Former hospital system executive, wrote hacking healthcare for O'Reilly, created the open source ClearHealth/HealthCloud EMR...
One of the few times in managing hospital systems I was actually shocked at unethical behavior was when we took over management of a system that through accidents of history included a series of dentistry clinics. Dentists do not have any equivalent to a hippocratic oath, they have no professional obligation to be honest with their "patients". The overriding operational theme of the clinics was how to defraud "patients" with completely unecessary work to maximize profits and borderline defraud dental insurance. I understand that people have a dim view of ethics in american healthcare but this was what I would consider criminal behavior in a medical setting but as further experiences taught me, is the norm in american dentistry. Suffice it to say that we divested from the dentistry clinics asap.
Here is one swiss study showing that 30% of dentists committed fraud in the studed visits or were so incompetent that their behavior constituted fraud. I would guess that american dentistry is closer to 50%.
Have you had your wisdom teeth out? You are very likely to be the victim of dental fraud.
As if that meant something for regular doctors. Agree with all your post and would like to share a some anecdata in case it's good for anyone here someday.
When I was around 16 I lost a premolar (I had an extra one, that messed up the real one, both died and fell down), all dentists immediately suggested I get an implant. Reasons given where:
* Your face will deform (no, really) because of your missing tooth
* Your other teeth will start moving and will get misaligned and fall as well
* Your bone around that area will disappear and you'll need a bone graft and you could die
I read a bunch about that online and came to know that implants do massive damage to your mandible and that's not to be taken lightly. Average implant life, if all goes well, is ~20 years, then you have to do it again, each time you do it you weaken your mandible and palate bones significantly. Back then I thought, in 20 years I'll be in my 30s, nowhere near being old and I would start having issues with this for life. I decided not to get it, and guess what? I'm 37 now and have never had a single problem because of that, ever. Every single time I go to a dentist I get the same speech, over and over, "get an implant or you'll die, do you want me to book the appointment now?" "no, I just want some cleaning done, thanks". Dentists are as unscrupulous as it can get.
Almost the same exact situation. Broke my premolar in a swimming pool accident when I was teen and forgot about it. Turned 25 and every dentist wanted an implant saying my face will deform, jaw will deform in couple of years etc.
More than 15 years have passed and my jaw line is better than ever.
In canada, if the dentist find out you have private health insurance its a free for all loot. They even insist of x-ray every 6 months. Very infuriating.
Yes but also the technology at my dentists office is 20 years ahead of the medical profession.
My Dentist has 3D imaging done in seconds during every visit, 3D printers so you they have a crown done same day, lasers to prevent scarring, ultrasonics. They’re using tools, chemicals, adhesives, and methodologies that are cutting edge. I have no doubt that a decade from now they’ll be growing and implanting replacement teeth.
Meanwhile, American doctors are still arguing about the value of preventive healthcare, refuse to use diagnostic tools, scoff at MRIs and imaging, won’t prescribe new drugs (GLP-1s), and struggle to use computers. And for the privilege of dealing with this entitled, technically illiterate industry costs insane amounts of money due to the AMA monopoly and artificial shortages of doctors. It’s really the biggest scam there is.
Dentists, at least from what I've observed, seem to kit out their offices once, when they initially hang out their shingle and then use it until they retire with only minor upgrades. So if you go to a younger dentist, they have new stuff, if you go to an older dentist they'll have old stuff. It might be different if you go to a dental franchise where a parent company owns and manages equipment, but most dental offices still seem to be one or a few practitioners that own the office around here.
Doctors don't have to organise themselves in a way that results in them providing cheap and effective healthcare services - they just need to monopolise enough so that nobody dares to go to somebody who isn't a real doctor. You mentioned prescribing new drugs - monopolising prescriptions alone is a huge reason to go to a real doctor. Think you know more? It doesn't matter if you do!
Just the way things are. There's a reason firemen are more popular than doctors.
One thing I really like about my current dentist is that they'll show me the imaging and explain things such as while a certain crack on the surface of a molar could be filled, there is no rot beneath it so we can just monitor it. Wisdom teeth is a great example, I used to go to a dentist when I was a kid that would always bring them up. I never got them removed and have never had problems with them. I'm sure it's one of those things where statistically a lot of people do have problems and it's also easier to remove them before they get impacted, but far too many dentists want to remove them using those statistics instead of basing it on the specifics of the individual patients.
One of the few times in managing hospital systems I was actually shocked at unethical behavior was when we took over management of a system that through accidents of history included a series of dentistry clinics. Dentists do not have any equivalent to a hippocratic oath, they have no professional obligation to be honest with their "patients". The overriding operational theme of the clinics was how to defraud "patients" with completely unecessary work to maximize profits and borderline defraud dental insurance. I understand that people have a dim view of ethics in american healthcare but this was what I would consider criminal behavior in a medical setting but as further experiences taught me, is the norm in american dentistry. Suffice it to say that we divested from the dentistry clinics asap.
Here is one swiss study showing that 30% of dentists committed fraud in the studed visits or were so incompetent that their behavior constituted fraud. I would guess that american dentistry is closer to 50%.
Have you had your wisdom teeth out? You are very likely to be the victim of dental fraud.
https://pubmed.ncbi.nlm.nih.gov/3135372/ https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3036573