Thursday, September 08, 2011

WDS Knows What's Best (...for it's bottom line)

When your dad is your dentist for all of your childhood (like mine), you get used to knowing the person who is doing your dentistry will do everything in his power to make sure it turns out right.  And because he made no money on it, he did what was needed--no more, no less.  That should be everybody's experience but economics and insurance interests conspire to punish that sort of long-term patient care approach.

I think a lot of people make the assumption that doctors and dentists must live high on the hog, raking in extraordinary fees just because they can.  We're led to believe that insurers have our best interest at heart and when they take a stand by only paying portions of the standard fees or making drastic cuts as WDS is now doing to Washington State dentists, that they are doing us a favor.

The perception of doctors and dentists hanging around the country club, driving BMWs and doing their job just for the money has never been my experience with my own dentist father, many of his colleagues or my own current medical/dental providers in Seattle.  These folks have all struck me as earnest people who have gone into the field of dentistry/medicine to help others.  The trade off of more schooling and carrying large debt loads to go through school to then to set up a practice are worth the desire to help improve people's lives through better health.

Many of the great doctors and dentists are "great" because they relate well to people, take the time to help solve problems and go above an beyond to take care of their patients.  But that does not necessarily make them great business people or insurance experts.   With the proliferation of medical and dental insurance, they have to see more patients in a day because they are paid less for visits and procedures.  It puts pressure on them to be quick and sometimes hasty.  It can possibly incentivize those with weaker character and struggling balance sheets to to do more unnecessary tests and procedures to make up the difference. More of their time has to be spent dealing with insurers and the cost of hiring someone to deal full time with insurers is part of the overhead that doctors must now support.  And it certainly doesn't help when insurers require practitioners to adhere to a dictated schedule of fees to be in the PPO or preferred provider programs.  These programs can become so vital to some practices (especially where WDS dental insurance is concerned) that it could represent up to 40-60%+ of a dentist's patients.

WDS knows in this economy, it has dentists over a barrel.  With so many of the insured being with WDS, they control the payouts for a majority of the patients in Washington State.  It's banking on most dentists, especially new ones, or commercial dental groups to carry on and absorb the cuts.  This does not bode well for good dentistry.  It puts practitioners at a crossroads to either accept the new decreased payouts and find corner-cutting in every possible area including care OR drop out of WDS as a preferred provider causing the patients to pay more for care they have previously received at less cost.  But I guess if one doesn't care about getting decent dentistry it isn't an issue.  Providers are also getting squeezed by rising costs of medical/dental supplies, office overhead, worker salaries/benefits, loads of malpractice insurance and general inflation--yet the insurers want to cover only a % of their fees or reduce the existing payouts further.

By being "cheap" or expecting medical/dental care to be virtually free, we as a society are supporting insurers dictating the care we receive and deserve that scanty care.  There is a choice to make and employers & individuals who sign on with these insurers like WDS have the power to accept these programs or not.  People need to realize quality care does cost money because it's worth it.   It's only your life and well-being after all.  Otherwise, by relying on an insurance company to dictate where we are seen, how we are treated and what procedures are acceptable--we as patients are saying that we think the insurance company--a business--knows better than our own doctors do.

No comments: