After visiting the dentist a few weeks ago and for some reason not getting berated for doing something wrong (I credit my electric tooth brush) I wondered why exactly do people who take excellent care of their teeth have to visit the dentist on the same schedule as those who do not? My first thought is that they do not have to, but also that the way in which a dentist receives payment incentivizes more checkups rather than less.
Why are insurers not incentivizing less care? Why wouldn’t an insurer pay dentists to see their customers less? I’m sure there is a scheme out there in which the insurer shells out less money for costs (billable hours and equipment cost), the dentist still gets paid a sizable amount of what he was billing the insurer for (probably his fee and not equipment or hygienist costs) and there might even be a small amount left over for a “Good Teeth” dividend for the patient in order to encourage good dental hygiene I’m sure the insurers could easily identify likely candidates by finding those in their database who have gone a reasonable amount of time without anything more than a normal cleaning (no cavities, special work and the like). They could then set parameters for when to check in on those patients and reevaluate their status around key ages where work is generally done (see age).
The end result is more money for the insurer, similar profit margins for the dentist (probably more, even much more at the expense of bad dentists, because the fewer bookings lead to space to pursue new business) and a rebate for those of us who take care of our teeth. I think the new business aspect for successful dentists is the real gain here. For example, my dentist is consistently rated #1 in the Somerville/Cambridge area but as a result if I ever have to reschedule the options are very very limited. I would assume those scheduling limitations hurt the business, and growth will eventually plateau short of taking on a partner or opening a second location (alternatively the dentist could push the boundaries by charging more for his time but I don’t know how that works with insurance to really speak on it). If the scheme I outlined here were to be implemented, a highly regarded dentist could increase his client book without doing anything other than a good job. This would not only be great for great for dentist but also the consumer, it makes desirable dentists more accessible as well as affordable.