Two more comments.

IMO The insurance industry is partly to blame by setting limits on lab fees to a
% of clinical.

Secondly, the local tech association developed a fee guide based on time, skill
levels, materials and associated costs. Then they factored in labour costs
determined by current wages earned in other occupations with similar
responsibilities and education. Most labs raised their fees once it was
released. Yet those fees are still at only 60% of what the association
determined would be necessary to provide pay equity to other occupations.

From the been there, done that - hard knock school of life. IMHO there are 3
types of techs. The "masters" or select few who are not part of the equation and
require no explanation. They have captured their select market that is willing
to pay for a consistently better product. Dental Technicians and Bench Techs are
different folk.

Bench techs are hired off the street and trained by Dental Technicians or Mega
labs to do one or two things. Maybe after they have been around a few years they
are allowed to do more. On one hand they are what allows the industry to keep
prices down. On the other hand they are the an integral part of the problem. As
long as the Mega labs continue to use bench techs the need for properly trained
technicians is diminished. Pricing is determined by economy of scale, and the
Mega Lab has a distinct economic advantage.

The disadvantage of this is that one bench tech does not really understand how
their work fits into the grand scheme of a prosthesis. The person waxing up a
cast partial has no idea of where someone is going to place the teeth 5 or 6
bench techs down the line. Nor do they understand how the acrylic will be
finished. Factor in the reduced training dentists now get in the area of
prosthetics due to curriculum changes and the problem is compounded. Dental
techs are much more knowledgeable but their work is frequently affected by the
pricing of the Mega Labs.

There is no easy way out of this one. IMO the best long term solution would be
to raise the bar for the bench techs. That is both in training and salary. That
in turn makes the offshore labs more appealing to the price conscious. Having
myself started as a bench tech in a mega lab, I don't see any real difference
between the offshore lab and the mega lab other than geographic location. I
still recall learning to trim a cast frame work, the quality standards that had
to be met were "Lotsa high shine and no wave". The other thing required will be
to get the dental schools raising the bar on prosthetic training.

I can only shake my head in disbelief that in some areas only a dentist can
provide a denture. That dentist may have gone through school without ever having
to touch a denture. The dentist can then send a denture case to the lab thinking
the Dental Technician will do the job right. I've personally witnessed many
cases that have been through the lab with all the work being done by bench
techs. Some of these cases have never been seen by the dental technician. All
this under a system of checks and balances set up to protect the patient. Scary
isn't it?

With all due respect to you both, I feel that is just not true. _I_
wouldn't feel competent enough to design a crown/bridge to be esthetic
and functional based on my currently quite limited knowledge and
experience in C&B... The CEREC cannot replace that competence, IMO.
Couple that with the reality of costs of those machines, and I can tell
you that if there's no cometent tech, I wouldn't do ANY C&B.
JMO
SP