More on Dr. Dickersons article

Frederick Fisher, DDS

New York, N.Y.

The article in your October issue about Dr. (Bill) Dickerson`s solution to an economically challenged family`s problem ("Walking the Fine Line") was wonderful. I want to share with my colleagues my experience with patients in similar straits.

I have a large, $600,000+ practice that is heavily involved with managed care and third-party reimbursements. Unfortunately a large percentage of my case presentations go unaccepted, mainly because of a real or perceived inability to pay. I will not extend credit.

To help these patients, I have an in-office interface with a major dental credit company that provides instant processing of credit applications. Those that are approved (less than 20 percent) proceed with treatment. I am paid and the credit company handles the collection - without recourse to me. But the 80 percent that are rejected do not receive the necessary treatment. Sadly, I see them at recalls with the untreated pathology progressing.

What I am saying - for me and I am sure elsewhere - is that there is a segment of our population that doesn`t have either the ability or desire - and maybe both - to pay for necessary dental treatment. In my 39 years of practice, I have accepted that as a fact of life and provide comprehensive care to less than 40 percent of my patients. Unfortunately, I do not have a patient base nor a circle of acquaintances willing to help those in need