Robert Maccario wrote a very informative article in your September 1997 issue, urging a different look at managed care. In a very detailed sidebar, he profiles a general practice averaging $35,000 in production per month. His calculations speak of incremental income in a situation where fixed expenses already are covered. I believe he misses a major point.
If I decided to become a member of a managed-care program, I believe that it is true that I may, in fact, derive new patients and fill any empty slots in my appointment schedule.
Unfortunately, the many patients I already have who are insured by that company would in that instant no longer be full-fee patients, but would automatically switch to managed care. If I had 300 patients covered by that insurance company who were willing to pay extra to be a part of this practice, and if I discounted all of their fees 30-40 percent, how many new patients would I need, and how much dentistry would I have to do, to merely break even? I know that I probably could come up with a slew of different answers and use statistics to prove each one.
But the fact remains, before I get my first new patient, I would effectively be giving back significant dollars to the insurance company for the privilege of having my name on its list.
Therefore, I continue to believe that unless one`s practice is well below critical mass or if one is practicing in a unique area where managed care is everything, it`s a delivery system that`s best avoided by most mature practices. It might fill some small spots in my schedule, but not at a price that would put more dollars in my pocket.
Steven H. Schwartz, DMD, FAGD
Budd Lake, NJ
