There are times I wonder myself how difficult it might be to "profit" or earn a living as a dentist. For the last 25 years we have always gone to a sole practioner, all Ivy Leaguers (dunno if coincidence or what), and really have seen overall services decline where it's become a lot of perceived nickel and diming (like an email we concourage you to pay cash otherwise we'll charge 4% for CC, more upsell, etc.). First and foremost these are hard working individuals and highly educated. So it just seems that for all these new upsells etc., just imho it's hard to make ends meet (when I say that I mean to make the business thrive and then for the owner to have their compensation, they likely put it into the business). the flip side is overhearing everyone's problems and why the can't pay today, or last time, or last year. Just tough--the business owner is not at all insulated from the patient's personal, often financial, issues. i.e. free services are obtained.Those are two some most abused practices, it's up to dentist to decide and they often do it to make extra $$. I have a friend who is dentist, some inside info, he doesn't do this and is disgusted with dentists who do.
If insurance allows for annual work it doesn't mean it needs to be done, but some dentists will squeeze everything out of insurance since they can. Many start trying to schedule patients for dental work every end of the year when they realize patient's insurance wasn't fully taken advantage of.
I am knowledgeable of a lot of what is going on in patient's lives.There are times I wonder myself how difficult it might be to "profit" or earn a living as a dentist. For the last 25 years we have always gone to a sole practioner, all Ivy Leaguers (dunno if coincidence or what), and really have seen overall services decline where it's become a lot of perceived nickel and diming (like an email we concourage you to pay cash otherwise we'll charge 4% for CC, more upsell, etc.). First and foremost these are hard working individuals and highly educated. So it just seems that for all these new upsells etc., just imho it's hard to make ends meet (when I say that I mean to make the business thrive and then for the owner to have their compensation, they likely put it into the business). the flip side is overhearing everyone's problems and why the can't pay today, or last time, or last year. Just tough--the business owner is not at all insulated from the patient's personal, often financial, issues. i.e. free services are obtained.
For us we have a $50 deductible I don't really care it's ok. Then everything above is 100% covered. For what is covered that is. I found out a mouthguard is not, whereas my last insurance with 70% coverage, it was.
I do have the utmost respect for people like yourself who are professionals and hard working. Again, I saw it with my current dentist. In conversation she was upset about a $9x UPS package not getting delivered and lost--just like anybody would. My employer would not worry about things like that, they are getting people in to the golf club and worried about the jet's billable hours.I am knowledgeable of a lot of what is going on in patient's lives.
As far as making a living, the biggest issue is insurance reimbursement not keeping up with inflation and I'm not saying if inflation has been 20% in the past 10 years they've come up a little short and increased fees 18% - some dental insurance companies have not increased their fees in 10 years. Some have but maybe 5-10% over that time. So a lot of dentists are leaving insurance or limiting it severely because there comes a point where the fee doesn't even cover the procedure. So your only really choice to make up the deficit is to take a pay cut (and no one likes taking pay cut) or do more dentistry, either by doing legitimate work faster and more efficiently, or if you're not on the up and up, finding more things to do.
Doing more dentistry and packing every moment of your day is exhausting and takes its toll. Dentisty is a PITA dealing with people's anxiety and mental issues and that takes its toll. Being a business owner is a PITA dealing with staff's mental issues and that takes it toll. Now, I'm certainly not looking for sympathy, I still make a great living, but I do hustle for my swag and end most day absolutely exhausted with little left in the tank.
I'm a pediatric dentist and so I talk a lot about orthodontics. I also employ an orthodontist and so when I refer a kid to my orthodontist, I absolutely benefit from the referral, but that is secondary to doing the right thing. Parents will often ask me, "Does Billy NEED braces?" I will answer with something like, "People NEED liver transplants and nobody NEEDS braces" followed by one of the following statements:I do have the utmost respect for people like yourself who are professionals and hard working. Again, I saw it with my current dentist. In conversation she was upset about a $9x UPS package not getting delivered and lost--just like anybody would. My employer would not worry about things like that, they are getting people in to the golf club and worried about the jet's billable hours.
But I feel I read the writing on the wall when she's asking me if I'm interested in braces. At my age? I had them as a teen. And the last dentist had a super sweet 22 yo. hygienist that I would loan DVDs to, and get it back 6 mos later! They were a Ukranian shop so at the time I loaned her the Red Army movie. Of course she left to get married etc. and in her place was a not so nice older person maybe my own age, always upselling. One time all these x-rays were NOT covered (more than 4) and I had to pay for all of them so that was the last straw. Too bad. This is a dentist who called us to congratulate us on the birth of our son. And she was the one I always could overhear how empathetic she was when someone could not pay....
Sometimes, I feel we need to all be more personable and not so whatever we are today, distant and impersonal if that's the word(s). When I was born, yes, there was electricity already, and, I heard the OBGYN doctor was on call and would meet the mom at the hospital. When my son was born, it was the doctor on-call in a rotation, could be someone the mom has never ever met at all, that's what I'm driving at...
The last generation of scanner we use was $55K and no they aren't free. As of next year, the last generation will no longer be supported because of the Windows version it runs. The new scanner is $65K, it does the same thing, and our old scanner is only 4 years old. We will keep using the older scanner until it actually needs some kind of support and then buy the new one.I went to a new dentist this year. They gave me x-rays, I figured why not. They also scanned my teeth, which took a while. On the way out they gave me a $4k plan for invisible teeth straighteners. I have straight teeth and have never had a cavity….
I suspect the scanners are given for free by the Invisalign-type vendor as a perk for selling the product as a profit center.
Medical insurance is primarily there so if you have a catastrophic disease/injury you're shielded from a bill that can be ten or hundreds of thousands of dollars.Modern digital radiographs expose patients to way less radiation than back when film was used. I guess I would rather my dentist have as much information as possible to help prevent small issues from becoming expensive restorations. My practitioner has a membership plan thing where the subscription fee covers all preventative care, and any dental work is discounted. Dental insurance is a scam anyways, so this is a better option for me.
Thanks for that clarification on the provision of the hw.The last generation of scanner we use was $55K and no they aren't free. As of next year, the last generation will no longer be supported because of the Windows version it runs. The new scanner is $65K, it does the same thing, and our old scanner is only 4 years old. We will keep using the older scanner until it actually needs some kind of support and then buy the new one.
I'm in no way justifying the upsell. Scanning everyone is obnoxious, unnecessary and to be honest a waste of time. We only scan people who approach us, get a consult, and sign a contract because THEY want ortho from us.I mean, sorry that tech is poorly forward compatible with OSes. I have run extremely high dollar analytical instruments in the past, and software forward and backwards compatability was a big consideration in selection of vendor and devices that are many times more expensive.
Point really was - I didn’t need a tooth scan, didn’t really want one (didn’t care that I got it either, as it’s mapping, not X-rays)…. But I was taken aback by the fact that it was immediately used to try to upsell me $4000 worth of stuff, on teeth that have been straight and fine for as long as I’ve had them - 30ish years now on my adult teeth?!?
The upsell because of the obnoxious cost of equipment and poor sw practices isn’t a good justification.
All x-rays cause tumors. Do not get any x-rays that aren't absolutely necessary.It is standard practice to get an xray of the entire set of teeth annually? How about a filling that needs to be "repatched"?
How do you explain the billions of humans who have been exposed to X-rays and never developed a tumor?All x-rays cause tumors. Do not get any x-rays that aren't absolutely necessary.
Your immune system has t-cells that kill cancer tumors. Tumors are always spontaneously occurring due to many many factors, x-rays being only one. Your immune system is in a constant battle with them and kills them off. They don't always win though as evidenced by the skyrocketing cancer rates in the US.How do you explain the billions of humans who have been exposed to X-rays and never developed a tumor?
Edit - not going down this rabbit hole this morning - I don't really care what your rationale is here.
I have a really strong background in immunology and specifically in CD4+ T-cells and whether or not something induces an immune response or tolerance. One of those papers used prostate cancer as the model, I've been published twice in leading journals (20 years ago) on these topics, and all I can say is you have presented a gross oversimplification here.Your immune system has t-cells that kill cancer tumors. Tumors are always spontaneously occurring due to many many factors, x-rays being only one. Your immune system is in a constant battle with them and kills them off. They don't always win though as evidenced by the skyrocketing cancer rates in the US.
As for the OS issue - that's dentistry and it's not like there are a ton of manufactures who make these.