TAO the Book Installment 10 – What patients are looking for

HEALTH CARE IN AMERICA

I am a baby boomer. I am part of the generation that was born between 1946 and 1964.  Baby boomers have the reputation for being quite independent.  There are 77 million baby boomers in this country, and they have driven the marketplace since they were born.  My practice has seen this over the years.

I began practicing in the early seventies when dental insurance became popular. I have seen insurance become a major force in the dental community, and I have witnessed its relative irrelevancy.  I have seen the coming and goings of closed panels, department store clinics and DMOs.  I have been part of the cosmetic revolution.

I feel that the key to success in today’s marketplace will be to pay attention to the “longevity” factor. The most important thing on the minds of baby boomers is aging healthfully as they go through their transition years.
Longevity is the key. According to the U.S. Census Bureau, there will be more than one million centenarians in 2050, up from 71,000 today.  Some gerontologists believe baby boomers could reach life spans of more than 120 years.  As people age they want to look and feel younger.  They mourn the loss of their vision, hearing, libido and their teeth.  Helping people keep their teeth will be (hasn’t it always been this way?) the number one desire of baby boomers as they get older.  When it comes to dentistry, the most successful of us will be the ones who address the fear of losing health, comfort, function and esthetics…in other words, comprehensive care.  According to Ted Roszak, in his bestselling book about boomers, The Making of the Counter Culture, written in 1969, and repeated again in his 2001 book, The Longevity Revolution,

“Every society that moves into the modern era will be an aging one.  This is not something to be thought of only in terms of how many people are reaching the age of 60 and will reach the age of 70. It’s the total social pattern of industrial society.  Industrial societies have a big destiny, which is to age.  And for that reason their values will change because nothing changes values more than a serious demographic shift.”

The dental community has been led to believe that the essence of modernity is youth.  I think they are wrong – the essence of modernity is aging.  I have felt this way for a long time and Roszak confirms my feeling when he observes that boomers will surrender to the aging process, and they will arrive at a different set of values.

He claims,

“It’s going to happen with the boomer generation, it couldn’t happen when they were young.  It’s going to happen when they’re old.  The values of their youth will be reborn in their old age.”

The one thing you can say about boomers is that they are idealists. Dentists performing work with meaning has been burning in the hearts and souls of boomer dentists since the day of graduation.  Following the marketplace through the business phases of insurance, advertising and cosmetics to the present time will lead us back to the values of comprehensive care.

Continuing dental education today is dominated by groups that stress comprehensive care with a unified theory of self-care, prevention, early detection, and sound restorative care based on a well organized systematic approach.  Continuing education organizations like The Pankey Institute, The Dawson Center, The Spear Institute are all based on comprehensive approach to dentistry and are in line with the market trends.
Health care in this country is changing. As we know it, health care has been more like crisis care.  Baby boomers will change that.  Dentistry has always led the way in prevention.  We have been the model for self-care.  The insurance industry has promoted crisis care for years.  I can remember how long it took them to get on board within fissure sealants.  Dentists didn’t have much of a voice in those days.  Today, consumers have a bigger voice, and government, corporations and third parties are beginning to listen.  The Internet will help in this regard.  There are presently three levels of health care in America:
1. Self-care: What you can do for yourself to keep your mind, body, and spirit healthy and functioning at your highest level, which nobody else can do for you.  Isn’t this what Dr. Robert Barkely preached in the seventies?
2.Health-care: What you must do for yourself to keep your mind, body, and spirit healthy and functioning at your highest level – utilizing the skills of a trained health care professional.
3.Crisis-care: What you must do for yourself to recover from an injury or illness that requires the support of a crisis care or health care specialist.
In the summer of 2006 I discovered a squamous cell carcinoma on my left leg.  I quickly had it removed with Mohs surgery, a technique that serially maps out the presence of cancer cells.  By the time I discovered the tumor, I was already in crisis.  Medicine has the technology to detect the early occurrence of many disease processes.  How thankful would I have been to find this tumor long before it surfaced.

Early detection of caries, periodontal disease and occlusal disease has always been in the hands of the dentist who values diagnostic procedures.  Our culture has been one of crisis care and has valued treatment much more…but this is changing.
Technology is bringing better tools to the health care industry.  Diagnosis will be much more honored and respected in the future.  Baby boomers will demand better diagnostic procedures, they will demand early detection and they will demand the education to help prevent disease.
The implant sector is exploding. The greatest advances today are coming in the area of implants, bone grafting and bone harvesting.  One day removable prosthetics will go the way of the dinosaur.  Dentists are beginning to learn more and more about the surgical phase of implantology.  The survivors in the dental community will be the ones who understand diagnosis and treatment planning rather than those who just understand the biology of implants.
Essentially there is nothing new to report.  Our patients expect us to be excellent diagnosticians.  Many years ago a patient came to me with mandibular pain.  I could not find any reason for his pain.  A few months later, the patient’s wife called to tell me that her husband suffered a heart attack, and the pain in his jaw was a symptom I missed.  I felt she was blaming me for missing the diagnosis.  People haven’t changed.  They want us to be experts and make sure we see everything.  They expect the best…don’t you?
As mentioned in The Art of the Examination, our patients see us as a result.  This standard will only become more prevalent in the future.

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