Wednesday, January 15, 2014

Dentists Besieged on Mock Your Dentist Day

Dateline: TORONTO—Mock Your Dentist Day has come around again and millions of North Americans are celebrating by standing outside their dentist’s office, hurling insults through loudspeakers, and holding up signs accusing dentists of highway robbery.

This day honours the audacity of dentists for charging an additional thirty dollars, on average, just for tapping a set of healthy teeth a few times for under a minute—after the hygienist has already done all the work, scraping and polishing the teeth.  

“I remember the first time I was truly appalled by my dentist,” says one man camped outside his dentist’s office. “Sure, my dentist used to rip me off like the rest of them, but he always had a smile on his face. My teeth are healthy; I mean I have no cavities or anything like that. So after the hygienist was done cleaning my teeth the dentist didn’t really have any work to do.

“But he pretended like he did and that, of course, was his crime. He’d take a metal instrument and tap my teeth with it absentmindedly, peering inside my mouth for an abnormality he knew he wouldn’t find. I used to mentally count how long that part of the dental check-up lasted. It was usually no more than half a minute or so. As I said, though, at least he wore a smile on his face and kept it light by making some amusing remarks—while he effectively reached into my pocket and stole thirty dollars from my wallet.

“You see, on top of the charge for the cleaning, my dentist charged thirty dollars for what he called the Dental Examination. I moved houses a few times, saw different dentists, and they all did the same. For those of us with healthy teeth, it’s organized crime and there’s nothing we can do about it if we want our teeth professionally cleaned, because they won’t let the hygienists work on you unless you consent to letting his holiness the dentist perform his bogus exam.

“Anyway, my funny little thieving dentist was on vacation during one of my checkups, so after the cleaning another dentist walked in while I lay back. Without saying a word, he sat down, tapped my teeth a total of four times, and after exactly sixteen seconds he stood up, pronounced my teeth healthy, and hurried out like he was oh so busy.

“‘Surely he’s not going to charge extra for that so-called exam,’ I thought. ‘Surely he couldn’t live with himself if he did so, couldn’t drive around in his BMW without puking if he happened to catch a glimpse of his pudgy rat face in the rearview mirror.’

“But no, as sure as the sun rises every morning, there was the thirty dollar charge printed on the bill. That dentist didn’t even do me the courtesy of telling a joke or two to distract me from the brazenness of his scam. And that’s when I’d had enough. So you’ll find me out here every Mock Your Dentist Day, telling them in the immortal words of the singer Sam Roberts, ‘You can take what you want from me, but you better believe that I can see you.’”

On the annual Mock Your Dentist Day, infuriated patrons throw eggs and tomatoes at the brick exteriors, pound on the windows, demanding there be no charge for needless exams, and shout slogans such as “We pay for work! Do more than smirk!” “Your job is funny! Return our money!” and “Hey, you dentist, we’ve been menaced!”

For their part, dentists are bewildered by the uproar. One asks, “Don’t they know how much we sacrificed to get through dentistry school? I had to memorize a lot of stuff and everything. No one would go through that hassle without knowing they’d be above the law afterward. So we extort a few extra dollars from our healthy patients. I have bills to pay. My third luxury car needs fancy new hubcaps.”

8 comments:

  1. Great post, really interesting. I love the style of writing

    Philadelphia Dentist

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    1. Thanks! If you're a dentist, I do hope you don't charge much for any unnecessary exam of healthy teeth.

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  2. Its hard to find a dentist who you don't mind having an appointment with. The office have always been pleasant, friendly and good at their job.

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  3. Dentists aren’t the most popular people in the world. But without them, we’d all have terrible teeth, and no doubt forget to floss or get regular check-ups...and in whole over the world on 6th March making a dentist day.

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  4. I'm a dentist. (Boo!)
    I've heard this complaint several times in my career: All he does is stick his head in, say hello, bounce that sharp instrument against my teeth and then run out with my $30.00.
    It's called efficiency. I've gone over your xrays in my office. The hygienist is trained to look for problem areas and have it written down for me to check. And I've seen hundreds of thousands of teeth over the years....I don't need a half an hour with you to see if something is wrong.
    Also, we hate you too. We are actually underpaid for the amount of face-to-face shameless insults we endure.


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    1. Well, since the patients look at their own teeth in the mirror all the time when they brush (those who don't brush don't go to the dentist either), I suspect they can usually tell when there's a change all by themselves, especially if there's a new pain in their mouth. So the so-called dental exam is useless. Dental expertise is useful in diagnosing and treating a problem that's found usually by the patient herself or, as you say, by the hygienist. How often does the dentist discover a problem with the teeth during that 30 second "exam" that the hygienist and the patient had both completely missed? Very seldom, I'd suspect. And xrays aren't taken each visit, so that particular justification won't fly. If, then, there's no such problem previously detected, why does the dentist charge an additional fee for an unnecessary, bogus exam?

      So no, I'm afraid we're dealing here with highway robbery. Did you think that because you're considered a professional that you were incapable of perpetrating such a brazen scam? Of course, most people who go to the dentist don't care about the bogus charge, because they have dental insurance and so the cost gets passed on to some collective. Like the mafia, dentists just take their cut.

      Never heard of any face-to-face shameless insults endured by dentists. Isn't that the function of the lighthearted comedy practiced by dentists in their office (satirized on The Simpsons by the phony laugh of the African-American doctor character)? To distract and amuse their patients so the reality of what's happening doesn't hit home and the dentists can get away without receiving the insults they're due?

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    2. You can't see what is going on BETWEEN your teeth in the mirror- that is what the bitewing X-rays are for. You don't see decay on certain surfaces or the roots of your teeth. You can't see the decay under an existing crown or filling. It often doesn't hurt until the decay gets to the center of the tooth where the nerves and blood vessels are. You can't "see" or feel periodontal disease- inflammation resulting in loss of bone. You don't always feel pain if you have decay or even a dental abscess because the nerve has died. You can't always see soft tissue lesions that need to be biopsied. You can't see an impacted wisdom tooth or canine. You can't get the big picture about needing interceptive orthodontic treatment without the proper X-rays and exam. You can't see internal/external resorption or endodontic lesions because they're rarely symptomatic.

      What you call a brazen scam is actually an efficient team-centered approach to oral care. The hygienist is trained to highlight certain areas and bring my attention to them. His/Her primary job is to clean the teeth, probe if necessary, take the X-rays if necessary and have the relevant information ready for me to review. What looks like 2 minutes of nothing to you is a carefully choreographed efficient system of being thorough. It takes years of training and experience to do a 2 minute exam.

      When you go to the hospital, do you grumble when the X-ray-technicians do their jobs and then give the reports to the M.D. to review? Why should you pay if the MD didn't take the X-rays him/herself? Don't you think the X-ray techs have seen enough pathology to have a pretty good idea about diagnosis? The judgment/diagnosis/treatment options by a qualified person who know what to do is what you're paying for.

      You've never heard of face-to-face shameless insults because you're not a dentist and you've clearly demonstrated you have no idea what you're talking about. I have yet to hear the physician in the office next door get blamed for the patient's irresponsible behavior. "I didn't have diabetes before I started coming here!" Now it's only about 1 out 10 who start with "I hate dentists" complaint or try to pass the responsibility of their health on to me, but those are the jerks that tend to ruin your day.
      You don't seem to value what we do. I can't count the number of times someone who has made the choice of eating rock candy for breakfast for the past ten years is upset at me because now he/she needs a root canal. Or the person who put off coming to the dentist when the tooth started hurting and now has cellulitis and a face like the elephant man gets upset because I can't extract the tooth that day.

      Dentists are all a bunch of thieves, the patient will growl, while having a $500 tattoo cooling on his/her arm. We have to be polite when the scumbag drug addicts calls repeatedly and abuse the staff because we aren't handing out Percocets to his/her liking. Entitlement and the I know-it-all attitude are rampant. Then there are the University of Google types who think everything is a conspiracy and insult your education to your face and have come just to argue.
      Believe me, there are plenty of money-grubbing crooks in my profession who give the rest of us a bad name....but even though I do my best to be ethical and fair, your attitude and ignorance are something I just have to put up with at least once a week. And I work in public health for 1/4 of what I could be making in private practice.
      Now continue your ranting, you anti-dentite.

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    3. I'm sure that dentists and hygienists have expertise that patients lack, and I'm sure they can spot problems that can't be seen by most patients. That expertise is worth paying for. However, I remain unconvinced that the dentist typically adds anything in his so-called exam. Much of what he can see in that very short period could theoretically be seen by the patient who uses a mirror. Certainly the hygienist would see the problems you list in your first paragraph. And if those problems are there, I have no objection to paying a dentist to confirm them and decide on a treatment. My objection is to paying $30 for a dental exam after the hygienist has already stared into my mouth for half an hour during the cleaning period and not found any change.

      Indeed, that happens over and over again, because as you get older you get into certain habits. You stop eating the very sugary foods you had as a kid and so on, so it's no surprise that most people's teeth remain unchanged for the majority of their adult life. Time and again, the dentist has "examined" my teeth and found no changes whatsoever. Is that supposed to be a coincidence? So after that pattern of healthy teeth has been firmly established and after the hygienist has found no abnormalities, yeah I have a problem paying the dentist to do a cursory exam to confirm what we already know. That's the bogus part.

      You say I'm an anti-dentite. Actually, I've gone to the dentist regularly for many years. I follow all of their advice. My uncle is an orthodontist and he did my braces and appliances when I was younger. One of my other uncles is a dentist and he was my dentist until he retired.

      I'm not against dentistry. I'm against being taken advantage of by snooty professionals who feel entitled to their privileges. Your seething contempt for your patients is consistent with my thesis. That class-based contempt is concealed by the dentist's phony upbeat attitude (again attested by the Simpsons doctor).

      Maybe there are foolish patients who likewise feel entitled to healthy teeth even though they don't work for them and so they blame their dentist. That sounds unlikely to me, but I'm open to agreeing that both sides are often in the wrong. Partly, this is for the obvious reason that dentists hurt your teeth to heal or care for them. That was satirized by Steve Martin's Little Shop of Horrors character (dentist as sadist). But I'm just pointing to the suspicious practice of that often wholly unnecessary dental exam.

      You don't think it's suspicious since you call it an example of efficient teamwork. Fine, but why not reduce the charge if no new problem whatsoever is found by either the hygienist or the dentist? How about charging only if the dentist actually adds to the conversation by finding some new development in the patient's mouth? This would be like the lawyers who charge only if they recover money for the client.

      When you say I don't know what I'm talking about, do you think I claimed to know about dentistry? I'm reporting my personal experience in a satirical fashion. (This article follows up on a previous one that reports it in a more straightforward way.)

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