Have a seat — it's time to talk money

April 1, 2004
Everything and everybody is and always will continue to be in motion. Science teaches us that stagnant organisms lose life and eventually become food for more dominant forms of life.

Tom Limoli Jr.

Everything and everybody is and always will continue to be in motion. Science teaches us that stagnant organisms lose life and eventually become food for more dominant forms of life. These observations of life and movement apply not only to the world of science and technology, but also to the open free market economy that is served by the profession of dentistry. The marketplace has and will continue to change.

Now comes the question of perspective. Who is seeing all this change and what are we going to do about it? Not so long ago, the profession of dentistry was one of sovereignty and independence. Every dentist was the king or queen and master of his or her destiny. Dentists answered only to themselves, their patients, and the licensing authorities charged with maintaining the safety and integrity of the profession. Then came the insurance companies and their clients. Patients were somehow separated from the primary bill-paying mechanism. Finally, someone other than the patient was responsible for paying the bill. The common enemy (the insurance company) was easy to use, abuse, and blame. Then, like the chameleon, the enemy continued to change with its environment. If it did not change, it would be eaten. But eaten by whom?

In my earlier years, I studied the sociological theories of Karl Marx. In his theory of alienation, Marx used the example of a man who built a simple chair for his child. During the building process of the chair, the man felt great pride and love in his work. Attention to every detail was not a challenge. The man knew that soon his child would enjoy the fruits of his many hours of detailed labor. The energy that went into the building of the chair was sparked and maintained by the love he had for his child. The product and the process became one and the same as the man experienced the joy of seeing his child in the chair.

As time passed, the man reflected back on the joy of building the chair. He then builds a chair for the child of the village baker. The chair was delivered to the baker in exchange for bread. During this chair-building process, something within the man began to change. Another chair was made in exchange for meat with the butcher, and still another bartered for vegetables from the farmer. But with each subsequent chair that he made, the man became more alienated from the process. It just wasn't the same as when he made the chair for his own child to use and enjoy.

What is the moral of the story? Ignorance of change yields alienation. Both the product and process of building the chairs remained the same. It was the change in intent (your child vs. someone else's child) that alienated the man. Are current and future changes in third-party insurance reimbursements alienating your practice from the marketplace? Don't alienate yourself and your practice from the business of dentistry. Nowhere is the analogy of the chair truer than in today's delivery of health care. Like it or not, competition for price, value, and convenience are major considerations that are unwisely ignored in today's health care environment. And, let's not forget the upcoming November elections. Are the politicians telling us that health care is a right or a privilege? Who draws the line between the two? Are the two actually one and the same?

Are dental and medical care really all that different? Does the American consumer see the doctors (MD/DDS/DMD) as products or processes? Is the future of dentistry a road map to overall health or simply a path to huge, lifeless, china-white teeth? What are the wants and needs of the consumers in your area? Don't let the lunatics run the asylum, or the government will step up and more comprehensively address the travesty of our underserved populations. The National Academy of Sciences in its Jan. 14 report is calling for universal health insurance coverage for all Americans by 2010.

So where do we go from here? As the Cheshire Cat said to Alice, "If you are lost and don't know where you are going, then any road will do." If you don't care, get out of the way and keep your mouth closed. How dare anyone speak poorly or with less honor of the doctor who treats an underserved or insurance-dependent patient base?

The roles of reimbursement are changing the structure of your bank deposit and appointment book, as well as your voting precinct. Follow the money back to the source and you will see whose chair you are actually sitting in.

See you on the road!

Tom Limoli Jr. is the president of Atlanta Dental Consultants and the editor of Dental Insurance Today, a bimonthly publication that addresses third-party reimbursement in the dental office. He also is the author of Dental Insurance and Reimbursement Coding and Claim Submission. He can be contacted by phone at (404) 252-7808. Visit his Web site at www.LIMOLI.com.

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