Who are the "real doctors" now?

by Dr. David Madow and Dr. Richard Madow

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As dentists, we have been known to complain and whine from time to time about those people we love to hate yet could not live without – the insurance companies. Yet compared to physicians, we actually have it made! A recent editorial in the Baltimore Sun newspaper truly illuminated the problems that our physician colleagues are facing nationwide.

Among the many headaches that physicians are experiencing, insurance companies subject them to "step therapy," in which five less-expensive protocols must first be tried before an actual prescription is put into practice. When it comes to providing actual treatment, their "pre-approval" systems make ours look like a giant hall pass.

Nearly 70% of physicians believe that health insurance protocols are having a crippling effect on their practices and 95% say that these restrictions have a negative impact on their ability to properly treat patients. Can we say the same? Not even close!

Let's face it. Dentistry has always had a love-hate relationship with physicians. We know that, as compared to our MD colleagues, we truly are a united force in fighting disease and promoting health to citizens. Yet there has always been a little inferiority complex on our part. Some of us even self-effacingly refer to medical doctors as "RDs" – real doctors. But it seems as though dentists in this country may have the last laugh.

Many years ago, when physicians made the decision to leap into bed fully unclothed with insurance companies and the government, we watched from the sidelines. Patients who became accustomed to medical insurance paying most – if not all – of their physician's bills, could become perplexed that dental insurance was mainly for preventive services, and had severe limits when it came to any substantial treatment. As it turns out, this system immensely benefits dentistry since it puts treatment decisions where they belong – between patient and doctor.

Have you seen an estimate of benefits for medical services lately? The insurance companies tell the physicians what to charge, to lower their reimbursements by a huge factor, and then make it clear that the patient is only responsible for a small fraction of the remainder. Does that sound like the worst dental HMO you have ever encountered? It is.

The good news is that most of us don't participate in these, and even dentists who do are learning to wean off them. Dental services not covered by insurance are actually to our advantage! The choices and fees are clear, and the decision is where it belongs – in the dental office and not in a stack of papers sitting on an overworked insurance company clerk's desk.

For well more than a century, dentistry and medicine have been two of the noblest and most honorable professions. Both have been blessed with great respect in communities, excellent incomes, pleasant working conditions – and best of all – the ability to cure and prevent disease. This betters the lives of all people.

Ask your primary care physician if he or she would encourage someone to enter the medical field. Chances are you will get a resounding "no!" As medical doctors work longer hours, are forced to spend less time per patient, experience a loss of control over what they can and cannot do, and watch their incomes stagnate or decline, many "RDs" today are frustrated and disillusioned.

But how about us? Dentists' incomes are rising despite the recession, admission to dental school is more competitive than ever, and many dentists – at least the ones we meet – seem to love what they do. The race to keep insurance and government intrusion out of dentists' lives is one in which we have overtaken our medical friends many times over. Most experts agree that whatever road government participation in health care takes, dentists will not experience much change.

So, congratulations for being a dentist! We have (for the most part) our autonomy, the ability to treat patients as we see fit – and most of all – our self-respect. And no third party is going to change that!

Since 1989, Drs. Richard Madow and David Madow have been helping colleagues achieve success and happiness in their dental practices. They are internationally known for their content-rich and humor-filled presentations. To find out how the Madow brothers can create greater success for your practice, visit www.madow.com.