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The Dental Insurance Myth

June 26, 2013

Filed under: Business of Dentistry — Tags: , — Barry @ 10:00 AM

222686138_ed1d0a1381_zIf you are a dentist who never participated with dental plans and live in a geographic area that has been hit hard by the recession, and if you are like me, then the thought of participating has probably crossed your mind a few times over the last couple of years.

Last week I heard a veteran dental consultant admit they she changed her tune.  In the past she advised dentists not to participate but lately found herself advising her clients to selectively participate.

I have thought long and hard on this issue…even about the future of fee for service dentistry as a continuing viable model.  The gut reaction is that fee for service has seen its last days, and the more plans you affiliate with, the better prepared you will be.

Readers of this blog know that I am a big fan of thinking…thinking critically, rather than reacting to my gut.

I live in Jersey, a highly competitive area for dentists.  Geography is important when looking at this issue.  For example, if I lived in a town where 75% of the population was covered by insurance, that would be a major factor in my decision-making process.

But I live in Jersey…lots of people…lots of dentists.  A level, competitive market.

Looking at the stats, probably only 47% of the population has dental insurance.  Fifty three percent do not.  I can live with that.  What do those 53% of patients have in common?  If you said that they have to pay for dentistry, you would be right.

And the 47%…well, they each have different ideas about who pays for their dentistry.  No two people think alike.  We can’t generalize about values.  I hear a lot of talk these days about entitlement issues, but let’s not get political.  In better economic times people have a less difficult time paying “out of pocket.”  But let’s not kid ourselves —out of pocket expenses are the issue…they always have been, and always will be.  Whether insurance is a factor or not…values trump everything.

The biggest difference is the size of the pockets.

I heard a statistic once that claimed that 95% of dental benefits are left on the table each year because people don’t want to pay after they reach their limit.  Hmm!  That bothered me on many levels.  The effect of dental insurance on actual treatment seems to be less than what most people believe.

So why does the insurance question cloud our thinking…and I mean everyone’s thinking…doctors, patients, businessmen and politicians?

Why do dentists allow this illusion to interfere with their life’s work?  By participating the dentist will certainly get an increase in patients.  They will come from that 47%…and bring with them the questions about who pays what and what gets covered, and what is excluded, and when they can do it and, and, and…

Those that don’t participate, only have to deal with one patient at a time, one case at a time.  By not participating the dentist maintains his autonomy (freedom to make all decisions), his ability to create meaningful dentistry on people who value the dentistry (they pay for it) and his level of competence by doing procedures that may not be covered by insurance companies…ever!

When I look at it like that, I feel better, knowing I am doing the right thing.  Economies change…but people remain constant…people want to keep their teeth.  When our culture finally wakes up to realize that it’s the dental profession that wears the white hats…not the insurance companies, then we may put insurance into the proper perspective.

Just my thoughts.

Television Mimics Life

September 18, 2011

Filed under: Marketing,What Would LD Do Now? — Tags: , — Barry @ 6:48 PM

When the King of Queens was popular on television I never watched it.  These days I watch it everyday on reruns.  I love Doug and Cari…and I guess their popularity can be explained by their universal truths.

The other night I watched an episode that portrayed Doug having a difficult time with the challenging problem of selecting a birthday gift for Cari.  This is a quandary I find myself in at least once each year.

Doug was overjoyed when he found the “perfect gift.”  Cari complained about how badly she looked in glasses, so Doug bought her Lasik surgery.  Pure win-win.

Until, (more…)

10 Ways to Become a Mediocre Dentist

April 7, 2010

Filed under: ARTICLES,Uncategorized — Tags: , , — Barry @ 10:22 PM

Okay, a touch of sarcasm in the title, but I think it’s quite appropriate for our times.  The future of dentistry is in the balance. Unless you live in a cave, you can’t  have missed a cultural shift in our profession.  It’s been occurring for years, and now we are in a definite realignment.  It all started with the fragmentation of dentistry.  First with the institution of dental insurance in the seventies, then the onset of professionals advertising and the loss of meaning of the original ADA’s Code of Ethics in the eighties.

The nineties brought us the proliferation of (more…)


March 29, 2010

Filed under: ARTICLES — Tags: , , , — Barry @ 4:09 PM

Yesterdays’ post had to do with showing dogs and standards.  I used the words apathy and complacency to show how we have become resigned to this lowering of standards.  Then it hit me…the word, “whatever” has been used so often in our culture that we have come to accept these lower standards.

As an aside, I was back at the dog show yesterday.  I met with a lady who actually introduced me to the boxer breed twenty years ago.  She is a judge today and the owner of some of the most gorgeous dogs in boxer history.   I respect her opinion more than anyone in this field.  Coincidentally in our conversation she revealed to me that she believes that before she dies she will actually judge a group of “white” boxers.  This has never been accepted in the AKC.  Of course we love all dogs, but dogs with potential genetic defects just don’t make the standard.  Politically correct and fairness really don’t come into play when we are talking about excellence and standards.  Free markets and competition is what made this country great.

Culture Shift?

March 27, 2010

Filed under: ARTICLES — Tags: , , , , — Barry @ 5:49 PM

Future Champion?

There are signs everywhere.  Everywhere you go these days you can see signs of a culture shift.  Just this morning I attended a dog show in Edison New Jersey.  I had an entry in the show, my one year old boxer puppy, Phoebe.  In years past I would look at the catalog to see the competition.  I noticed that just about one third to one half of the entrants were sired by dogs that had not received their championship status.  Some years ago an entrant who was sired by a non-champion was an anomaly.  Was a shift occurring?

The American Kennel Club (more…)