James R. Pride, DDS
As you probably are aware, Reader`s Digest has published an inflammatory article in its February issue titled: "How Honest Are Dentists?" On the newsstand, the special cover proclaims "Exclusive Investigation: How Dentists Rip Us Off."
This Viewpoint explains:
- Why we need to perform a proper new-patient examination and consultation.
-Why we need to spend the proper amount of time with our patients,, building relationships and asking the right questions.
- Why we must listen to our patients` needs and wants for their oral health as we proceed with making proper diagnoses.
The article by Ecenbarger is disturbing on several counts, not least among them being that it may very well set dentistry back 20 years in the public`s perception:
What About the Others?
The tone of the article is inflammatory. Out of the 50 dentists Mr. Ecenbarger talked to about his oral health, he describes 13 "good" dentists, including those on his trusted "panel." He showcases 12 "bad" dentists. These numbers add up to 25. What about the other 25 dentists? What were their diagnoses? Apparently, there was nothing dramatic or "newsworthy" to report there.
The ADA`s Dr. Leslie Seldin rightly responds in the article that patients should seek out two or three opinions if they have not yet established a relationship with a dentist they can trust. Mr. Ecenbarger had 12 dentists allegedly misdiagnose him. Yet, true to his inflammatory tone, Mr. Ecenbarger sums up the article by stating, "I got 50 opinions and I am not comforted."
What about the other 38 dentists he talked to? Do their diagnoses not count? The reader is left to feel as if there are no ethical dentists anywhere in America.
The title says that dentists uncategorically rip patients off. This is simply incorrect and untruthful. The title alone is sensationalism of the worst order. But, then, this wouldn`t have been much of a story unless it was written with the kind of twist that would allow "How Dentists Rip Us Off!" to scream from the cover.
Slams Direct Reimbursement
The next disturbing element in the article is the way it slams the direct reimbursement employee dental benefit. Mr. Ecenbarger incorrectly assets that dentists like it because "there is no third party such as an insurance company questioning their work." Again, the implication is that dentists are "ripping off the system."
Direct reimbursement plans have an annual limit on the amount of the benefit-typically $1,000. Mr. Ecenbarger`s repeated assertion that because he had direct reimbursement the "bad" dentists tried to contrive huge treatment plans and fees simply makes no sense.
Direct reimbursement is many wonderful things, but it is not a carte blanche, unlimited benefit. Mr. Ecenbarger clearly has no idea what direct reimbursement is, or how it works. Neither, apparently has he heard of managed care and the truth about the way such insurance plans can limit patient care.
Direct reimbursement eliminates all of these constraints and lets the dentist and the patient decide what is appropriate care based on the condition of the patient`s mouth and the patient`s long-term goals for his or her oral health. Patients get to see their dentist of choice. The patient`s employer pays the dental bills up to the annual maximum and saves money over conventional insurance plans by eliminating the expensive monthly premiums.
Of course, insurance companies are out of the action altogether and they don`t like that.
We are very suspect about the use of direct reimbursement in Mr. Ecenbarger`s "research," since less than 500,000 people participate in such plans through their employers across the U.S. and the majority of people don`t even understand the term. Why didn`t Mr. Ecenbarger say he was in a capitation plan, a PPO, or a major insurance plan? It leads us to believe that there is something going on here besides honest journalism.
The author is founder and president of the Pride Institute in Greenbrae, Calif. He is a founding board member of the Alliance for Dental Reimbursement Plans.