual procedures performed on those patients. All you need to do is to affiliate yourself with this organization and you, too, can get patients like this, with apparently unlimited dental needs and, presumably, pocketbooks to match.

Before we are all swept up in the hype, it might be worthwhile to consider the possibility that this organization may not be entirely a good thing for dentistry. To begin with, basically what it does is provide, in return for a fee, the names of dentists to prospective patients. Put less gently, it is receiving a kickback for a referral. If I informed my orthodontist that I expected a payment from him when I referred patients to him, he probably would, and rightly so, report me to the state board. If there is a difference between this and what 1-800-DENTIST does, I fail to discern it. The practice of paying for referrals violates long-standing ethical canons in the healing professions. These canons exist because of concerns that when patients are referred for financial gain, the patient`s welfare may suffer. These concerns are just as real today as they ever were.

In addition, there is an implicit message to the public that the screened dentists affiliated with this organization are somehow better than the other dentists, the "unscreened," if you will. If not, what justification is there for 1-800-DENTIST to exist? But if its screened dentists are better, where does that leave the rest of us, the unscreened? We must be, presumably, second-rate; the ones left over when the screening process is complete. Why our honored profession would tolerate this ludicrous effort to categorize dentists by this self-styled screening organization is beyond comprehension. Each state we practice in licenses us by one standard and holds each dentist out as capable of meeting the dental needs of the public. Who authorized this commercial organization to further screen our colleagues?

This organization further trivializes our profession by asking the public to respond to the 1-800 format. Would any of us really pick a brain surgeon by calling 1-800-BRAIN or an oncologist by calling 1-800-CANCERDOC? The 1-800 format has been used in our society for getting lower long-distance rates and air fares. It has not been, and should not be, identified with the selection of a health professional. We all need to be concerned with the image our profession maintains and guard it jealously from attempts to sully the image for profit.

1-800-DENTIST exists basically for one reason: it provides patients to fill empty chairs. In our quest to keep our chairs full, though, we must be careful to maintain the dignity and honor of our profession. Our state boards need to review this organization and determine if it preys on the uneducated and naive among the public, and whether it promotes the highest ideals of dentistry. And as dentists, we need to ask ourselves if this organization is allowed to exist only because we do not insist that our dental associations help market our services in a manner we would control, not 1-800-DENTIST.

In the end, 1-800-DENTIST is predicated on a lie to the public. The lie is that the participating dentists are somehow preferable to dentists that don`t participate with this organization. This amounts to a professional slander to a huge group of American dentists. As one of that group, I resent that slander. Maybe we all should.

Jay C. Herrington, DMD

Gainesville. FL

Response from Michael Apstein, Chief Executive Officer, 1-800-DENTIST: Let me get a couple of facts out of the way right at the top. Futuredontics, in its 1-800-DENTIST cooperative program, does not charge nor receive a fee on a per- referral basis. Our cooperative service allows dentists to come together, pool their resources and advertise in a way that no one of them could afford to do on his or her own. In so doing, they have not only helped their own practices, but helped thousands of other practices and dentistry at large by creating advertising that is uplifting to the profession and educational for the consumer. Television commercials about dental sealants, whitening, laser therapy and implants are areas where 1-800-DENTIST and its member dentists have led the way in educating the public about advances in dentistry.

As to the issue of screening, in the most typical way one finds a dentist, word-of-mouth or Yellow Pages, prospective new patients in their process usually obtain very little information. Further, one of the significant problems with managed-care programs that promote closed panels, is that the consumer is denied the freedom of choice to pick a dentist who best matches his or her needs.

We believe that new patients should get all the information they want about their new dentist. One of the goals of our advertising is to promote the significant amount of information we have collected on our member-dentists, which typically is not available via the Yellow Pages, word-of-mouth referral or a managed-care program. Are we promoting our service and our dentists by stating that? You betcha! And it is just the kind of promotion dentistry needs more of. The Milk Advisory Board recognized that drinking milk has to be more than just good for you. Its campaign promoting milk mustaches, along with the slogan "Got Milk," made it cool, too.

One of the problems in dentistry has been that dentists have been slow to promote their own practices, advances in dentistry and dentistry at large. Many consumers are known to view dentistry as painful, expensive and unnecessary. But the worst part in our sound-byte, e-mail, MTV, 30-second-attention-span society is that dentistry is just plain boring.

Dentistry has failed in one of its principal missions if over 50 percent of the U.S. population does not go to the dentist. While it has succeeded in tremendous advancement in a number of areas, it has failed to communicate those advancements. Futuredontics has developed a marketing approach in 1-800-DENTIST that makes a small dent in this phenomenon. It is an approach that has succeeded in getting a million people a year to reach out and give dentistry a try. To suggest that it "trivializes the profession" or "sullies the image" reminds me of standing on the wharf in San Francisco and watching crabs in a basket. Those of you who have seen it will know that when one crab climbs up the basket and starts to head out, the other crabs will pull the freedom-seeking crab back down into the basket. I often have thought crabs in a basket were a good analogy for what has happened in dentistry.

Our advertising creates hundreds of millions of positive household impressions about dentistry month in and month out, more so than any other dental organization in the U.S. And yet, the writer would seek to take the image of dentistry and "guard it jealously." Isn`t that another way of saying "keep it boring?" Dentistry is a noble healing- arts profession, but if it is to survive it also must embrace the business side of dentistry, including self-promotion.

I am proud of 1-800-DENTIST for a number of reasons: from the quality of our commercials to our excellent operators and their patience in dealing with people who often are scared and have not been to the dentist in years. I will agree that 1-800-DENTIST is guilty of one thing: we do fill empty chairs. And that is the thing of which I am most proud. In 12 years, we have sent millions of people who needed dental care into dental offices. We`ve done it by adding a little pizzaz. Maybe I just don`t get it, but somebody is going to have to tell me again how that is bad for dentistry.

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