“The less a service is perceived to be a ‘need’ the more profitable it can be provided to those who ‘want’ it.”
Avrom E. King
The insurance industry’s philosophy toward dental care is that it represents the servicing of ‘needs’, and that each ‘need’ can then be reduced down into various identifiable procedure codes.
This process represents the use of a concept known as “reductionism”, and insurance companies must use reductionism to bring dentistry into the marketplace AS IF it were a commodity, and NOT the professional services it truly is…professional services which are highly dependent upon the care, skill, and judgment of the treating doctor (and completely UNIQUE to each and every doctor).
Once dental services are brought into the marketplace AS IF they are a commodity, the competitive market forces can be leveraged to drive down the COST of services to patients.
Notice here, that it is not the dentists who are bringing their services into the marketplace, it is a third party, functioning as a MARKETER of their services who then takes a slice of the action for themselves for playing the role of “middle man” in a doctor-patient relationship.
None of this would be possible if we dentists failed to agree to allow others to market our care, skill, and judgement AS IF it is only a commodity. So, this begs the questions, “Are we just the personification of a commodity? and “Do we really want to be doing this to ourselves?”
How can we set a fee which is truly commensurate with our care,skill, and judgement if we can’t set the majority of our fees in the first place? And if our fees do not properly support the level of our care, skill, and judgement we routinely provide, do we even have a viable business model?
Obviously, we can’t sustain our practice at a high level if our fees cannot support it. In that case, we must eventually reduce the quality of our service to be more commensurate with the level of reimbursement we are receiving.
That is why I said “no” to “participation” twenty years ago, because HEALTH IS NOT A NEED (it is a want and a self-directed process), AND DENTAL CARE IS AN EXPERIENCE AND NOT A COMMODITY.
On this topic, Bob Barkley famously said, “Dental health is peculiar. The rich can not buy it, and the poor cannot have it given to them. I can make people more comfortable, more functional, and more attractive. But I cannot make them more healthy. I can teach them how to become more healthy, but whether they remain that way will be up to them.”
If we continue to accept that we are just “providers” of a commodity, and allow insurance companies to mediate our transactions, then we have no choice but to accept the situation for what it is – a codependency relationship that we have chosen to participate in. And hence, we must stop the whining, and work on how to fine-tune our servitude to the various insurance companies.
But they if we view our work as being something entirely different- as being facilitators of health, then we can break free of all of this dysfunction, and start to move back toward professionalism, and move back toward creating the freedom to practice in ways we know are best, which in turn bring about much more joy and prosperity in our lives.
Paul A. Henny, DDS
Thought Experiments LLC, ©2018
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