Fear of managed care

I have had enough articles on your doomsday forecast that managed care is going to take over dentistry, as it has in medicine. In fact, these articles in Dental Economics may just make some of our colleagues sign up for the nearest PPO or HMO contract.

I made my decision a long time ago never again to participate in a managed-care contract, no matter what the cost. I have expressed these personal opinions regarding managed care at our local dental society meetings as well.

I see managed care for what it really is: a method of providing substandard dentistry at a lower cost to the public, something corporate America is striving for to reduce costs to employees. What is interesting to me is that, while dental schools are reducing class sizes, some dentists fear that managed care is the only choice for them if they are to survive. Don`t believe it! Some colleagues act as if this is a new phenomenon. Managed care has been with us for many years. When I graduated in 1983, the only position available was in a managed-care facility. The ADA should be against increasing dental school class size and also construction of new dental schools in this country. Has our ADA leadership taken this position? The same questions need to be asked concerning the recent announcements to close another dental school. Even with all the managed care around us, 80 percent of dentists still are in private practice.

Personally, I would like to see most dentists say to themselves, "I will not sign these contracts because I know it will be harmful to my patients, even if it means a temporary decrease in my income."

Managed care will fail. I know, because I was associated with it right out of dental school. I observed, first-hand, the problems with it and eventually was able to survive without it. I can tell you that since my personal vow never again to participate in managed care, I am not only surviving, but I`m doing very well.

Please stop the articles that feed the fear that is permeating the members of our profession. Managed care is unethical in my eyes and always will be. I remember a quote from a teacher in dental school: "If you are good to dentistry, dentistry will be good to you."

Dino J. Bordini, DDS

Ashland, WI