Linda Miles, CMC, CSP
Preventing evidence-based dentistry - as defined by insurance carriers - from defining the practice of dentistry should be a priority for every dentist who cares about the face of dental care in the future. Each practice must make a strong statement to every patient who comes in for care that dental insurance is rapidly becoming a joke!
When patients hear the word "insurance," they think "take care of me," as in home, car, and health insurance. Twenty years ago, the dental patient`s maximum allowable benefit was the same amount as it is today, yet dental fees have more than doubled.
In my 22 years of practice-management consulting, I have taken a conservative approach to accepting assignment of insurance as a courtesy to patients, making it easy for them to do business with my clients. Over the years, we have seen insurance-free practices flourish, because the practices were on very strong ground when they became insurance-free. We also have seen other practices lose many patients when they tried to go insurance-free. These practices were not on a strong foundation, commitment-wise, to begin with, and doctor and staff were not adequately trained to make a smooth transition. Now, with the newest tactics being employed by the dental insurance companies, my message is to become insurance-free gradually over the next 12 months and quit letting the insurance companies dictate patient care.
What can each individual practice do to make this transition successfully? What can consultants, authors, and speakers do to assist in this movement? What should organized dentistry be doing? The answer is: do something ... fast! Insurance companies are biting the hands that have fed them for years ... and fed them well.
Dentists who stick their heads in the sand and let others fight their battles will be the loudest whiners in the years to come. They are the ones with practices being "bought" by insurance companies left, right, and center! Promises of equipment and practice set-up costs sound very inviting, but based on what I have heard from dentists I know, the ones who have gone this route have learned later that "there is no free lunch." The price they paid was monumental ... all to do dentistry at huge discounted fees! Most of these dentists have seen the light after a year or two.
My theory is "No docs, no PPOs, HMOs, etc." Dental team members have much more of an opportunity to defend quality care than most dentists do. They spend more time with patients and need to become more confident and competent in using good verbal skills to educate patients about the difference between quality care and discounted or diluted care.They must use phrases such as:
"The insurance industry`s goal is to make money from premiums and save money by diluting quality care."
"Dental insurance preventive-care programs are changing. Just when we thought the benefits to our patients would improve, they have worsened! Just as you pay for other personal services such as hair care, facials, and manicures, you will need to pay for preventive-care dentistry if you wish to maintain a healthy, attractive smile."
Consultants, authors, and speakers must realize that the latest changes proposed by insurance companies regarding evidence-based care will reverse the progress preventive care has made over the past 30 years.
Practices will suffer and become emergency "break-and-fix clinics" in three to five years if evidence-based care becomes a reality. Patients will experience poor dental health, and the industry as a whole will see total destruction in the products and services that are a part of 21st century dentistry.
Organized dentistry on a state level must quickly see this problem as it is. Getting information from the red-tape, bureaucratic channels that exist at the upper level would take years. By that time, it would be too late to do anything to help their totally disillusioned member-dentists.
This is a grass-roots issue that affects individual practices, not something to mull over for three years while the insurance companies gain momentum. Dentists need to wake up and smell the smoke before the fire of evidence-based dentistry destroys the profession they have so diligently created.
Each of you needs to be talking to your state-association executives, your legislators, your dental team, and your patients before this new strategy of insurance carriers becomes a fact - a done deal - and not a tactic!