ALL of my patients cancelled dental appointments today - 3 hrs notice

[Mika]

Fucking inconsiderate pieces of crap didn't let me know on the weekend w/a message on my service.

I had no time to fill my chair with patients who wanted to or could come in early.

It cost me several thousand dollars in staff salaries, rent, insurance etc.

This is one reason that I, and a lot of DDS's, do not make a lot of money.

[Sequoia]

1. Charge them for it

you know the rules...24 hours notice.

[Wickerman]

2. Gotta agree

our dentist does so - and we live in small town USA

[Mika]

6. That's the way to lose patients

I usually eat it, unless I want to shit-can them.

I'm too nice a guy to get rich off of this profession. :hi:

[tandot]

8. Are you anywhere close to North TX or South-West OK?

I am looking for a dentist. And I wouldn't cancel without giving at least 24 hours notice.

[Mika]

15. Sorry. I'm in Miami-Dade, Fla.

I don't get upset if the person had a real emergency or something, its just that I know most patients don't realize the damage done when they don't give proper and fair notice.

I should at least double their next chair time fee. But people already are prejudiced enough about how much dough DDS's are rolling in. Most dentists would cut costs on that patient - by using an ultra cheap offshore dental lab or cheap materials or something. But I don't do that. I deliver what I believe to be high end, high cost dentistry... and worth every penny in value.

[Pithlet]

19. I wish you were near me.

I'm looking for a dentist, and you sound great.

[7th_Sephiroth]

64. remember

dendists have a higher suicide rate than air-traffic controllers

[Mika]

70. Yep, It must be...

"dendists have a higher suicide rate than air-traffic controllers"

It must be all of that money they're rolling in. ;-)


:hi:

[7th_Sephiroth]

75. its the stress

no one appriciates them, they get charged out the ass for insureance and staff, they get screwed over alot and depending where you are you cant stay in buisness

[Darth_Kitten]

79. My dentist charges a fee.....

if you cancel two days before your appointment. I think. :shrug:

Nice guys have bills, too, you think these people have valid reasons to cancel? Nope.....

Bill em, that's an order. :) ;) :evilgrin:

or post a sign, notifying they will be charged if they cancell without a valid reason so close to appt day. They are adults, they should accept that. :hi:

[truhavoc]

3. Several thousand for staff, rent, and insurance in ONE day??

Seems a bit excessive...Sounds like you should move, and either pay your employees less or let some of them go.

[MidwestTransplant]

7. I think he means over the course of a year

[truhavoc]

9. That is not how it sounded, it sounded like due to the cancellations TODAY

all of these negatives happen. Possibly he meant all cancelations in general throughout the year? I guess maybe then..

[Mika]

10. It is excessive. My rent and insurance kill me

Not to mention that I pay real wages for real staff (who got the afternoon off).

Then, I have to reschedule these patients, who's next appointments take the place of other patients.

I lose today, the reappointment slot in the next few weeks, then the appointment slots for patients who could have sat in their place the 2nd time.

Its the "1 f-up = cost of 3" principle in dentistry.

[pagerbear]

4. I need a new dentist

I promise I won't cancel without 24 hours notice!

[arwalden]

5. Dentists Scare Me...

Hygenists are mean. It hurts to have my teeth cleaned. I get chills, goose bumps, and I feel nauseous. It's like chewing on aluminum foil.

Maybe they were frightened.

-- Allen

[shadu]

18. It is better when they strap you in so you can't get away

I like it when the drill goes thru my jaw and comes out the other side. (One small hint: never let them use procaine or novacaine.
Screaming 'STOP' is at least half the fun.)

[Mr.Green93]

30. you need the happy gas

makes going to the dentist fun.

[Mika]

86. Many hygenists are mean because they don't get paid much

Hygenists are paid by differing means. Some are employed by the DDS, some are freelance.

My patients love my hygenist(s). They're paid well (by me) to go slowly and carefully. Its a loss leader in my business, but it makes my patients very happy to get great, low stress care. Patients come back, and have healthy clean teeth. Everyone ends up being happy.

--

Allen, have you told this to your hygenist? How about the dentist? Is he/she receptive to your reaction? If not... move on. It doesn't have to be that way.

Best wishes to ya.

[arwalden]

88. My Last Hygenist Lauged At Me...

and poked fun (in her own odd way) at the fact that I had difficulty in keeping my tongue still. Try as I might to keep it still, it seems to have a life of its own and I'm guessing it just undulates a bit (possibly distracting her or getting in her way).

Anyway, she kept saying "stop it, stop it. You can't stop can you? ha-ha-ha! Stop it... why cant you stop? Hey look his tongue is alive." And other such nonsense teasing.

I felt like an idiot. I had no idea that I was such a "trouble" for hygenists.

Perhaps that's why it hurts? Who knows.

-- Allen

[Mika]

89. You are a gent, Allen

Perhaps you aren't too much trouble.

To do any job well takes a bit of time and most hygenists are trying to stick to the schedule (that many times has been overbooked, because many dentists are trying to turn hygene into a 'profit center' within their practices).

Many are setting the timer for 30 or 45 minutes, and when it goes off.. you're done.


Its not a good model for proper professional hygene, but hygenists must work within a dental practice which is expensive no matter what the arrangement is. Think of how much time the hygenists would spend on the details if they were getting the payment directly from you.

[liberalhistorian]

11. I think a major reason why dentists

don't really make all that much money is due to dental insurance. Many employers either don't offer it or offer it separately from medical insurance and at higher prices. Then, when someone actually does have dental insurance, it doesn't cover nearly as much as it should, usually even less than medical insurance.

Plus, most people HATE going to the dentist no matter how much they know that they need to have checkups and cleanings, etc., and they either put it off until they're too miserable to take it anymore or they just don't bother altogether. If you don't have dental insurance, you usually have to pay upfront, or at least a substantial portion upfront, and a lot of people just don't have it so they put it off.

Those two reasons are the primary reasons why a lot of dentists don't make all that much money. It's not their fault, it's just the way it is.

[ArkDem]

36. from salary.com

The median expected salary for a typical Dentist in the United States is $109,440. This basic market pricing report was prepared using our Certified Compensation Professionals' analysis of survey data collected from thousands of HR departments at employers of all sizes, industries and geographies.

[Trillo]

90. Thank you. It sets up an interesting question

It appears dentists, in fact all professionals, are overpaid.

From data:
http://www.census.gov/population/socdemo/education/p70-51/table02.txt

We learn that a Professional degree offers on average $5,534 per month income.
A high-school degree offers on average $1,380 per month income.

A dentist goes to school, I believe, for 8 more years than a high school graduate. The ratio of high-school to professional years spent in education is approximately 12:18, or reduced, 2/3, which converts to about 66%. This means that a high school graduate, while they spend 2/3 of the time that a professional does in school, they earn roughly 1/4 of what a professional does.

If we assume that education leads to higher income, this data points to a vast disparity of deferred compensation per hour spent in class. In a system that rewards what one knows with income in the earning years, we can conclude that high-school students are not being taught necessary survival skills as efficiently as professionals are.

[Rabrrrrrr]

91. Or perhaps a more logical conclusion,

--> 20 years of schooling provides more necessary survival skills than 12. I agree that our schools could be a hell of a lot better, but to suggest that the level of education gained through high school should be equivalent to that of a dentist? I don't think I can buy that one. What's to keep any motivated high school graduate who doesn't want to get professional schooling to go into something else that pays well - welding, plumbing, electrician, oil rig worker, working for GM on the factory line?

(your ratio should be 12:20, BTW, assuming 8 years of extra schooling for the dentist)

And how can you define overpaid? What's overpaid? Anything over the poverty line, since that's the minimum necessary for survival (or, let's be honest, adjusted somewhat upward since I think we can all agree that the poverty line is ridiculously low)?

So if a professional at roughly $5,500 a month is overpaid, and I will assume that you are complaining that the $1,400 a month for the high school graduate is underpaid, then perhaps somewhere in the middle is your magical "just right" pay level? Maybe, $3,450 a month?

[Trillo]

92. It's about fairness. Thanks for the correction,

13:21 it is indeed, if one includes kindergarten. That changes the ratio to about 3/5, or 60%. That's still a far cry from the 24% relative compensation for high-school students.

I never said anybody was overpaid, but it is a valid observation from the data.

I suggested that high-school students are baby-sat, while college students may actually learn a valuable "survival skill." The outrage is that learning limited to the lower levels confers no or marginal survival benefits. The data suggests High School is likely more about indoctrination than learning useful facts.

Regarding your "middle figure", you would have to adjust it based upon relative population, skewing the curve more towards the lower side. Rougly 3/4 of the population has only K-12 schooling. But that's not the only way to achieve equality.

I would prefer to see a world where hours sat in a classroom seat is compensated similarly amongst all. Since a Dentist has about 166% (5/3) more educational time invested, their increased earning capacity should be about 166% of earnings as measured against those of high-school level, instead of 400% (the inverse of 1/4).

That would at least be fair.

[shadu]

12. where are you? I need a dentist

[demnan]

13. Let us know what city your practice is in

Those of us near you could PM to use your service.

[Mika]

17. I'm in Miami, and NOT soliciting

Thanks for the offers of support, fellow DUers. Thanks. :hi:

I have too many patients already. I'm just bitchin about the last minute cancellations, and the cost of downtime.

I COULD HAVE TAKEN A 5 DAY WEEKEND GETAWAY!! Instead I'm in the pit of hell - Miami.

[LeinesRed]

14. Maybe it's the post-Memorial Day..."Oh my God, today is TUESDAY"

not Monday syndrome. I'm a teacher... no homework is finished today either.

[HFishbine]

16. $800

for a forty-five minute root canal. It's hard to be sympathetic.

[Mika]

21. You got a bargain. In Miami its $1000-$1500

In Miami the average cost of operating a single operatory dental practice is a little over $550 per hour.

Dental offices can only be located in medical waste zoned areas (meaning expensive rent). My malpractice insurance is over $55K per year (and rising). My employee health package costs $3k per month. My OSHA processing costs thousands. A good dental chair is $10 to $15K.

Not to mention that I had ed loans to pay off.


I could be a whore and do cheap assembly line dentistry & make a fortune, but I chose not to.

[HFishbine]

23. Well

Nothing personal. I'm sure you're a dedicated professional, but face it, justified or not, the public perception is that the cost of dentistry is a rip-off (and at the rates you cite, $160,000 a month seems to justify that perception).

on edit: it is rude for your patients to cancel on such short notice. I would never do it.

[Mika]

28. Please tell me how you came up with those numbers?

"and at the rates you cite, $160,000 a month seems to justify that perception"

Dream on. I don't come close to that per year.

[HFishbine]

29. Dirty math

$160,000 a year? That's only two root canals a week (and nothing else). Get to work!

[Mika]

32. LOL. Good one

Gee. Its not like every minute in a dental practice is drilling, filling, and billing.

I guess that I should just eliminate ALL of the non profit services to my patients.

I should fire my hygenist. I should fire my dedicated staff and hire illegals with no benefits. I should have a bus bench in my waiting room (wait, I shouldn't have a waiting room, patients can stand in the hall). I should use the cheapest drugs, cheapest materials, cheapest diamond drills, cheapest offshore dental lab, cheapest lighting, etc.

I should charge them for phone calls, I should charge them for perscription writing, I should charge for every minute spent calming and reassuring young patients, I should charge for the midnight emergency calls, and I should charge for the advice and consultations by the minute.


Sounds like a great practice strategery. ;-)

[HFishbine]

33. Maybe you should

As someone who doesn't wake you at midnight, who doesn't ask you to calm my kids, who doesn't really need the free toothbrush, and who doesn't need brand name drugs, I guess I'm subsidizing those things for your other patients. (Please keep a good drill on hand though, that I'll pay for.)

[Pithlet]

34. Nice change of attack.

First, it was a claim of profiteering, and now it's "subsidizing" decent care for other people.

I'd like my own personal dentist, too. That would be cool. Because sharing the planet with other people is such a pain.

[HFishbine]

37. Welll Excuuuuuse me

Excuse me if I allow myself to be informed. Mika took the time to explain why costs are so high and I responded appropriately to the information he provided. I can see why you have a hard time sharing the planet with other people.

[Pithlet]

52. Oops.

I'm sorry. It is clear that you're a very nice person. I totally misread your post. It's so obvious. I don't know how I could have been so off the mark.

[HFishbine]

55. Proof?

Care to back that up, or are you just speculating?

[Pithlet]

56. Back what up?

That you seem like a nice person? Speculation, I guess.

[HFishbine]

57. Okay

I'll take your word for it.


;)

[Mika]

38. Nope

"I guess I'm subsidizing those things for your other patients."

You aren't one of my patients. You don't subsidize any of those things for my other patients.

I do.

[HFishbine]

40. Of course

I meant a generic "me" -- the patient who doesn't incur costs for you for which you do not charge -- that "me."

[Mika]

46. Nope

As I said previously, I do.


My patients come to me knowing full well who I am and how my care vs. pricing works.

Those who want less service (and less value) can choose to go somewhere else. Those who want my service and value can choose me.

[HFishbine]

50. Not really

Unless you are operating at a loss, you are not subsidizing anything. If you are taking a salary, but not charging Billy's mom for showing Billy the plastic jaw and explaining how mastication works, then somebody is paying for your time.

[Mika]

58. Wrong

I work at a variable rate. Not a fixed rate.

Its one of the benefits of being the owner/boss. I can take less, at my own expense.

I didn't get into this profession out of greed and desire to become wealthy. I was inspired by the dedication of compassionate and caring practitioners, of which there are not enought of these days in America. I was motivated by the needs of desperate patients. I was motivated, and by reaching for and working hard for the independence to do just what I felt what was needed... care for patients.

[HFishbine]

62. Did they make you take a business class?

Look, I'm not questioning your motivation or dedication. All I'm saying is that if you draw, let's say $5,000/month salary and you have two patients:

Patient A is on time, doesn't shoot the breeze before getting in the chair, always keeps his appointments, remembers to take his antibiotics before his appointment, is content with generic drugs and declines the free tooth brush and floss. He doesn't have insurance so he pays in cash.

Patient B needs a lot of hand-holding, needs to chat for ten minutes just to get comfortable, sometimes has to be rescheduled because he forgets to take his antibiotics before his appointment, asks for brand name drugs, takes an extra free toothbrush for his brother, asks if he can take this week's Time magazine, and calls you at 10:30 p.m. because he's experiencing normal post-proceedure pain. He has insurance, promises to mail in his co-pay next payday and leaves you to file the paperwork to collect the balance.

Patient A and Patient B both come in on the same day for the same proceedure. Unless you are charging patient B more, then patient A is paying a higher price for your time and expenses. Hour for hour, patient A is making a greater $/minute contribution to your salary.

[Pithlet]

65. Or

Patient A could go to a dentist that doesn't do all the handholding and offer all the extras, and possibly pay less that way. There are plenty of those, I'm sure. I, for one, might want to pay a little extra to go to a dentist who had those kinds of things to offer, particularly since I have a family that requires a lot of dental attention.

[Mika]

66. Maybe I would charge patient B more.

Or, I might decide to charge patient A less per hour as a perk for being so efficient.

Or I could take less per hour for patient B at my own expense.


Maybe patient A wants to pay more for fast efficient service.

Maybe patient B wants to pay more for slow luxury service.



There's more than one way to skin a cat. It takes all kinds.




Business school suggested that maybe I should just gouge them all and double my prices so I can get that Benz.


I run a health care practice, not a health I don't care practice - health care isn't just a business enterprise.

[TX-RAT]

67. Remember your first post?

I didn't get into this profession out of greed and desire to become wealth.
Your first post.....
Cost me several thousand dollars.
Reason DDS's do not make a lot of money.

I was motivated by the needs of desperate patients. I was motivated, and by reaching for and working hard for the independence to do just what I felt what was needed... care for patients.

Your first post....
Fucking inconsiderate pieces of shit.

With that attitude be happy you have patients at all.

[Mika]

68. It is fucking inconsiderate of them.

Especially after the care and consideration I gladly give to them. Consideration is a two way street in a healthy relationship.

It did cost me thousands of dollars. I'm supposed to be happy about that? I don't make a lot of money.

One is an inconsiderate piece of shit for running up the costs of caring practitioners who already are time/cost hindered.

It will only add to the costs of dentistry overall, or reduce the viability of low profit high level care practices - for everyone.


I absorb most of the costs of these miscreants as do many DDS's, that is one reason that many DDS's do not make a lot of money (contrary to the accusations that all DDS's are super rich).


Granted, my first post was not as tempered as it could have been, due to the freshness of the multiple burn clusterfuck. But, I stand by it. They are inconsiderate pieces of crap, and I won't neglect to point that out to them. They can do as they please.

[TX-RAT]

35. What do you do for patients when your late for their appointment.

Recently had to wait 2hrs past my appointment time to get in. Had to drive 1 hr to get to the dentist.

[Mika]

42. I RARELY do that

I don't schedule too many patients in one day - that's more than likely why that happens. Like airlines that overbook flights.

I don't do that.

But, if some kid knocks their tooth out in a car accident, and we have a chance to save the tooth by immediate surgery, then my patients are kind enough to understand that there are medical priorities in an emergency. My staff would do their very best to call them in advance and to accomodate them (one of the non profit centers of a dental practice - care and compassion).

They know I would give them priority if they were in the same condition.

[radwriter0555]

20. Yeah? Then stop charging us $3000 for implants that actually cost

$150, okay?

No offense. I'm a little pissed about you dentists charging such jacked up prices for little bits of metal and amalgams that really cost under $200.

[Tarheel_Dem]

22. geez rad......

i know exactly what you mean. just had an implant a couple of weeks ago, and unfortunately the root canal & extraction ate up my entire dental benefit for the year, so i wound up having to pay the entire cost of the implant. i'm gonna need another, but since it's in the back of my mouth, i'll just have to wait until i save up the money. i'm not down on dentists, but the cost is just ridiculous.

[Mika]

27. If you paid cash the costs would be way less

Most DDS's will be more than happy to negotiate a good price for direct payment. It saves all of the goddamn hastle dealing with insurance companies - who pay late if at all.

The costs of dentistry would drop significantly if the insurance companies were done away with. I have to pay an employee just to deal with insurance.

The system is built on a scam. But that doesn't negate my overhead costs. To keep costs down as much as possible, I take a small salary.

[ArkDem]

39. Your number of patients would also drop significantly.

[HFishbine]

41. Not necessarily

A lot of people don't have dental insurance (I wouldn't be surprised if most don't). I think a dentist that advertised "discounts for cash payment" would see a whole new clientele.

[ArkDem]

47. If he has to hire a person just to deal with insurance, my guess

is that quite a few are insured.

[HFishbine]

53. Well duh

I didn't say that most people who go to the dentist aren't insured. I speculate that most people don't have dental insurance. There's a difference. Don't you think that a dentist who advertised discounts for cash payments would see an increase in patients who don't have insurance?

[ArkDem]

60. Not necessarily. I would think the main thing people look for is

quality of service.

[Mika]

54. Less than half are insured

But limited insurance at that.

I am not an HMO/DMO paid practitioner. I have signed no capitation contracts w/any insurance carrier. I am fully independent.

It takes a full time employee to deal with the insurance companies because they're so goddamn crooked. Try resolving complex dental procedures and billing issues with insurance companies... it takes many hours per patient to deal with them.

I gladly work with direct payment patients (even direct payment plans), and I encourage it. Look at how much coverage most policies have vs. your annual payment for such bad coverage.

[radwriter0555]

48. That IS the cash price here in southern california. The fact that the

materials literally cost under $200 in no way justifies jacking the prices up by thousands of dollars.

There isn't an insurance company on the planet that pays a penny for implants.

Thanks to the kind and profiteering dentists in southern california, I get to walk around without two teeth.

Insurance won't cover bridges, because I will be missing matching molars on each side. They are baby molars I've preserved all these years, because there were no permanent molars under them. These molars are 40 years old now and have succumbed to time and pressure.

So the archaic forms of dentristy available to me are DENTURES for $750. Gee, won't those be pretty?

Or bridges, where I get to destroy 4 teeth to make 2 look decent. OH! And the insurance company WON'T PAY FOR THE BRIDGES BECAUSE I WILL BE MISSING A TOOTH ON EACH SIDE. Insurance cos don't cover bridges where the tooth on the other side is missing, and in my mouth, it isn't even MISSING yet!

Or implants, which START at $2,600 PER TOOTH, for, again, those materials which cost less that $200 per tooth.

THANKS!!!! LOVE my smile!

[Missy Vixen]

76. Okay, now I'm hot

I'd like to know why so many here think doctors, dentists, etcetera, should spend hundreds of thousands of dollars on their education, setting up a practice, malpractice insurance, employee salaries, on and on and on, then begrudge them making a good salary for their hard work.

Our dentist works her hiney off. She offers tremendous care. I know that her overhead must be incredibly high. At the same time, we are lucky enough to have a great dentist ten minutes from our front door.

Our doctor is another hard-working professional. She goes out of her way to offer superior care. When I ended up in her office in tears one day because I was so depressed, I'm sure the person behind me had to wait an extra ten minutes that day, but I will sit and wait that additional ten minutes for someone else who desperately needs her help someday as well.

If I went to school for eight years (and had to take recertification classes besides,) I'd sure as hell want to make a good salary. Why shouldn't they? Don't you think that the crap they take off of their patients all day long could be a bit wearing as well?

Just wondering,
Julie

[radwriter0555]

80. I'd like a health care system that allowed me more than 10 minutes with

my doctor, or for it to take less than 6 weeks to get an approval for a simple procedure.

I'd like more choices in getting rehab for my knee, but instead I had to join a gym and do it myself rather than drive 24 miles round trip and then NOT be sure my therapist would show up.

It would be nice to actually have OPTIONS for health care, that don't cost thousands and thousands of dollars a year, in ADDITION to the premiums.

But we don't.

We're stuck with doctors who paid FAR too much for their education, and who should have gone to school in foreign countries to learn the same things, get the same credentials for a fraction of the cost.

now WE get to foot the bill for their education, and the less than 10 minutes we get with them, if we're lucky.

and I'm still out two teeth I can't afford to replace.

[Mika]

83. No dentist treats patients in 10 minutes

I not only spent six years of my life getting the required ed, but I paid for it too. Not my sugar daddy. I worked several jobs at the same time in a financial juggling act worthy of Barnum and Bailey. I ate ramen noodle soup for months on end. Don't think that all of us are born with a silver spoon in our mouth.


Actually, if truth be told, I changed my life's direction after a trip to Cuba in the 1980's. I saw dedication of health care practitioners that was truly awe inspiring. I saw a health care system that truly works for the people despite shortages forced on them. I've been to Cuba and several other Caribbean and Latin American countries over the last 20 years with a few non government dental charities. I have my rewards... but they are not at all financial wealth. FYI, I would move to Cuba to join their health care network in a heartbeat if I could. But for now, I give what I can right here. The need is great.


radwriter0555, unlike the USA if you lived in Cuba your health care would be complete and at no extra cost to you. Not bad for a 3rd world country.

[Mika]

24. Ok. Then you pay my ed loans

Actually, you can't say that it costs $3000 for a little bit of metal - just as you wouldn't consider car prices by the steel weight.


I know of no one who charges $3000 JUST for the implant. That prive sounds like it includes surgery, impressions, temporization, and final crown placement.


You don't think that the skill and surgical experience required to place an osseointegrated implant, all of the preliminary pre-op prep work and final crown is worth it?

Then..... gum your food in health. Good luck.

__

FYI, I support universal health and dental care - but not only on the backs of practitioners. It will take a systematic change.

[dweller]

26. Mika, have you heard of this?

http://news.bbc.co.uk/2/hi/health/3679313.stm

what are your views on this developing process?
just curious,
dp

[Mika]

31. It sounds great

But its several generations away.

I can hardly wait. No more dentists. Just oral surgeons (and if you think that family dentists are expensive...)!



Most dental problems involve more than just the patient's teeth. One has to look at the whole body condition, because the patient's oral health is a good reflection of their overall health.

[radwriter0555]

49. I don't understand how 2 hours of time costs me $2,600...

tell me there isn't a MASSIVE profit margin on this.

I get to support the mercedez driving, million dollar home owning dentists.

Or at least other suckers do.

[ArkDem]

51. If they keep making that kind of profit for very long they will be

able to drive a Mercedes!

[Misinformed01]

59. How have you had time to stay on DU all day?

My dentist's office is crazy busy...every day-

Wonder if he's a Dem or a Republican?

On edit: sorry, Radwrite..this wasn't a question for you--it was for the original poster. This thread has fascinated me for hours....btw...my sister used to work in a dental lab...you are right on about the numbers, and I haven't seen anyone here be able to dispute you-

[Mika]

72. Huh. Did you read the post? ALL of my patients cancelled today - last minu

"My dentist's office is crazy busy...every day"


My office isn't "crazy busy". It never is. I don't run a dental mill.



--

"Wonder if he's a Dem or a Republican?"



Me? I'm a Kucinich Dem. (See the avitar I use?)


--


"my sister used to work in a dental lab...you are right on about the numbers"


Dental lab technicians REALLY get the shaft, in general. Its not a recognized medical/dental profession by the ADA. Therefore, generally, they work for cheap.


Only in the USA is there ABSOLUTELY NO CERTIFICATION REQUIREMENT for dental labs. Pay for a state DPR license.. and you're a dental lab owner. Thats it.

I am a member of the National Association of Dental Laboratories (which is rare for DDS's) who is pushing for certification requirements of dental labs so that they can become recognized members of the dental profession by the ADA, and make a reasonable wage. The ADA membership doesn't want this. They want to keep the dental labs invisible from the patient (to keep the disparity in prices secret).

I know the scam. I worked in a dental lab for quite a while.

[radwriter0555]

81. I did the research on the numbers for implants, and the info came from

dentists on how much these little materials cost.

I can get it done in mexico for about a grand a tooth, and even less if I really literally talk to people while I'm down there.

Funny how everywhere else in the world people manage to get GOOD care without going broke.

[Mika]

84. Very true

"Funny how everywhere else in the world people manage to get GOOD care without going broke."

Especially in Cuba and much of Europe.

I'm ALL for a socialized H-C system, but that requires major changes. Without controlled costs, how can their be controlled prices?

[Mika]

63. It wasn't just two hours

It included pre operatory lab work, diagnostic wax-ups, surgical stints, and consultations. Quite a few hours of work went into your case before you plunked your ass down in the chair for surgery. Do you know that I have to take surgical courses every year to maintain my licenses, costing thousands of dollars? Did you know that a low speed single-use bone saw is hundreds of dollars? Did you know that the torque driver costs close to $1K? Did you know that there is a different torque driver for each of the dozens of implant systems? I have to keep those in stock - up front.

No need to give a dental lesson here, but its an expensive business to be in. It takes a huge investment (loan) to build a dental practice.


I don't own a Mercedes. I can't afford to waste money like that. I have a 3yr old Nissan Altima (wow - BIG time wealthy car).

I don't live in a million dollar house either. Don't want to.

I'd have to charge more than its worth to my patients, which wouldn't be right.

[Pithlet]

25. By that reasoning

Haircuts should be for free, because we don't actually get anything tangible. In fact, we walk out with less than what we had when we went in there, so hairstylist should be paying US to cut our hair.

[Donkeyboy75]

44. LOL!

[catzies]

43. My semi-annual is today. I'm keeping it, I SWEAR!

Oh, and you're in Miami-Dade. :hi:

I grew up there and loved my childhood dentist and orthodontist. My dentist may be deceased by now, and I know my orthodontist was a state senator from Kendall.




edit 4 speling

[Lou_C]

45. You need to setup a 24 hour notice sign and rule

If they don't cancel 24 hours in advance then they will be charged.

[CO Liberal]

61. If I Don't Give 24-Hrs Notice....

...I have to pay a cancellation fee. If I don't give 48 hours' notice to cancel an epidural injection, the cancellation fee is a hundred bucks.

[Mika]

69. Its kinda hard to be ruthless with such a concrete policy

After all, its expensive enough isn't it?

I'm trying to be considerate. Most of us are feeling the economic squeeze. But not all.

I work with my patients, based on reality, based on fairness.

[Missy Vixen]

77. Mika

>I work with my patients, based on reality, based on fairness.<

This is true. At the same time, those patients who cancelled today aren't being fair towards you, your time, and the expenses of your practice.

Our dentist charges the missed appointment fee. You bet we cancel with at least 48 hours' notice when we can't make the appointment. Our hair stylist now charges a missed appointment fee if the appointment isn't cancelled with 48 hours' notice.

You will lose the patients that took advantage of other dentists. You'll gain additional patients who want the best of care from a dentist who asks his patients to give him and his practice the respect it deserves.

IMHO.

Julie

[kymar57]

71. Hey Mika

Just wanted to throw in my $.02 and see if my record as Thread Killer holds up.

After years of dental denial(deathly afraid of dentists,childhood issues)I decided last December to get some longtime problems taken care of.

I'm not talking about a few fillings.My teeth were a mess(think Deliverance). I don't know if I just got lucky or what but I ended up at a local dentist's office with the kindest,most caring and capable staff I could have imagined.

Long story short. After blowing through 2 yrs of company provided dental coverage(03 and 04) and almost 10k out of pocket expenses, I wrapped up my treatment in early May.

Now,I won't be so dramatic as to say it change my life, but it sure is great to to smile at people again.Best money I ever spent.

Bottom line,this is one DUer who appreciates your years of training and the service you provide.

DRILL ON

:hi:

P.S.I was never late for an appointment.

[Mika]

73. Congratulations & Thank you so much, kymar57

I can't tell you how many times I've cried along with my patients at the moment of change in their ability to smile. Smiling is VERY healthy for you. Smiling does change lives. Keep it up!! More importantly, restoring someone's ability to nourish themselves by chewing their food properly is the goal - in addition to doing it esthetically.

Its our job to restore NATURAL looking and functioning teeth. Being able to do that is a pleasure, and worth every bit of the agony (don't think that dentists like hurting people, most do all they can to reduce the intrusion and feel much stress restoring your teeth).

Please take care of your crowns and/or bridges. Floss (get the floss threaders for bridgework), get an irrigator (like a Water Pik), and get one of those new "sonic" type of toothbrushes. Use them all gently and several times daily. Get check ups on your work regularly.

Thanks again. :hi:

[Rabrrrrrr]

74. Let me add in my support, as well!

YAY for good dentists! I'm glad I have a good one. Bloody expensive, but he's not as good as he is because he goes on the cheap for equipment or training.

Mika, know that there at leasst some people here who realize that for any professional, the time the customer/patient sees the professional is but a small part of the total expenditure for the professional.

Yeah, the bridge my dentist mdae for me probably cost him $400 or less. But considering the $550 hourly rate just to keep the office going, and the time needed to coordinate and keep track of all the bridges and crowns being made, the probably 5 hours total over many weeks I spent sitting in his chair and having prep work done, plus someone to deal with my insurance, plus the cost of the temporary bridge and all the molding materials and making sure everything worked perfectly and fit perfectly and the follow up appointment to check my gums and make sure everything was healing up...

I can see why it costs so damn much even though "That damn bridge couldn't have cost more than a few hundred dollars!"

Screw that. Not everyone is that dumb. Having people cancel sucks, and as you say, it's not good business practice to charge people for cancelling. Though if I had a client who cancelled many times, I might, for that person, start charging after warning them.

Also, i don't know why some people think that a dental will be higher if you prescribe brand name drugs versus generic. Seems to me that,at least for my dentist, it takes him the same 5 seconds to write outa generic as it does a brand name. :wtf: :shrug:

[Mika]

82. Thank you, Rabrrrrrr

Thanks for the vote of support.

Let me just inform you that there are many cheap and bad dental labs out there, especially in Miami. There are also a few very good ones.

Lab prices vary from $19 for an Chinese offshore made crown to over $350 for a state of the art zircon based all ceramic crown.

I do much of my own lab work, and I use a state of the art small lab, I pay a high price for their great work work. Each practice supporting the other based on fair play and fair pay.

Most people have a pretty low dental IQ and or don't care how their work looks or feels, nor care who makes it or where its made.

But some do care.

That's where DDS's like me come in.....

[Darth_Kitten]

78. Bill them.......

pardon my intrusion, but what bastards. Bill em!!! :mad: :nuke:

[bhunt70]

85. I think posting a 24 hour sign is appropriate. I've read your reasons

why you don't want to but truthfully think of it like this.

Most of the people will never have to pay a cancellation fee. They will either cancel within the allotted time, or not cancel. The people that do cancel within that window of time are putting you at a disadvantage for your service which directly impacts you AND your other customers.

Think about this, customer A has a 10 o'clock appointment, customer B wants to come in for a 10'oclock appointment on the same day but you cannot accommodate them because of customer A. Perhaps this is customer B's only available time for a week and so they will either have to reschedule while the problem gets worse or they push back another appointment.

Meanwhile Customer A decides to stay out too late etc and wakes up late, misses the appointment, and leaves your chair empty for that hour.

Well Customer A has just affected Customer B directly. With 24 hour cancellation you could have contacted customer B in time for them to be available and had your chair full for that time. Customer A has affected both you and possibly (most likely) other customers.

With the sign requiring 24 hour cancellation (or even one free cancellation but the next time they get charged a fee if it's not 24 hours before) you help lessen the damage that customer A has done.

Truthfully I think it is very considerate to those who never abuse the policy.

[Mika]

87. Thank you for the solid advice

I wish all patients were like you and most others on this thread.

Believe me, I fully understand the implications of their cretinous behavior. My staff and I tried our best to convince them to come in and to get patients in at the last minute, to no avail.

Even charging them $100 doesn't cover jack-sh*t in overhead. It only alienates reticent patients, whereas the goal is to get them to come in for needed treatment. Its a double edged sword. Penalty fees seem reasonable to reasonable people, but, to the unreasonable or unreasonably scared.....