CARMICHAEL, Calif., April 30, 2013 /PRNewswire/ — Have you ever questioned a dentist's recommendations? "Is this really necessary?"
Gordon J. Christensen, DDS, identified the problem in the Journal of the American Dental Association in stating that many dentists "have been upset by the extensive therapy of sometimes questionable necessity and the blatant overtreatment sometimes observed in dental publications and in practice. I agree wholeheartedly with their sentiments."**
The Institute of Medicine in Washington DC has reported that 30% of healthcare expenditures are unnecessary*. Unnecessary expenditures are wasteful, and unnecessary treatment is particularly so. Unnecessary treatment can include deep cleanings where regular cleanings are appropriate, crowns where fillings will do, fillings or crowns where none are needed, and more.
The financial incentives of our system reward all treatment, including unnecessary treatment. The incentives can be large, as with a local dentist who reportedly increased his practice volume by $700,000 a year, a five-fold increase, with overtreatment in the mix.*** Dentists are largely able to define their own work and the consumer is passive. A more watchful, informed consumer and the separation of diagnosis from treatment is the fix. Bureaucratic micromanagement is not. I suggest that unnecessary treatment is a major driver of healthcare cost, that it is common, and its extent is underappreciated.
What is the remedy? Modify the system's incentives:
- Separate diagnosis from treatment sales to give the consumer more objective information
- Educate the individual patient to oversee their own care with that professional assistance
- Separate prevention from treatment
- Maximize patient choice by ending all insurer restrictions on provider selection
These measures, properly implemented, can cut average patient expenditures by half. On a national scale that would save $40 billion annually. These measures could make care more affordable, improve quality, and put the patient in control.
Dr. Ken Hajek, a 1977 graduate of the University of California School of Dentistry, is the CEO of Second Opinion Dental, a venture start-up. He can be contacted at Emailor 916-616-6712. http://secondopiniondental.net/
*http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=13444
** JADA 2012; 141 (10): 1259-1262, Positive Changes in Dentistry Related to the "Great Recession"
*** http://blog.dentistthemenace.com/2012_02_01_archive.html