Mass Dentistry

chillibreeze writer — Netra Dudhbhate

Ever since I got a license to practice dentistry in California I have been doing only mass dentistry. Whether it is a private clinic or a corporate clinic or medical based clinic. Everywhere the scene is similar.

What do I mean by mass dentistry? It seems to me that I deal with very large numbers, such as

1. The huge number of patients I see
2. The large number of fillings I do per patient
3. The production I get out of one patient, i.e., the money made per patient
4. The amount of time I spend with each patient – this is inversely proportional to the other numbers mentioned above
5. How I manage a balance between quality, quantity and patient satisfaction.

I have worked in many clinics. “Maximize the time” is the only motto. In most clinics, the number of rooms per doctor is 2 or 3 or even 5 rooms per doctor. Sometimes you have to work with minimum help or even no help. Still humanity, patience, tolerance and anger management are some of the few qualities expected of you. When you are the only one handling 5 rooms, half the time you do not even know what exactly you are doing. You are definitely running from one patient to another. You numb one patient, examine another, extract someone’s tooth, clean the teeth for yet another and when you come back for the numbed patient he or she is angry, numb no more and ready to get out of the clinic as soon as possible.

But you do not care if he or she wants to come back to the clinic or not as the only expectation from you is more production per day.

If I were in the patient’s chair I would want the best treatment available. But is it possible? When I myself do not spend enough time with my patients how can I expect someone else to spend time with me.

I do not blame the owners of the clinic. They are more business people than dentists. Their action is driven by insurance payments rather than patient satisfaction. But what about us? Those who are working towards their goals, do we act as per the owners’ wishes or do we save ourselves from legal matters arising out of neglected patients?

Once the office manager told me that good doctors are found on the road. She is right. This doesn’t mean that I consider myself a good doctor - most of us are good. But we get molded by the system.

The only qualification wanted is how worse you are (from the patient’s point of view) and how much more you earn for the company (from the clinic owner’s point of view).

I have seen doctors being aggressive with treatment planning, doing things which are not needed just to keep their position secure. Every owner will say that they expect quality and quantity but mainly they are interested in quantity. Have you ever heard of quality going hand in hand with quantity? I have not. People say there has to be balance if you want business but it is not possible.

Eventually you also become one of the herd. You cannot open your own clinic and you have to do what is expected of you. 5 minutes 1 filling. 1minute exam. 2 minute cleaning. We follow the instructions. Patients complain. You do not stop to hear their complaints, as it is a waste of time. A general dentist sees no point in cleaning as insurance does not pay enough. He assigns the job to an RDA or RDH and soon he is out of work. So he is forced by the system to do more difficult work like implants, dentures, partials, surgical extractions at bigger risk and still the same payment. The owners are eating cake. Their employees are working hard. No appreciation, no gain. Only pain.

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—About our writer: Netra says, "Inner thoughts - A dentist's point of view."

 

 

 

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