The responsibility then lies with those who market managed care to prospective clients — they need to honestly inform clients that what they`re selling is not `high-quality, ideal care ...`
Dear RDH:
Tammy Bergmann`s article about managed care in the June 2000 issue contained the following quote: "Certainly, there is a niche for traditional dental care and fee-for-service dentistry. A portion of the population desires high-quality, `ideal` dental care and is willing to pay for it. It all depends on the values and needs of an individual." This quote is the most important point of the article.Patients and employers are not informed that, by choosing a managed care dental program, they will be forfeiting "high-quality, ideal care." In fact, I`m sure that they are told and they believe that they will be receiving the same type of care — they`ll just have to pay less for it.
Thereality is that if the patient and employer pay less for treatment, the direct impact in theoperatory is that the dentist and staff will have to accept less compensation or they will have to spend less time with their patients, resulting in diminished quality and undertreatment.If the dentist decides to become a part of managed care, he either accepts that he`ll make less profit or he looks for ways to increase his bottom line. Since dentistry is a labor-intensive service, the biggest cut the dentist can make is the amount of time spent on each procedure.As a hygienist, I know firsthand that I cannot provide the same quality of care and disease prevention if I have 30 minutes with a patient that I can if I have 60 minutes.
Someone has to take a "hit" — either the insurance company, the patient`s employer, the doctor and staff, or the patient — because there`s only a finite amount of money to go around.Understandably, there are some patients who clearly cannot afford dental care without managed care, but there are manypatients and employers whochoose not to spend additional dollars on dental insurance and treatment.
The responsibility then lies with those who market managed care to prospective clients — they need to honestly inform clients that what they`re selling is not "high-quality, ideal care," but basic care that is better than no care at all.That way, the patient and employer can prioritize their own spending decisions and they`re not duped into thinking that managed care and fee-for-service care are the same thing.
Neva Everhart, RDH, BS
Sacramento, California
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