Dental care and roof repair

April 1, 1998
In the world of managed care and insurance, there is a rule of thumb concerning patient subscribers: Given enough time, people`s perceptions of what actually is happening can be changed.

Carol Tekavec, RDH

In the world of managed care and insurance, there is a rule of thumb concerning patient subscribers: Given enough time, people`s perceptions of what actually is happening can be changed.

In the world of employers and employee benefits, there also is a rule of thumb concerning health-care delivery. This rule says: Health care is a commodity and all providers are the same.

The two perceptions work together to shape the expectations that consumers have concerning health care in general and dental care in particular. Dentists and dental-service purchasers often are on opposite sides of the expectation spectrum. Dental personnel understand the vast differences that can characterize treatment from one office to another. Pur- chasers of dental care often only react to the bottom line.

Dental care and roof repair

Dental-care purchasers do not believe that health care is exempt from economic principles that govern all service businesses. They point to challenges that most face in these industries, be they dental providers or roof repairmen:

1. A lack of consumer knowledge concerning the service being purchased.

When a hail storm damages a roof, the consumer must rely on the expertise of the repair person concerning what needs to be done and how much the repairs will cost. Few consumers have any knowledge of roofing materials, time required for repairs or the costs of supplies. They must rely on the roofer to provide both the information and the repairs. While there is a vague consumer perception that one roofer might provide a better roof than another, consumer capacity for evaluating the job performed generally is lacking.

In dentistry, there is some consumer knowledge of dental treatment and dental-health principles, but it varies widely. Few patients have any knowledge of dental materials or techniques or the costs involved. They must rely on the dental office to provide both the information and the treatment. While there is a general consumer perception that one dentist might provide a better treatment plan than another, patient capacity for evaluating dental care is minimal.

2. The use of specially-trained persons to provide the service.

Persons repairing a roof must have knowledge, gained by training or experience, in how repairs are made. Dentists require years of special training; staff members have varying amounts of education.

3. Liability for inadequate performance of a service.

If a roof is repaired in a shoddy manner, the next time it rains, the roof may leak. The roofing company would be liable for any damage caused to the house. If a patient receives inadequate dental treatment, the dentist would be liable for damages caused by the treatment.

Does this mean that dentistry and roof repair are the same in the perception of the public? In many cases, the answer is "yes." However, to use the same premise embraced by managed care: Given enough time, this perception can be changed.

Employers are beginning to recognize that they may be paying for managed-care services that their employees are being prevented from receiving. Health-care anecdotes regarding barriers to treatment already have resulted in legislative changes. A general feeling about quality concerns is giving impetus to enhanced methods of evaluating dental plans on the basis of expanded standards, not just cost alone. Credentialing of health-care providers and plans is likely to be an employer desire for the year 2000 and beyond. Standards will include criteria concerning technical ability, patient perceptions and appropriateness of care. While cost always will be a consumer concern, the future likely will see an expansion of consumer awareness of quality.

There always will be room for an excellent roofer and an excellent dentist. Consumer perceptions of what actually is happening will support them and help them succeed.

Carol Tekavec, RDH, is the author of two insurance-coding manuals, co-designer of a dental chart and a national lecturer. Contact her at (800) 548-2164 or at

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