The recent Viewpoint article by Robert Maccario, while sounding great in theory, is comparing two different industries. Unlike the postal service, which is shipping inert objects whose associated costs are relatively predictable, we are treating people with a whole spectrum of individual needs. The time, care and skills to treat someone may vary significantly from one patient to the next, even if the procedures are the same. They cannot be treated identically, assembly-line fashion, which is, I believe, where this concept of "excess capacity" breaks down.
The other issue is the patient perception and office image. A managed-care patient also may let his friend know that "Dr. X accepts 25 percent less on his fees for me." What image does this project when the nonmanaged-care patient is asked to pay full fee? Is the managed-care patient getting lower-quality dentistry or is the non-insured patient paying too much?
I agree with the quote from the DuMolins, "There are more relationships that must be understood than just a profit and loss statement." Yes, there are. One of the most important of those is the relationship you have with each patient, personalizing care based on the time and skill needed to meet his or her needs.
Frederick C. Lally, DDS
Tunkhannock, PA
