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Medical Forum / General / Dentistry / June 2006A Strategy to Avoid America's Rip-off Dentists
First thing: They're all in it together. From coast to coast American dentists have all signed-on to the religion of overcharging. And you can forget about dental schools which were once a safe-haven for those seeking reasonable dental fees -- no more. Today even dental schools which certainly don't need the money, overcharge; possibly to get the students in the right frame of mind before they graduate. So what to do? Here's what I recommend: Get all your dental work done overseas while on vacation. For example, prices is Mexico City are 20%% -50% less and the dental work is very good. If you're nervous about being treated by a Mexican trained dentists, locate one who graduated from an American school; they've got plenty of them. And if you bring the kids, that $10,000 worth of dental work the family needs can drop to $5000 to $2500. Terrific, no? ricland >First thing: They're all in it together. From coast to coast American >dentists have all signed-on to the religion of overcharging. And you [quoted text clipped - 15 lines] > >Terrific, no? Wonderful! "Hey kids, we're off on holiday.. we're all going to the dentist!" I don't think so. Ann I have dentist tomorrow at 8.30am.. see if he's heard of ITP.. ha! > Today even dental schools > which certainly don't need the money, overcharge; This is an amazingly ignorant statement. Even though MORE dental schools are needed in the United States, over the last fifteen years several schools have CLOSED. Why? Because they were going broke. The fees charged by dental schools for their work don't even cover their costs. An organization that can't even cover its costs is forced to close -- like Loyola of Chicago, like Nortwestern, like Emory and like Georgetown. But of course, it is easier to make up ignorant statements than it is to check the facts. > So what to do? > > Here's what I recommend: Get all your dental work done overseas while > on vacation. For example, prices is Mexico City are 20%% -50% less and > the dental work is very good. I don't suppose that you are in a position to judge whether "the dental work is very good." How much of that "dental work" have you personally examined over the last ten or twenty years? Where did you obtain your dental education yourself? How many such patients have you examined? Here in southern California, dentists are in a position to evaluate the quality of dental treatment from many other countries, as we have so many immigrants, and are so close to the Mexican border. Most of what we see would flunk any American licensure exam, period. > If you're nervous about being treated by > a Mexican trained dentists, locate one who graduated from an American > school; they've got plenty of them. Gee, I can't imagine why anyone would be nervous being treated by dentists who don't have to maintain American standards because they operate in a much more lax regulatory environment. American dentists must maintain strict standards for sterilization and operating procedures. American dentists are subject to peer review and have to obey licensicng laws, and are always under the threat of malpractice actions in American courts. Just try obtaining a free American-style Peer Review in Mexico. Good luck. - dentaldoc > > Today even dental schools > > which certainly don't need the money, overcharge; [quoted text clipped - 45 lines] > > - dentaldoc I have no idea why the dental schools you named have closed and suspect you don't either. However, I'd be willing to research the question and report back if you're willing to go on the record as saying the reason was money. Deal ...? As to your specific charge of "sterilization and operating procedures," I, and I'm sure others in this newsgroup, are sadden that you would stoop to that level. Implying foreigners are dirty is the kind of comment that I thought we Americans stopped making decades ago. Then again, maybe you didn't include British dentists just brown ones. If so, be sure to let George know, I'm sure he'd appreciate that. ricland > > If you're nervous about being treated by > > a Mexican trained dentists, locate one who graduated from an American [quoted text clipped - 3 lines] > dentists who don't have to maintain American standards because they > operate in a much more lax regulatory environment. LOL-lax regulation, American Dentistry is thy name. Who regulates a dentists work quality on site? Who regulates their machines? Who supervises them or their employess? The worst that can happen is a slap on the wrist from the dental boards made up of, you guessed it.. "a board of highly sympathetic supervisory dentists", years after the fact! But don't the boards spend most of their time going after people who don't worship RC and amalgam anyway? or working with legislatures to concoct convoluted "arbitration laws" and "certificate of expert requirements" so that the fox is practically guaranteed of guarding the henhouse at all times? Or perhaps you've confused the American lawsuit system with "regulation"? Paying a lawyer $20,000 for a $5,000 botched RC isn't regualtion. > American dentists must maintain strict standards for sterilization and > operating procedures. American dentists are subject to peer review and > have to obey licensicng laws, LOL, who enforces these strict standards? Operating procedures? Who superivises the quality of office equipments such as amalgamators? Who tests the lines for bacterial contamination? Peer review from dental boards is just a eumphamism for no regulation at all! Politicians are peer reviewed too and have extensive review from "ethics committees". And what about "ethical codes"? Just look at the ADA, which, my gosh, swears on an Oath of God and country about a dozen times each year that it is just a trade organizatin with no legal responsabiity at all! >and are always under the threat of > malpractice actions in American courts. Which they have no concern over at all since their cushy insurance plans will pay for the legal judgements and court costs, not to mention you'd practically have to butcher a patient to violate the "standard of care". In reality few medical professionals ever pay out of pocket. Not to mention the astronomical legal costs required to bring a lawsuit unless a lawyer feel its a slam dunk million dollar bonanza!. But is the American Legal system your definition of regulation? As i stated above see tort reform mandatory arbitration laws, consiracy of silence and certificate of expert requirements. That's correct , you actually have to get another dentist to testify to prove the negligene of the first, with one shining exception (informed consent)! That's Bill's definition of American justice, unless you have $10,000 to ship in an expert from the other coast! > Just try obtaining a free American-style Peer Review in Mexico. Good > luck. In mexico who knows what constitues justice? > > > If you're nervous about being treated by > > > a Mexican trained dentists, locate one who graduated from an American > > > school; they've got plenty of them. > > > > Gee, I can't imagine why anyone would be nervous being treated by > > dentists who don't have to maintain American standards because they > > operate in a much more lax regulatory environment. [quoted text clipped - 53 lines] > > In mexico who knows what constitues justice? Ha, ha, ha... Busy writing your snappy comeback, Dr. Bill? Take your time; we'll wait. ricland > First thing: They're all in it together. From coast to coast American > dentists have all signed-on to the religion of overcharging. And you [quoted text clipped - 15 lines] > > Terrific, no? Bon Voyage! Steve > ricland > First thing: They're all in it together. From coast to coast American > dentists have all signed-on to the religion of overcharging. And you can [quoted text clipped - 15 lines] > > Terrific, no? You'd need a flaming long holiday if you tried that in the UK!!!!!!!!! > ricland > > First thing: They're all in it together. From coast to coast American > > dentists have all signed-on to the religion of overcharging. And you can [quoted text clipped - 19 lines] > > > ricland What the hell are all these Brits doing here? Somebody giving away free kidney pies and Guinness? ric > First thing: They're all in it together. From coast to coast American > dentists have all signed-on to the religion of overcharging. And you [quoted text clipped - 17 lines] > > ricland What about the emergency, are you going to jump on the next flight to Mexico and get that chipped tooth taken care of? What about those yearly exams? Better yet, how do you handle it if you need more work done than can be done in a single visit? Not to drive a Mack Truck through the holes in your theory, but here are some actual figures for your theory. From where I live, per person it costs about $500 for roundtrip airfare to Mexico City, then an additional $70 per night for a hotel, then another $30 for food per person, and $20 for transportation. That means, for a family of 4 to go to Mexico City and say for 5 days to get work done and to make sure they are not in pain, and get any adjustments made, would cost $2600, and to do that 2 times a year would cost $5200. That price does not include any "fun" activities while in Mexico. According to what you say the price difference is between US and Mexican dentists is 50%. So, unless you are having $10,000 or more worth of dental work done, it is cheaper to have your work done in the US. So, for example if you have dental exams, and a few fillings, you may only spend $5000 in a year (assuming you don't have dental insurance), in which case you have $5000 for a vacation. > > First thing: They're all in it together. From coast to coast American > > dentists have all signed-on to the religion of overcharging. And you [quoted text clipped - 40 lines] > (assuming you don't have dental insurance), in which case you have $5000 for > a vacation. Move to San Diego. ric > Move to San Diego. > > ric It is cheaper to just get some good dental insurance. >> Move to San Diego. >> >> ric > >It is cheaper to just get some good dental insurance. There is no such thing as good dental insurance. First of all it isn't "insurance", it is a pre-pay discounted plan". Secondly, most of the dentists - not all - who participate in it are either rip-off artists or incompetents. I've had plenty of experience to back up my statements. > Terrific, no? > > ricland Come back in a few years and let me know how your plan worked out. T > > Terrific, no? > > > > ricland > > Come back in a few years and let me know how your plan worked out. I'm waiting for some fine fellow to step forward and explain to me why a crown costs $1000. ric > I'm waiting for some fine fellow to step forward and explain to me why > a crown costs $1000. > > ric Well, if that fine fellow ever steps up, ask him if he can explain why my car dealer charges $115/hour for labor, or why my cable bill is closing in on $100. If he can answer those, I have more. Keep me posted! T > > I'm waiting for some fine fellow to step forward and explain to me why > > a crown costs $1000. [quoted text clipped - 8 lines] > > T Look. One of the reasons half the people you see are walking around with bad smiles is because they can't afford dental prices. By age 40, most people need serious dental work. I'm talking four unit bridges and things like that. A four unit bridge can go as high as $4000. This means if a person doesn't have insurance, he's looking at spending two months take home pay to get his teeth fixed. Meanwhile, the typical dentist takes home $4000 in week. Why couldn't the dentist's take home pay be $2000 a week? Sure, he'd have to put off the Mercedes for a while and the 1.5 million dollar home wouldn't come till the end of his career, but if he managed to eke out an existence on $2000 a week by dropping his prices 50%, wouldn't that mean more people would get their teeth fixed? ricland >> > I'm waiting for some fine fellow to step forward and explain to me why >> > a crown costs $1000. [quoted text clipped - 26 lines] > > ricland Because we don't live in a Socialist country. The simple answer is supply and demand. This applies to dentists and to fast food workers. For a given population there few people qualified to be dentists, but a lot of people qualified to be fast food workers. Since a dentist is a rare commodity they can charge more per hour to work than a person flipping burgers. Just think about the quality of dental care you would get if there were as many dentists as people flipping burgers. I can hear it now "Welcome to McDental, would you like to supersize your anesthetic?" While dropping the price would help more people to go to the dentist, you still have a lot of people that wouldn't go. Also, look at what people say about dental care in the UK, where a lot of that work is paid for by the government. >>> > I'm waiting for some fine fellow to step forward and explain to me why >>> > a crown costs $1000. [quoted text clipped - 43 lines] >Also, look at what people say about dental care in the UK, where a lot of >that work is paid for by the government. Well it isn't is it? Paid for by the government I mean, because the dentists won't take the lower pay that the other guy talked about. They want high pay, the highest they can get so they won't work at government prices and we all have to pay them what they ask. Ann > Look. One of the reasons half the people you see are walking around > with bad smiles is because they can't afford dental prices. By age 40, [quoted text clipped - 12 lines] > > ricland Cool plan...I'm just wondering how you plan to get the dental supply house, my dental lab, the electric company, water company, telephone company, postal service, state licensing board, outdated magazine subscription service, office supply store, my assistant, my hygienist and everyone else who makes up my overhead to also accept this 50% decrease? You see, the average dental office has an overhead that is 50% or higher. If I drop my fees in half, unless everyone else also drops their charges by the same 50% I am working for free. Seems like you have given this a lot of thought...let me know when you iron out the details. T >> Look. One of the reasons half the people you see are walking around >> with bad smiles is because they can't afford dental prices. By age 40, [quoted text clipped - 31 lines] > > T Takes less than that to go broke. Average general dentistry overhead is around 70% Gross $400,000 Overhead $280,000 Profit 120,000 Cut rates 30% Gross $280,000 Overhead - guess what? - stays the same $280,000 Profit Nada Cut rates 50% Gross $200,000 Overhead $280,000 Profit - go find a second job to subsidize the dental office -$80,000 > Takes less than that to go broke. > Average general dentistry overhead is around 70% [quoted text clipped - 12 lines] > Overhead $280,000 > Profit - go find a second job to subsidize the dental office -$80,000 You are very correct...I just used numbers that were easier to work with for our deep thinking friend. Hope you have been well sir...I have lost track of the regular band of merry makers...good to see your name here. T > > Look. One of the reasons half the people you see are walking around > > with bad smiles is because they can't afford dental prices. By age 40, [quoted text clipped - 27 lines] > > T Both you and "YouGoFirst" raised excellent points which will be addressed forthwith. Of course neither your nor YouGoFirst wrote anything particularly original or interesting, but that is another matter to be addressed at another time. YouGoFirst described how supply and demand works. He presented a textbook case of what happens when supply outstrips demand. But his example has no application here since supply and demand have little to do with dentals prices as I will show. You, Tony, approached the question from the other direction -- fixed costs determine the high prices dentists charge -- that is, dentists would love to stop squeezing their patients, but can't because people are squeezing them. This argument is not as easily dismissed. Yes, dental labs sock it to you, as do suppliers, and even the lowly dental hygienist thinks she should share your plunder. A vicious cycle, no doubt about it, but is it really as simple as that, Tony? Also, does it really absolve you -- the guy at the top who started squeezing first? Thirty---years ago Sterling Optical started charging 10 to 20 times the price of ordinary eye-glass frames. Those reading glasses you see on the rack at drug stores that retail for $5 are the identical frames Sterling (and today everybody else) sells for $125. It was a bold move and everyone thought Sterling would price itself out of business, but this did not happen. Instead, Sterling became the dominant optical retailer in the country, and the little guy who was charging a mere five bucks for his frames went under. Adam Smith must have turned cartwheels in his grave upon hearing this. It didn't make sense. It took all of the wisdom he had piled into his Economics Bible "The Wealth of Nations" and stood it on its head. Of course Smith knew nothing of today's insurance companies or high-powered industry lobbying group of which I'll discuss in a moment. But back to the optical business: in short time all the little guys were gone to be replaced by Sterling Optical or Sterling Optical clones. Pricing was identical in each. Pricing has remained identical in each for the past 25 years. Now, were Adam Smith here, he would say this is not possible, that the iron law of capitalism would drive one of these places to lower their prices and this would be the place the huddled masses would go to buy their eye-glasses. Nope. One of the things Smith didn't fully understand is the power politics have on the market place. In order to practice dentistry in the U.S. you have to be a member of the club and there are two crucial things the club does: (1) it makes sure dentists are qualified, (2) it makes sure there are no impediments to squeezing the consumer as much as it can. to be continued... > You, Tony, approached the question from the other direction -- fixed > costs determine the high prices dentists charge -- that is, dentists [quoted text clipped - 6 lines] > it really as simple as that, Tony? Also, does it really absolve you -- > the guy at the top who started squeezing first? I don't recall writing that dentists "would love to stop squeezing their patients, but can't because people are squeezing them." Your comments suggest you have some understanding of economics, so I shouldn't have to clarify things for you. There are fixed costs and flexible costs. Profit is always a flexible cost and depends on the desires and motives of the individual. The intent of my comment was to show you that your simplistic example of dropping charges 50% = a 50% reduction in dentist profit is flawed. There are fixed costs associated with running a dental practice. If the practice is even close to being well run, carving 50% out of that overhead would be impossible. A 50% drop in fees would likely result in an almost 100% drop in dentist income. As for the "lowly hygienist" (your term, not mine), there aren't all that many jobs that offer a high school grad with 2 years of additional schooling an opportunity to make a darn nice income like hygienists make. In my neck of the woods they command about $35 to $40/hr and are in short supply. There are many recent dental school grads working in practices where they would be happy to have a guaranteed salary like that! Shed no tears for the "lowly hygienist". Your comments about Adam Smith suggest you don't need me to explain this to you, so I won't bother playing along any further. Good luck in solving this economic concern of yours. T I'd suggest use baking soda for a tooth powder, and skip the rest of this advice. OTOH, if in Meheko, get some dentistry.  SignatureChristopher A. Young You can't shout down a troll. You have to starve them. . First thing: They're all in it together. From coast to coast American dentists have all signed-on to the religion of overcharging. And you can forget about dental schools which were once a safe-haven for those seeking reasonable dental fees -- no more. Today even dental schools which certainly don't need the money, overcharge; possibly to get the students in the right frame of mind before they graduate. So what to do? Here's what I recommend: Get all your dental work done overseas while on vacation. For example, prices is Mexico City are 20%% -50% less and the dental work is very good. If you're nervous about being treated by a Mexican trained dentists, locate one who graduated from an American school; they've got plenty of them. And if you bring the kids, that $10,000 worth of dental work the family needs can drop to $5000 to $2500. Terrific, no? ricland most dental schools are way underfunded! I disagree, this is totally wrong. > Today even dental schools > which certainly don't need the money, o >First thing: They're all in it together. From coast to coast American >dentists have all signed-on to the religion of overcharging. And you [quoted text clipped - 17 lines] > >ricland My wife is Mexican so I think I can speak to this issue with some knowledge. There are good dentists in Mexico, but you have to be very careful in looking for them and finding them. Even in the big city where she lived, and her sister being a dental student, it was difficult for her sister to get her to a good dentist. She said "Go to this dentist, he teaches at the University." She did so. But that dentist was not available so his assistant did the work. The assistant did less than great work, and she had to have some of that work re-done. One other time, a dentist closed up a surgery and left the cotton in her mouth. She of course had a terrible infection, had horrible unbearable pain until she went to another dentist who fixed the problem on an emergency basis. Another dentist "fixed" the gap she had between her front teeth when my wife was a teenager. He fixed it by inserting a little tiny tooth there. She wasn't old enough to know better, and did not realize what he'd done til it was done. I could go on with stories of her relatives having problems with doctors and dentists in Mexico. Her sister's mother in law died while getting a colon cleansing by some quack who did not know what she was doing. I know a guy who saw a doctor in Cancun start to use a dirty needle on him. Even though he was in pain and had a broken wrist he high-tailed it out of there and got on a plane to the states. I would never get major medical care done in Mexico. I WOULD get dental work done there, but ONLY after being very SURE the dentist was a good one, by knowing someone who had major work done by the dentist more than once, etc... Now, the other side of the coin is that sometimes this stuff happens here in the U.S., too, and certainly I have had several very bad dental experiences here in the U.S.; one cost me a tooth which I could not afford to lose ; now I'm having to get an implant there. My wife had to have an apicoectomy because of a bad root canal here. And a dentist here did very bad bridge work on her, too: All were HMO dental insurance dentists. I no longer use HMO dental insurance dentists in the U.S.. I also only use endodontists now, for root canals. I found that the local University graduate students at the dental school do excellent work and have close supervision. You wrote: One other time, a dentist closed up a surgery and left the cotton in her mouth. She of course had a terrible infection, had horrible unbearable pain until she went to another dentist who fixed the problem on an emergency basis R E P L Y Yeah I know. Another guy sewed up an entire rabbit inside an extraction site. I read about this on the PETA website -- Joel34 |
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