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Medical Forum / General / Dentistry / August 2005Ethics in Dentistry????
Living in S. California and being aware that in my city there are only a HANDFULL of dentists that accept ANY MediCal patients (even children w/a toothache or an emergency like a car accident!), And a small percentage of those don't have wheelchair access. I'm wondering WHERE the ethics of dentistry are??? I'm not saying that all dentists should accept all those with MediCal. But what if EACH dentist accepted a few of these patients??? (And was proud of it???) As I understand it, it's not a MANDATORY thing, that if you accept MediCal, you have to accept every patient that calls! You can pick and choose! Indeed, a few years ago, my dentist of 10 yrs, took up to 5% of his practice in MediCal patients. And most of those he'd had for years! Good, stable, taking care of their teeth MediCal patients! (He's since moved to another city and I can't get to him.) Which is exactly what the OB/GYN's in our area did a few years ago when there was a 'crises' in that field... HOW can you all buy new houses, go on vacations, sleep at night, etc KNOWING there are kids w/toothaches and elders who can only eat mush because of a broken or mis-fitting denture??? It's not like they can wait 2-3 months for an appointment with the local University Hospital and get treated for a dental problem...as they can for their medical problems (which I'm sure most would gladly do!). OK, I'm putting on my hard hat now!!! google & yahoo evvy garrett search www.amazon.com search www.powells.com > Living in S. California and being aware that in my city there are only > a HANDFULL of dentists that accept ANY MediCal patients (even children > w/a toothache or an emergency like a car accident!), And a small > percentage of those don't have wheelchair access. [clip] Where did you get this information and are you certain as to its accuracy (+/-)? Webby >Where did you get this information and are you certain as to its >accuracy (+/-)? The info is ONLY personal knowledge. In spite of numerous requests, I am unable to obtain actual #'s & ratios. email me privately and I'll tell you where I live. Perhaps with your 'knowledge' you could get better results from the State and Dental Board??? I do know that one of the FIRST things a person asks another when they find out both have MediCal is: "Do you have a dentist?" or some version of! I DO KNOW that there is not a dentist in my own ZIP code that accepts MediCal. I DO KNOW that there's not a dentist in two adjacent ZIP's that accept MediCal. I DO KNOW that there is ONE dentist, one ZIP to my north who does accept MediCal, but that office does not have wheelchair access! I DO KNOW that two zip codes east of me there are two dentists that accept MediCal and NEITHER of them has wheelchair access! There are two Western Dental Clinics (both 3 busses away), And the dentists go through there like water though a tap. One of these offices if very physically DIRTY. The other has a very poor lab. (Don't know about the lab in the 'dirty' one, only went there once!) There are 3-5 other dentists I know of that accept Medical, I've been to them, years ago, and would not return. This is because they don't seem to speak or understand English and/or facilities were extremely dirty ie blood running down 'spit' bowl, etc! Many disabled/elderly will use their food money for the month and go across the border to TJ if they or a friend can speak Spanish. They then depend on the local 'free meal', senior or otherwise, places and the 'emergency' food programs that month. (btw, you'd probably be absolutely STUNNED at the numbers of disabled/elderly that have actually taken up residence in Mexico. They travel to the US to see their docs, pick up their SS checks at the post office, etc. All of these folks BORN here, many worked their whole lives here! But they have no other options-unless they want to live on the street or in a nursing home...) These things I know from personal experience! In the sixth largest city in the US!!! spondee@REMOVEcox.net The part about "wheelchair access" is what I'd like to address for now. If people who need to get around in wheelchairs but do not have MediCal need to go to the dentists in the areas you've described, what are they to do in order to actually get to their dentists? What do you mean by "wheelchair access"? Do you mean there isn't any elevator to floors above ground level? Or, do you mean that there isn't enough room for them to get through the office door in a "chair" or into the bathroom in a "chair"? I just don't understand what you're trying to tell readers. What do you mean by "Perhaps with your 'knowledge' you could get better results from the State and Dental Board???" If you're in a wheelchair and need to see the dentist, does it really matter whether you have MediCal to help pay your bills or nothing to help pay your bills? Please, help me/us out here. Webby > >Where did you get this information and are you certain as to its > >accuracy (+/-)? [quoted text clipped - 46 lines] > > spondee@REMOVEcox.net >If people who need to get around in wheelchairs but do not have MediCal >need to go to the dentists in the areas you've described, what are they >to do in order to actually get to their dentists? The same thing people in wheelchairs AND MediCal do... >What do you mean by "wheelchair access"? A wheel chair CAN NOT ACCESS the place in question. (Do go rent yourself a wheel chair for a day and try to get around YOUR area! A learning experience - for sure!) >Do you mean there isn't any >elevator to floors above ground level? Or, do you mean that there isn't >enough room for them to get through the office door in a "chair" or into >the bathroom in a "chair"? It's all the same thing isn't it??? If it's a ground floor office, and a wheelchair won't fit through the inner door, you don't have access! If it's a ground floor office and there are 2 steps in front of the door, you don't have access! >If you're in a wheelchair and need to see the dentist, does it really >matter whether you have MediCal to help pay your bills or nothing to >help pay your bills? Well of course it does... spondee@REMOVEcox.net > >If people who need to get around in wheelchairs but do not have MediCal > >need to go to the dentists in the areas you've described, what are they [quoted text clipped - 23 lines] > Well of course it does... > spondee@REMOVEcox.net I suppose I may be confused about how this is a matter of ethics in dentistry. Webby > I suppose I may be confused about how this is a matter of ethics in > dentistry. ...and that makes two of us. It is a shame, but it is the choice that California voters, (in their collective wisdom) have made. They have reduced funding to the point where social programs are being starved into extinction. It has nothing to do with the ethics of the dental profession and everything to do with money. Vaughn >>I suppose I may be confused about how this is a matter of ethics in >>dentistry. [quoted text clipped - 7 lines] > > Vaughn Medicaid fees in NY are actually quite livable. However, the administration is such a horror that few dentists want to bother. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Medicaid fees in NY are actually quite livable. However, the > administration is such a horror that few dentists want to bother. > > Steve Another issue that turned me off on working with Medicaid was that the patients were horribly unreliable in presenting for appointments. They were almost universally late, or wouldn't show up at all. Another thing that annoyed me, and may have been a function of the area I was working in at the time, was that a good number of my patients were actually employed with good paying jobs, but worked off the books, so, on paper, they were below the poverty line. That made the process all the more unrewarding! No thanks...I'll dispense my charity on my terms. T >>Medicaid fees in NY are actually quite livable. However, the >>administration is such a horror that few dentists want to bother. [quoted text clipped - 12 lines] > > T Fraud in public assistance is a separate issue altogether, but your point is well taken. The perception that everyone cheats certainly decreases the incentive for dentists (and others) to be willing to help. As for the no-shows and late appointments, this is one of those cliches that probably has a basis in truth. When I was first in practice I did take medicaid, but there really wasn't much in the area of my practice, and in general I didn't find them notably more or less reliable than my other patients. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Fraud in public assistance is a separate issue altogether, but your > point is well taken. The perception that everyone cheats certainly [quoted text clipped - 6 lines] > > Steve My experiences were working in a practice in an area where there were many seasonal employees and many in the construction trades. I think the visit that pushed me over the "never again" brink was a guy whose family was on medicaid talking about problems boarding their horses. T >I think the visit >that pushed me over the "never again" brink was a guy whose family was on >medicaid talking about problems boarding their horses. > >T Thought that one 'mounted' a horse.... guess that boarding a horse is similar to boarding a plane ;-) -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >I think the visit > >that pushed me over the "never again" brink was a guy whose family was on [quoted text clipped - 5 lines] > guess that boarding a horse is similar to boarding a plane ;-) > -- Hey, I grew up in an area where the only horses are the ones on the merry-go-round that came around on the back of a truck, so you need to cut me some slack on the horse talk! I thought they called it "boarding"...what is it really called when talking about finding lodging for one's pony......stable? house? stash? crib?...I honestly don't know! T >> On Tue, 21 Jun 2005 13:54:15 -0400, "Tony Bad" ><spamspamspam@bakedbeans.spam> wrote: [quoted text clipped - 18 lines] > >T You said it correctly, was just poking fun at the patient. Stable is the building, stall is where the horse sleeps. Boarding is keeping your horse in someone else's stable. And yes, you usually have to pay for that to cover hay, feed, and for someone to 'muck' the stall. Did these 'seasonal workers' transport the horses to the job site, and was a horse a requirement of the employment ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > You said it correctly, was just poking fun at the patient. > Stable is the building, stall is where the horse sleeps. [quoted text clipped - 5 lines] > Did these 'seasonal workers' transport the horses to the > job site, and was a horse a requirement of the employment ? Thanks for the info. It was out on eastern long island so the seasonal work was usually landscaping, construction, domestic help for the rich folks that head out that way in the summer. Not sure if any needed a horse for work...LOL...I kind of doubt it! T >> You said it correctly, was just poking fun at the patient. >> Stable is the building, stall is where the horse sleeps. [quoted text clipped - 12 lines] > >T Ahh, the Hamptons. (?) Don't forget that you have to transport horses, that requires a horse trailer and a stout truck. Horse ~1,800 - 2,000 lbs. and they move around somewhat in the trailer. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com 1 ton dualee.....$30-50K (depending on options, 4X4, diesel, extended cab, leather, etc.) Fawks > Don't forget that you have to transport horses, > that requires a horse trailer and a stout truck. [quoted text clipped - 6 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Depends how many horses you are haulin'. My buddy can haul 3 horses with his trailer that has human living quarters; his heavy duty 3500 diesel, which is not a dualee... pulls it just fine. 'tis a gooseneck. One ton may not be enough. >1 ton dualee.....$30-50K (depending on options, >4X4, diesel, extended cab, leather, etc.) [quoted text clipped - 11 lines] >> Take out the G'RBAGE >> wubbabubbazG@RBAGEyahoo.com -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > > On Tue, 21 Jun 2005 13:54:15 -0400, "Tony Bad" > <spamspamspam@bakedbeans.spam> wrote: [quoted text clipped - 18 lines] > > T That's OK, he thinks you park a boat. carabelli >> me some slack on the horse talk! >> [quoted text clipped - 8 lines] > >carabelli Why do you park on the driveway and drive on the parkway ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > > On Tue, 21 Jun 2005 13:54:15 -0400, "Tony Bad" > <spamspamspam@bakedbeans.spam> wrote: [quoted text clipped - 18 lines] > > T Out west humans board their horses if they can't keep them at home. Webby Silly me, I thought it was a way of getting their attention with a 2X4. Fawks >>I thought they called it "boarding"...what is it really called when talking >>about finding lodging for one's pony......stable? house? stash? crib?...I >>honestly don't know! >> >>T > Out west humans board their horses if they can't keep them at home. > > Webby > Silly me, I thought it was a way of getting their attention with a 2X4. > [quoted text clipped - 9 lines] > > > > Webby We are quite civilized these days out west .... we use 2x4s to build houses ... too many houses ......... and not enough horses! Webby > Thought that one 'mounted' a horse.... Suit yourself, but I prefer a more conventional (some would say dull) family life. Vaughn > As for the no-shows and late appointments, this is one of those cliches >> that probably has a basis in truth. When I was first in practice I did >> take medicaid, but there really wasn't much in the area of my practice, >> and in general I didn't find them notably more or less reliable than my >> other patients. I'd like to point out that when you are depending on the public bus for transit, many factors apply! Did you know, for instance, that you can NOT get an electric wheel chair or scooter wet!!!!! It might not only ruin the equipment, but void any warranty. Not to mention an elderly/disabled person's state of health. I have to shuffle appointments frequently because of all the above! spondee@REMOVEcox.net >I think the visit >that pushed me over the "never again" brink was a guy whose family was on >medicaid talking about problems boarding their horses. Of course, I don't know about your area, but here in California, the race tracks employ MANY, they get sub-standard housing, and a pittance in pay (part of the pay, being the housing, which they have no choice about). It used to be even worse. They got the sub-standard housing, period. Many of the jobs center around horses, grooming, feeding, cleaning, exercising, etc. It takes a LOT of people to put a jockey on a horse and race them! And those people are often undereducated legal/illegal's. Not only do the tracks employ folks, but also private parties, breeders, owners, etc. It could very well be that in referring to boarding 'their' horses they were referring to horses they were hired/assigned to take care of... It's better to ask than assume. spondee@REMOVEcox.net > It's better to ask than assume. > > spondee@REMOVEcox.net Ahhh, the irony. It would appear you assumed I needed to be educated on this subject...perhaps you should have asked first. T >> It's better to ask than assume. >> [quoted text clipped - 4 lines] > >T a.s|u|me ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > > It is a shame, but it is the choice that California voters, (in their > > collective wisdom) have made. They have reduced funding to the point where [quoted text clipped - 10 lines] > -- > Mark & Steven Bornfeld DDS In California, the Medicaid (called "Medi-Cal" or "Denti-Cal" here) fees are about thirty to fifty cents on the dollar. Hardly livable, when you consider that dental office overhead is often about sixty percent or more. The paperwork and administration is not as bad as it used to be, but is still rather difficult compared to normal dental insurance plans. - dentaldoc > > Medicaid fees in NY are actually quite livable. However, the > > administration is such a horror that few dentists want to bother. [quoted text clipped - 13 lines] > > - dentaldoc In NY, and this may have changed since I worked with Medicaid patients, the fees were pretty good for kids, which was good, as it increased availability of care for children that needed it, but the adult fees were fairly low. T > It has nothing to do with >the ethics of the dental profession and everything to do with money. Well then, what are the 'ethics of the dental profession? spondee@REMOVEcox.net > On Tue, 21 Jun 2005 10:07:14 GMT, "Vaughn" > Well then, what are the 'ethics of the dental profession? Well, you could start here, http://www.ada.org/prof/prac/law/code/interpretation.asp but remember that a dentist need not belong to the ADA. Vaughn > > It has nothing to do with > >the ethics of the dental profession and everything to do with money. Twice I have tried to direct your attention to the government that runs your inadequate dental program, and to the voters that ultimately run that government, and twice you have ignored me. I don't really blame you for your point of view. You are looking for dentists that take your program and not finding any, so your focus is on the dentists and that is what you see. I respectfully suggest the you widen your focus a bit. My graduate degree happens to be in the field of Public Administration and I have spend considerable time on this sort of stuff, so I naturally see your situation in an entirely different light. I see a dental care program that only pretends to exist because the govenment lacks funding to run a *real* program. Worse yet, it is the voters themselves who created this situation, so the government (as it should) is just obeying the collective commands of its citizens. It is really fair to ask dentists to "pick up a bill" when it is the voters (your fellow/sister citizens) who have stiffed you? I think your situation is sad, but I think that your anger is directed in the wrong direction. If you want to do yourself some good, get active and involved in the political process. Vaughn >I suppose I may be confused about how this is a matter of ethics in >dentistry. Then why did you pose the questions re wheelchairs??? And access??? spondee@REMOVEcox.net > >I suppose I may be confused about how this is a matter of ethics in > >dentistry. > > Then why did you pose the questions re wheelchairs??? And access??? > > spondee@REMOVEcox.net Because I was contemplating .... ???? Webby > HOW can you all buy new houses, go on vacations, sleep at night, etc > KNOWING there are kids w/toothaches and elders who can only eat mush [quoted text clipped - 4 lines] > > OK, I'm putting on my hard hat now!!! How about everyone who feels as you do adopt a patient, and split the cost that a dentist has to eat when he treats these patients. It is easy to be all outraged and tell everyone what they should do when it costs you nothing. I don't live in California, so I can't speak for that system, but in my state, I paid my dues with regard to public assistance dentistry...now I have vacations to go on, new houses to buy...actually, I need to mow my lawn and change my oil. T >> HOW can you all buy new houses, go on vacations, sleep at night, etc >> KNOWING there are kids w/toothaches and elders who can only eat mush [quoted text clipped - 14 lines] > >T Yeah me too, have to mow the lawn at my summer home' and change the oil in the Bently. Don't you hate when that happens ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com yes i really hate when that happens :) Sorry to hear about your problems , but there are many terrible medical patients out there( very HIGH cancellation rate , hard to get numb because of heavy substance abuse etc) Medical fees are horrible -example $ 330 for molar RCT. The overhead is high and the dental school very expensive- $ 70.000/year. Dentists need to make a leaving too;is the most stressful profession in the US ( highest suicide rate),and Medical just doesn't pay enough .I do not think is unethical to refuse MC, is just a matter of choice. Anywhere I go , I see something like this: We reserve the right to refuse service to anyone. Why a dentist shouldn't do the same? Try LA if you do not live too far , you can find MC dentists here regarding your question: HOW can you all buy new houses, go on vacations, sleep at night, etc > KNOWING there are kids w/toothaches and elders who can only eat mush > because of a broken or mis-fitting denture??? It's not like they can > wait 2-3 months for an appointment with the local University Hospital > and get treated for a dental problem...as they can for their medical > problems (which I'm sure most would gladly do!). How can we all live in USA knowing that people out there are dying from malnutrition? That is life, and is sad, but am I supposed not to sleep at night because some dentists do not take MC ? I do not think so. We are not in a perfect world And if I buy houses , go on vacations etc, is because I have worked hard to get here. > Living in S. California and being aware that in my city there are only > a HANDFULL of dentists that accept ANY MediCal patients (even children [quoted text clipped - 30 lines] > search www.amazon.com > search www.powells.com And the systems rigged to benifit you, for now. ( not to mention the conservative values of pro bono, did they remove that from the code of professional ethics, or is it merely forgotten by the philistines ?) Can't take a kid in during a one or those high cancellations. How 'bout you have their family cook dinner for you and your family . Might make you a broader/wiser person. Since "wisdom is sold in the desolate market where none come to buy", you might find age makes You more intensely, and narrowly, adolescent. "if others were not fools ( to teach us ) we would have to be fools oursevles". "Law is the opposite of nature" ( you guessed it!~ Aristotle ) > And the systems rigged to benifit you, for now. ( not to mention the > conservative values of pro bono, did they remove that from the code of [quoted text clipped - 6 lines] > teach us ) we would have to be fools oursevles". "Law is the opposite > of nature" ( you guessed it!~ Aristotle ) Is it only the dental profession you have this problem with or ...?? Webby I have a hard time with papio's procurer, the small of heart, the small of mind, the ungenerative, the unimaginative... at least under circumstances where they serve no one or nothing for certainly those of diminshed capacity deserve allowences to their disabilty. It's strutting mendacity and strutting lack of heart and strutting complaisant; where all ones thoughts may be forcast by asking how an object of thought affects their narrow appeties ( ie going fast, eating, sex, power over others and over things, status within the tribal unit, you know psyche 001, anthro 001. By people who have a choice deciding that they are nothing mosre than talking apes with cars and properties, men reverting to pre hominid "vision" of life, trained monkeys pretending to be Men ). I expect more from those with pretensions to knowlege, understanding, or wisdom. too much huh >I have a hard time with papio's procurer, the small of heart, the small >of mind, the ungenerative, the unimaginative... at least under [quoted text clipped - 9 lines] >monkeys pretending to be Men ). I expect more from those with >pretensions to knowlege, understanding, or wisdom. too much huh Troll .. Stephen Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. spon started this thread, I have supported him with with just argument. It does piss me off when "proffessionals" are so captivated by a passing ideology ( law of the jungle ) that they refuse to do pro bono work for less money. What happend to the class who needs pro bono 10-20 yrars ago hopefully happen to those who take the "top dollar on the barrel head" this and in ensuing years ( viva globalization, don't stop now, we need Asian dentists, doctors, and lawyers, etc )The Snipers who complain with mere name calling are more the troll. Incidentally, Adam Smith said the butcher didn't work MERELY for good will.... the butcher would likely find something a hungry child could eat. VCMS Every dentist I know personally will do free work for any person they can actually verify need and the desire to improve their lot in life. I, personally, will actively seek out a person each year to do thousands of dollars of reconstruction on--for free. (Don't start mailing me your resume because I search for the person, locally, who does not expect it and who is fighting really hard to improve their life.) I already did one this Spring. This is what we do. However, I know of no general dentists who accept Medicaid patients, because we have no way to verify actual need, and the vast majority of them do not appreciate our effort and the time it takes us to do it. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > spon started this thread, I have supported him with with just > argument. It does piss me off when "proffessionals" are so captivated [quoted text clipped - 8 lines] > will.... the butcher would likely find something a hungry child could > eat. > spon started this thread, I have supported him with with just > argument. It does piss me off when "proffessionals" are so captivated [quoted text clipped - 8 lines] > will.... the butcher would likely find something a hungry child could > eat. I see you'd rather pontificate on what the rest of the world should do...again I ask...what do YOU do? T If you want to rant at us attempting to use impressive multisyllabic words at least spell them correctly. Myself ? Plain folk don't need big words to communicate most of the time and my patients appreciate it. Even when talking about dentistry. carabelli there are two "multi-syllabic" words that are beyond an eighth grade education. One is for it's literary allusion (pity "professionals" don't take the time to become literate, prefering expertise in hording or consumption ) the other because it is the best word to express the thought. Did you have trouble understanding the post? I surely thought dentists could still and at least read to the level of an eight grader, or have your schools declined so badly. Tell me, I'll try to developic a mono-syllabic prose style just for you cute face. Sorry about the typos > there are two "multi-syllabic" words that are beyond an eighth grade > education. One is for it's literary allusion (pity "professionals" [quoted text clipped - 5 lines] > a mono-syllabic prose style just for you cute face. Sorry about the > typos Good, now try to improve your sentence structure. We're still all waiting for a coherent post from you. carabelli > Good, now try to improve your sentence structure. We're still all waiting > for a coherent post from you. Speak for yourself. ;-) Vaughn >> Good, now try to improve your sentence structure. We're still all >> waiting [quoted text clipped - 3 lines] > > Vaughn Vaughn, you of all people........... I'm gonna get a beer. carabelli One typical experience with philosophy and ethics: Years ago, I was trying to help a local family. They had run up quite a bill for dental treatment and told me they were having trouble paying it. They wanted to barter out the balance. I said "OK". A few months later they came to me saying they had half of a hog to clear out the bill. My freezer was full at the time, and I just said I would zero out the account and they could donate the meat to a 'needy' family. The 'needy' family turned out to be a friend in their church who was having 'trouble' with his painting/construction business. A few months later, I called the beneficiary asking if he could help me with a day or two of labor staining my deck (that my dad and I had just built). After all, he had a few hundred dollars of free meat given to him (from me). No was the answer. Fawks >>And the systems rigged to benifit you, for now. ( not to mention the >>conservative values of pro bono, did they remove that from the code of >>professional ethics, or is it merely forgotten by the philistines ?) > Is it only the dental profession you have this problem with or ...?? > > Webby Sounds like you got *porked*. (couldn't resist) >One typical experience with philosophy and ethics: > [quoted text clipped - 27 lines] >> >> Webby -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Sounds like you got *porked*. > > (couldn't resist) Good one. Dan will be jealous! Fawks Porky broke a fingernail while others loose everything. " ...wisdom is sold in the desolate market where none come to buy... " , not alot of that in the American "professional", ... " practical men are good, they are necessary, they find something that works and they keep doing it, wisdom comes from failure. " > One typical experience with philosophy and ethics: > [quoted text clipped - 19 lines] > > Fawks Yeah, it's hard not to feel like a chump in this kind of situation. OTOH, you didn't do it for the ingrate, you did it for the hard up family, and they obviously appreciated the gesture. You're a good man, Fawks! Steve >>> And the systems rigged to benifit you, for now. ( not to mention the >>> conservative values of pro bono, did they remove that from the code of [quoted text clipped - 3 lines] >> >> Webby SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> The 'needy' family turned out to be a friend in their church who was >> having 'trouble' with his painting/construction business. [quoted text clipped - 14 lines] > >Steve >> A few months later, I called the beneficiary The beneficiary was the ingrate. I still say Fawks got *porked*. <hehe> -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>> The 'needy' family turned out to be a friend in their church who was >>> having 'trouble' with his painting/construction business. [quoted text clipped - 23 lines] > > W_B Cured carabelli Go ahead.....ham it up. Fawks > Cured > > carabelli Ooh, you're bustin' my chops. >Go ahead.....ham it up. > [quoted text clipped - 3 lines] >> >> carabelli -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Ooh, you're bustin' my chops. Snort carabelli > >Go ahead.....ham it up. > > [quoted text clipped - 9 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com >> Ooh, you're bustin' my chops. >> >Snort > >carabelli Are you ribbin' me ? >> >Go ahead.....ham it up. >> > [quoted text clipped - 9 lines] >> Take out the G'RBAGE >> wubbabubbazG@RBAGEyahoo.com -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Yeah, it's hard not to feel like a chump in this kind of situation. >>OTOH, you didn't do it for the ingrate, you did it for the hard up >>family, and they obviously appreciated the gesture. >> You're a good man, Fawks! I'm glad THAT point wasn't 'lost'... spondee@REMOVEcox.net No, I think they thought, "Great, we got the bill zeroed out and we can give this meat to our best friends" (who will, I'm sure, help them out later) "That rich dentist didn't need it anyway". BTW, I was just a few years into private practice with many thousands of dollars of debt. Fawks >>Yeah, it's hard not to feel like a chump in this kind of situation. >> [quoted text clipped - 5 lines] > > spondee@REMOVEcox.net > No, I think they thought, "Great, we got the bill zeroed out and we > can give this meat to our best friends" (who will, I'm sure, help them [quoted text clipped - 4 lines] > > Fawks Don't become an old, bitter, cynical man like me. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > > No, I think they thought, "Great, we got the bill zeroed out and we > > can give this meat to our best friends" (who will, I'm sure, help them [quoted text clipped - 8 lines] > > Steve Don't be so hard on yourself - an old, bitter, cynical gentleman. carabelli > Don't be so hard on yourself - an old, bitter, cynical gentleman. > > carabelli LOL! Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> No, I think they thought, "Great, we got the bill zeroed out and we >> can give this meat to our best friends" (who will, I'm sure, help them [quoted text clipped - 8 lines] > >Steve Curmudgeon ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>No, I think they thought, "Great, we got the bill zeroed out and we >>>can give this meat to our best friends" (who will, I'm sure, help them [quoted text clipped - 15 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com I've been called that, and worse. I'm starting to think they may have a point. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Too late.....well I'm not too awful bitter......yet. ;-) Fawks > Don't become an old, bitter, cynical man like me. > > Steve > And the systems rigged to benifit you, for now. ( not to mention the > conservative values of pro bono, did they remove that from the code of [quoted text clipped - 6 lines] > teach us ) we would have to be fools oursevles". "Law is the opposite > of nature" ( you guessed it!~ Aristotle ) "never judge a man until you have walked a mile in his shoes"...(Chief Wild Eagle...or it may have been a camel cigarette commercial) Tell me what you do to help, and I'll tell you what I do. T >Anywhere I go , I see something like this: > >We reserve the right to refuse service to anyone. > >Why a dentist shouldn't do the same? Of course, and I said so in my original post. The question is: do dentists and dentistry have an ethical obligation to TREAT the needy??? To take SOME Medical patients... >Try LA if you do not live too far , you can find MC dentists here LA IS too far. No Car, can't even afford the round trip Amtrak, or the transit once I arrived there. >regarding your question: > [quoted text clipped - 10 lines] >That is life, and is sad, but am I supposed not to sleep at night because >some dentists do not take MC ? Absolutely NOT. You are not supposed to sleep at night if YOU don't take some MediCal patients... LOL >I do not think so. > >We are not in a perfect world > >And if I buy houses , go on vacations etc, is because I have worked hard to >get here. And the elderly/disabled have worked hard also. Are you saying that they haven't??? spondee@REMOVEcox.net Medicaid is a failed system in most states. It ends up costing the office more to treat through the state system than it does to simply treat pro bono. So that's how we handle it at my place. carabelli And how much tax money is being wasted with administration that could be channeled directly into Medicaid clinics (which could be staffed with physicians and dentists that want to be out of the demands of private practice, protected from frivolous lawsuits, and not have to deal with insurance hassles? Fawks > Medicaid is a failed system in most states. It ends up costing the office > more to treat through the state system than it does to simply treat pro > bono. So that's how we handle it at my place. > > carabelli >Medicaid is a failed system in most states. It ends up costing the office >more to treat through the state system than it does to simply treat pro >bono. So that's how we handle it at my place. > >carabelli Pro Bono, isn't he the singer for U2 ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >Medicaid is a failed system in most states. It ends up costing the office > >more to treat through the state system than it does to simply treat pro [quoted text clipped - 4 lines] > Pro Bono, isn't he the singer for U2 ? > -- Does he have big lips?...oh wait...that is another thread. Sorry T >Pro Bono, isn't he the singer for U2 ? You must be thinking of 'Suck Me"... spondee@REMOVEcox.net >>Anywhere I go , I see something like this: >> [quoted text clipped - 5 lines] >dentists and dentistry have an ethical obligation to TREAT the >needy??? To take SOME Medical patients... No. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com (snip) > Of course, and I said so in my original post. The question is: do > dentists and dentistry have an ethical obligation to TREAT the > needy??? To take SOME Medical patients... "Dentistry" with a capital "D" has no such obligation. The obligation (such as it is) comes from our hearts--as in "I have an obligation to help others". Steve >>Try LA if you do not live too far , you can find MC dentists here > [quoted text clipped - 31 lines] > > spondee@REMOVEcox.net SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >"Dentistry" with a capital "D" has no such obligation. Hmmm. Does Medicine? Law??? spondee@REMOVEcox.net >>"Dentistry" with a capital "D" has no such obligation. > > Hmmm. Does Medicine? Law??? > > spondee@REMOVEcox.net There are of course codes of ethics. This is all well and good, but when you pick up the handpiece (scalpel, legal brief) it's you and the patient (client). I'm not talking about whether it's "ethical" to advertise, of course. Most so-called codes of "ethics" really seem to me to exist primarily to control the competitive climate in which the professions operate (including interactions between professions and the law and politics) rather than true ethical behavior as I (and I think you as well) would define them. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Living in S. California and being aware that in my city there are only > a HANDFULL of dentists that accept ANY MediCal patients (even children > w/a toothache or an emergency like a car accident!), And a small > percentage of those don't have wheelchair access. > > I'm wondering WHERE the ethics of dentistry are??? Your subject is mislabeled. It should read "Ethics in Government" or more to the point "Ethics in Society". Sometime our society does a poor job of providing minimum services to people who need them. California voters voted themselves a huge tax break a few years ago and something had to give. You are obviously one of those "something's", and I agree that is a shame. I will bet that you will find that many (certainly not all) dentists take on a small percentage of unprofitable patients. Many of them that do so probably avoid MediCal because of the bureaucracy. I am sure you can see that the real problem is that MediCal pays less than it costs to provide the service. I am not a dentist, and I get paid where I work. Do I do "free" things for people? Sure, all the time. But the government is not involved. But just think of the government jobs our taxes support (like the people in the offices checking Medicaid claims). Someone is benefiting from the system. (Just not the dentist or medicaid recipient) Fawks > I am not a dentist, and I get paid where I work. Do I do "free" things for > people? Sure, all the time. But the government is not involved. >Living in S. California and being aware that in my city there are only >a HANDFULL of dentists that accept ANY MediCal patients (even children >w/a toothache or an emergency like a car accident!), And a small >percentage of those don't have wheelchair access. > >I'm wondering WHERE the ethics of dentistry are??? Alive and well. >I'm not saying that all dentists should accept all those with MediCal. >But what if EACH dentist accepted a few of these patients??? (And was >proud of it???) Why would anyone accept less than they are worth ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Why would anyone accept less than they are worth ? So the syllogism is (back to philosophy!) that the very poor are worthless because they have teeth and can't pay a dentist??? spondee@REMOVEcox.net >>Why would anyone accept less than they are worth ? > >So the syllogism is (back to philosophy!) that the very poor are >worthless because they have teeth and can't pay a dentist??? > >spondee@REMOVEcox.net The point being that the dentist office must produce a profit to stay in business. Altruism is good, but it don't pay the rent sister. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >The point being that the dentist office must produce a >profit to stay in business. A 'few' selected MediCal patients will not stay your ability to 'profit' or stay in business... spondee@REMOVEcox.net >>The point being that the dentist office must produce a >>profit to stay in business. > >A 'few' selected MediCal patients will not stay your ability to >'profit' or stay in business... >spondee@REMOVEcox.net Who is the selector ? IIRC if you accept one you must accept any. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Who is the selector ? > >IIRC if you accept one you must accept any. You, or your staff selects... No you do NOT have to accept any and all! spondee@REMOVEcox.net >>Who is the selector ? >> [quoted text clipped - 3 lines] >all! >spondee@REMOVEcox.net Do not believe that to be the case. For example: You either accept medicaid patients or you don't. You can't cherry pick. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >For example: >You either accept medicaid patients or you don't. >You can't cherry pick. Of course you can... spondee@REMOVEcox.net >>For example: >>You either accept medicaid patients or you don't. [quoted text clipped - 3 lines] > > spondee@REMOVEcox.net Sure you can--until you get caught. I don't take medicaid, so I don't know how it works precisely, but my understanding is that if you work with the system you may only decline patients if you are not able to provide clinically appropriate care, in which you should be able to guide the patient in obtaining this treatment elsewhere. There is the more practical problem that you must be very careful when selectively refusing patients, lest you be charged with discrimination which could leave you open to criminal as well as civil liability. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Life is so hard on dentists. How may have been Taken to court on the obove grounds? > Life is so hard on dentists. > How may have been Taken to court on the obove grounds? Tell us what *you* do to make the world a better place grasshopper. carabelli >Tell us what *you* do to make the world a better place grasshopper. > >carabelli Another one I'd like to see a reply too. But in all fairness, it's difficult to list THIS, as folks see you as self-aggrandizing, or on an ego trip, etc. Years ago, I actually belonged to a 'list' (kinda like a cross between a 'random acts of kindness' thing and an office 'secret friend' thing.) where folks did exactly that. Listed when they did something that helped someone, someway, in an impersonal, non-emotional way. And it wasn't 'bragging' but sharing. Most found it really helpful; they got their 'kudu's' and all involved got those small little ideas of how to make things better for a person or the world. And the kick in the pants to do it! Somehow, I lost track of the list (or it folded) when my puter died and I was without for months. Someday... I may do such a list myself... spondee@REMOVEcox.net >Listed when they did something >that helped someone, someway, in an impersonal, non-emotional way. >And it wasn't 'bragging' but sharing. Sounds like 'tooting one's own horn' to me. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > > Life is so hard on dentists. > > How may have been Taken to court on the obove grounds? > > Tell us what *you* do to make the world a better place grasshopper. > > carabelli I asked the same thing twice, with no reply. I think a lack of proper sentence structure and being an internet troll is this persons contribution to society. T >Life is so hard on dentists. >How may have been Taken to court on the obove grounds? I'd like to know the answer to that one also! spondee@REMOVEcox.net > >Life is so hard on dentists. > >How may have been Taken to court on the obove grounds? > > I'd like to know the answer to that one also! > > spondee@REMOVEcox.net If it is once, why would anyone jeopardize their livelihood? T >> >Life is so hard on dentists. >> >How may have been Taken to court on the obove grounds? [quoted text clipped - 6 lines] > >T ...for less pay... -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Sure you can--until you get caught. > I don't take medicaid, so I don't know how it works precisely, but my [quoted text clipped - 7 lines] > >Steve My BIG suggestion is that you consult w/dentists and attorneys and state agencies in your STATE. (I'd be interested to know also). But here in CA, A dentist does not have to give a reason for taking or not taking a patient. Nor for 'firing' a patient (docs too!). (OK, your tonsils have been removed, you have healed, if you need any further surgical care, here is the names of 3 surgeons.) I also do NOT believe that (again the STATE thingee) that selectively refusing patients would lead to discrimination charges, etc. Discrimination (ie race, creed, physical disability, etc) HAVE to be proved and validated. Would like to see actual stats on this one. I think what we are up against here is strictly MYTH. A handy myth that dentists can use to sooth their guilt... spondee@REMOVEcox.net >> Sure you can--until you get caught. >> I don't take medicaid, so I don't know how it works precisely, but my [quoted text clipped - 25 lines] > > spondee@REMOVEcox.net The issue isn't whether charges of discrimination can be proven. The issue is that they can be charged. This is (from what I've heard) a particular issue in employment, but it is a problem with refusing treatment as well. I'm not a lawyer, and I have no idea how often these charges are brought, nor how often they succeed in either civil penalties or criminal charges. I would not necessarily be aware of these cases unless I hear about them in medico-legal lectures, except in the high-profile cases that make the general news. The ones I can think of off-hand are those brought by HIV-positive patients who have been refused treatment. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Sure you can--until you get caught. >> I don't take medicaid, so I don't know how it works precisely, but my [quoted text clipped - 12 lines] >here in CA, A dentist does not have to give a reason for taking or not >taking a patient. Nor for 'firing' a patient (docs too!). Untrue, it is called abandonment. >I also do NOT believe that (again the STATE thingee) that selectively >refusing patients would lead to discrimination charges, etc. Again, untrue. Just because *you* believe something doesn't make it true. >Discrimination (ie race, creed, physical disability, etc) HAVE to be >proved and validated. Would like to see actual stats on this one. > >I think what we are up against here is strictly MYTH. A handy myth >that dentists can use to sooth their guilt... You are so full of it, am willing to bet that your eyes are brown. >spondee@REMOVEcox.net -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Again, untrue. >Just because *you* believe something doesn't make it true. You're such a troll!!! LOL and just because you SAY something doesn't make it true!!! spondee@REMOVEcox.net > >Again, untrue. > >Just because *you* believe something doesn't make it true. > > You're such a troll!!! LOL and just because you SAY something doesn't > make it true!!! Temper...temper! Did you bother to read up on the subject? Google is your friend. Vaughn > > >Again, untrue. > > >Just because *you* believe something doesn't make it true. [quoted text clipped - 6 lines] > > Vaughn Well, truth be told there are enlightened liberals and mindless liberals. Ditto for conservatives. Anyway, it's easy to decide how to spend other people's money. carabelli In article <tQQwe.372926$cg1.311529@bgtnsc04-news.ops.worldnet.att.net>, > > >Again, untrue. > > >Just because *you* believe something doesn't make it true. [quoted text clipped - 6 lines] > > Vaughn Yes, Google is spondee's friend: _______________________________ Note: The author of this message requested that it not be archived. This message will be removed from Groups in 1 day (Jul 2, 1:52 am). >For example: >You either accept medicaid patients or you don't. >You can't cherry pick. Of course you can... spon...@REMOVEcox.net ______________________________ If a person is on a crusade, why would that person not want Google to keep track of the history of that crusade? If you look into this thread in Google, you'll barely see any reference to the one who started the entire thread. In order not to be archived, a person has to do the technical stuff/directions. (I am aware that W_B does this.) But I do wonder if spondee realizes that you or I or anyone else could be gathering and archiving every visible post spondee sends out to usenet. I have better things to do that |
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