Dear Young Doctor: Patient-Centered Dentistry

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Dear Doctor, 

After 27 years of seeing Dr. Dorris, upon his retirement I had my first visit to you yesterday for a dental cleaning and exam.

During my cleanings and exams, he played my favorite music from his extensive collection of CDs, as he’d asked his patients to tell him their favorites.  He would put a pair of sunglasses on me to shield my eyes from the bright light and from any water sprayed there accidentally.  He’d spread some numbing stuff on my gums, of a flavor of my choice, to prevent any pain. He’d placed a variety of cartoons and beautiful posters on the ceiling. 

Remarkably, he did the cleanings himself.  Beginning by talking about dental hygiene, he would riff about his philosophy of a healthy life.  The visit would end by having me choose from various kinds of dental floss and toothbrushes, and he’d hand me a home-made page or two with some advice on dental self-care and life.

His new dental hygienist commented yesterday that in my 58-year-old body, I have the teeth of a 20-something.  That’s the evidence of his skill and our partnership.

You installed new technology for cleaning my teeth.  Perhaps my teeth are cleaner; I have no way to tell, though I do know the high-pitched sound as the water jet hit my gums was irksome, it felt endless, and my shirt and my face were wetter at the end.  That said, my teeth felt clean, and I don’t begrudge paying for the cleaning.  But what hurt the most was my shock at your $100 bill for the 30-second exam you gave me after the cleaning.

With those fees, you may make more money than Dr. Dorris.  But I doubt you’ll have patients who drive 40 minutes each way for 27 years for that kind of service.

As is true for most healthcare, your prices are simply way too high. 

Read another story about patient-centered dental care. 

An MRI, or a fleet of cars: High healthcare prices

Of the cars I've owned over the years, my favorite was my homely first car, a pale yellow 1976 Ford Maverick with a lime green interior, which I bought, very used, from a good friend, after it had run 113,000 miles. The purchase price in 1985: $325. The car wasn't pretty, but it was rugged, and served me well.

My mother recently had an MRI in an Atlanta hospital as an outpatient. Thankfully, the MRI helped to rule out a serious condition, and she promptly got back to 100% health after a course of antibiotics. The hospital billed her Medicare plan $3,200 for the 10-minute test! The price tag was so high that I struggled to find an appropriate yardstick: it was enough to buy a fleet of ten Ford Mavericks.

When prices are that high, something has to give; not everyone will have insurance that covers such tests, and some will go without care, usually people who lack excellent insurance.