Sunday Dental Thread: Swollen-and-in-pain issue...

[PCIntern]

Short and sweet: Here in Philly, people are being laid off, expecting to be laid off, going out of business presently, going out of business shortly, or out completely. As I stated in other threads, we are counter-intuitively busy because our clientele expects to be without any health benefits at all whatsoever very soon. I run an insurance-based practice with at least 90% covered to some fair degree by one of five companies, all of which are favorites of posters here.

Now listen to where it gets REALLY interesting: on Mondays I receive checks in bulk payment from about eight companies and thus the VAST amount of money comes in on the first day of the week. The next five days bring lunch money as far as we are concerned. That means that if payments don't come in appropriately on a given Monday, we have a great deal of difficulty making payroll, laboratory fees, rent, insurance, supplies, and many other expenses. Now I don't expect 95% of the people here to feel terribly sorry for their dentist, since there are legions of posters who talk about being ripped off by their dentist, their former dentist, or their childhood dentist-who-didn't-use-novocaine.

But back to business: the insurance companies have seen fit to close ranks and slow the payment process down remarkably and thus impair our very existences. Now many of you may say, "So what?
Screw 'em." And I understand and empathize...your individual positions may undoubtedly be worse off than many or most dentists and deserve more sympathy and/or empathy.

However, if many many dentists are forced to close or collapse their practices in the manner in which physicians have done, the access to care will be diminished and, to put it mildly, there will be big trouble. This is an epidemic among professionals: here in Philadelphia, there are almost no new practitioners in many medical specialties, and neurosurgeons and the like are fewer and further between. This is highly problematic for society as a whole and in the microcosm of dentistry I can see this serious issue progressing exponentially as clearly as the great blue sky. It is of utmost importance that health care be fixed in some manner as soon as responsible people can.

[aquart]

1. Universal single payer health care MUST include dentistry.

[PCIntern]

3. Yes,

now we need to convince 535 lawmakers of that fact. I bet there aren't 20 who would vote for it now. IMO, it will never get to the floor of any federal deliberative body.

[dysfunctional press]

13. AND vision/eyeglasses.

[Codeine]

21. Buy your eyeglasses online.

it's insanely, insanely cheap. Like blow-your-fuckin'-mind cheap.

Start here:

http://www.slate.com/id/2198746/

[dysfunctional press]

24. i don't wear/need glasses...yet. except if i want to see things farther away more clearly.

but- i don't imagine they do the actual eye exam and prescription online, do they...?

or maybe it's available as an app at the iphone store...:shrug:
if someone hasn't figured out how to do a full eye exam with the iphone yet- they will.

[grasswire]

2. how would all these people feel....

....if they were to be employed by the U.S. government? Would they be more comfortable staying in their professions? Salaried, relieved of paperwork, assured of employment -- would that be welcome?

[PCIntern]

5. This one would...

no lie.

My professional life, quite frankly, sucks.

Simple as that.

[Horse with no Name]

4. I so agree with you

I have a crown that came off yesterday and the OTC glue doesn't hold it in.
I'm afraid I will swallow it.
It will be weeks before I can get in to see my dentist.
More than likely--the crown won't fit when he sees me and I will have to have another.:eyes:
Or, it will take 3 visits to put it back in.
That is what OUR dentists around here do.
Takes 10 visits to complete any major work--I have figured out that he spends approximately 5 min on each visit with any given patient.
Forget about having two fillings done at once. It isn't going to happen, even if they are next to each other.:eyes:
Anyway--end of my rant. I realize that the dentists around here are just trying to meet their expenses and the insurance never kicks anything back for being overbilled.
However--it is frustrating that BECAUSE of the broken system, practitioners are forced to resort to more creative solutions to provide adequate care.

[PCIntern]

6. you are in a heap of trouble...

it does NOT have to be that way. I taught this stuff for over a decade and have been in now over 30 years. the words for what you posted is pitiful practice of dentistry. Sorry this is happening to you.

[BeatleBoot]

7. Cash Flow, sucks, doesn't it?

I have worked every weekend since last December just creating and running cash flow and risk & exposure models.

That's about 70 to 80 hours per week.

Just because certain aspects of our economy are in turmoil.

I am happy to be working, but I've reached my fill.

Funny how Detroit always goes under first (2003) and the rest of the country follows (2008).

[PCIntern]

9. We're about 18 months ahead of the curve...

we knew it was BIG TROUBLE a long time ago. I posted that back then...predicted a near-collapse - I was wrong...it's a near TOTAL collapse.

[Warpy]

8. I've always seen dentistry as a real bargain

considering the amount of equipment even the smallest dental practice must have. A GP can send you to a hospital for a series of X-rays. That dentist must have the equipment in his office.

I've also taken care of patients who didn't have the work done and ended up with everything from infected and blown heart valves to abscesses in the brain.

Remember, your teeth are living attached to your blood and lymph systems and anything wrong with them is very likely to spread to critical areas.

I've never had dental insurance in my whole life and it was often a stretch to pay the man. I had to opt for extractions over heroics.

However, considering the alternative, it was still a huge bargain. You can ignore some health issues. Ignore your teeth at your absolute peril.

[Cerridwen]

10. I have love/hate ideas about dentists, business, and "the rich."

I love the good ones; hate the bad ones.

I had an awful dentist as a teen. Years later, he sold his practice to some new "kid" ready to set up his first practice. Unfortunately for the "kid," he spent the first year or so fixing the problems the previous quack left him.

In later years, I had dentists and an orthodontist (wore braces as an adult. exciting!) and an oral surgeon. All damned good. Not their fault I got the lousy "dental gene."

I'd love to see a universal, single-payer program put into place that includes dental. How insurance (or medicine in general) ever got away with separating care of our teeth from care of the whole body, I'll never understand.

I feel the same about business. Love the good ones (non exploitive) hate the lousy ones (exploitive).

My definition of the "rich" differs from many I've seen on here. If, when discussing rich, the words "depending on what part of the country" or "compared to the cost of living," we are *not* talking about rich.

I wish you and all of us well in this struggle to put people before profit.

[JerseygirlCT]

14. I had the most awful orthodontists and dentists as a kid!

They had to sedate me, I was so terrified. You might think that would have clued my parents in, huh?

And though cosmetically I look fine (my top front teeth are straight enough), I've never had a real bite - it's always off, and thus lovely migraines/tmj. This from the orthodontist who told me it was all about puberty in a condescending voice when I really needed my first root canal. Idiot!

[Cerridwen]

15. Yes, that's the other part of the equation. Poor dental care in

youth leads to all types of problems as an adult. Leading to more health issues leading to more need for medical health care...

When the bad ones are bad, they can cause irreparable and lifetime harm.

Damn!

[JerseygirlCT]

16. Luckily the last two especially (one retired, one took over)

were/are wonderful.

The first one of these would insist I call him on a Sunday morning after seeing me on a Saturday for an emergency - often past his hours on Saturday. If I didn't call, not wanting to trouble him, he'd call me. And when he retired, he actually spent time with the new one making sure he knew all about me! (I was abscess central for a while once I began my second pregnancy... the dentist said that was because my body was being stressed by the pg. Who knows? But several root canals and several extractions later, I was so glad for his help!)

[Cerridwen]

18. Oh, one (actually two) of *those* kinds of providers.

The ones who act like it's a calling. I love those ones!

I've been fortunate to have a few health care/dental providers like that.

My favorite part of being an adult in braces was that I always got a t-shirt for keeping my teeth brushed and flossed between visits! Oh, and sitting in a waiting room with a bunch of 10-12 year olds and reading their magazines. I was cool with it but they gave *me* some funny looks.

:rofl:

[JerseygirlCT]

19. What, you didn't bring your Gameboy?

LOL. I can imagine. My kids' orthodontist is very kid friendly - but I can see that making adults feel a little... old.

[Cerridwen]

23. It was fun - for me. I'm not sure *how* the kids felt. LOL n/t

[kestrel91316]

11. The "recession" has hit veterinary medicine hard. It started with

us cat vets (because "it's just a cat" is so much easier to say when money's tight), but now has spread to dog & cat practices. I hear that NOBODY is hiring, and jobs for new grads have about dried up (sounds ominously like 1982 when I graduated and pickings were mighty slim).

I know of one cat vet with a practice twice the size of mine who has had to go deeply into debt to stay afloat so far. There are probably many more. Closing a practice is not done lightly, because it's so damned hard to open a new one, with cities hating the very idea of barking dogs and medical waste and, god forbid, actual JOBS. So we tend to cling on for dear life and exhaust our life savings in the process, hoping for better times ahead.

[JerseygirlCT]

12. And dentistry is still looked at, far too often, as an extra

not quite as important as "real" medical care. I don't have dental insurance, for instance. (Fortunately I can manage that). But I have to say, never in my life have I been in as much pain as I have from a couple of abscessed teeth. I've had my share of medical problems in the rest of my body - but boy, if I couldn't have had that treated, I don't know what I would have done.

I'd dearly love to put a whole lot of insurance companies right out of business and see a single-payer (gov't or non-profit run) system. And dental and mental health care must be treated on a par with everything else!

[alfredo]

17. If you are a veteran, sign up at your local VA. If you have a dental school

nearby, you can find better prices there. Not only are you getting good care, you are helping the next generation of Dentist. Lexington Ky has an excellent dental school, and so does Louisville (U of L). Lexington (U of K) is the place to go for dentures. The Lexington Ky VA is excellent, and many VA doctors also work at U of K med center.

One of My nieces works at U of K, the other Niece works at VA. Both have worked at private hospitals but left because they cut corners on personnel and care.

[Holly_Hobby]

20. What I'd like to know is why I only have $600 coverage annually

My husband had an 8 tooth fixed bridge on top and a 6 tooth fixed bridge on the bottom, over 2 years. It cost A LOT more than $1,200 over those 2 years.

Why aren't teeth important to insurance companies? Two of my relatives died of bowel obstructions because their dentures didn't fit and couldn't afford new ones. They couldn't chew their food properly and DIED. They both were in the hospital and had surgery, now how much did THAT cost???

If our dentist ever goes out of business, I'll scream. He works with us financially.

[PCIntern]

22. b/c your employer picked a shitty plan

b/c iot's CHEAP.

and he/she can say that they provide 'dental'...

HA!

It's like a 5 dollar gift certificate for a Cadillac (MAD Mag)

[Mika]

25. I simply don't do insurance in my practice.

We'll help some patients with some of the forms and paper work, but not the collections.

The practice has shifted to a lot of basic composite repairs, not too much cosmetic, some implant case flow from the last year. I really work to give good value to my grateful patients.

Cash flow? - We know where we stand week to week. (Although my first appt isn't until 11am Mon.)

---

There's another thread here today with some complaints about how us con artist DDSs make $3000 an hour. :rofl:

[PCIntern]

26. you're lucky I suppose...

a fellow here in my building - good dentist, not a bad guy - decided he'd had enough with insurance. Been in town here 27 years at the time. Did what you do..help with forms...smiling transition, we'll help you, we're sorry, etc...lost more than 80 percent of his practice and, when he decided to come back to the 'fold', only got a 10% back and basically had to start over again. catastrophic. I was the beneficiary of his decision and must have gained over 100 very nice people.

Ins. here is not limited to lower/middle income people..we have very wealthy folks who are very careful with their maximums and don't want to pay the deductibles, etc. Frightening...