lack of trust in medical/dental profession

[Bdoc]

So this is stemming from my recent visit to the dentist and my reading the many discussions here about dental xrays and possible un-needed procedures. i would first like to say this is not a dig against only dentists as I trust my fellow MDs just as much.

First i will talk about my fellow MDs. Orthos have been the big culprit for myself and my friends. I know multiple experiences where myself and other people have gone to orthos with MRI results already done of either a shoulder or back for chronic pain and without even seeing the doctor, the office demands an xray. This is a complete money grab that even my non MD friends can identify and im honestly appalled. (one payed 300$ out of pocket for it bc he doesnt have insurance).

Now, onto my recent experience at the dentist. I am not the most compliant dental patient but have never had a cavity or any surgery. They did xrays and found an asymptomatic cavity(great! Fix it before it becomes a problem) Now here is where i become skeptical. The hygenist recommends a "deep clean" that is conveniently not covered by my insurance and costs 1800$ out of pocket. My initial reaction was wow, my teeth are disgusting and i should definitely do it, but then i thought about it. Medicine/dentistry is now a business. $$ trumps everything and they might be possibly trying to gouge me. That realization really bothered me and which is why im posting here. I truly did not trust her recommendation. Does anyone else feel this way?


Also, they are doing a laser clean next week. I have never heard of it but maybe thats the new standard and i dont go to the dentist enough to know.

[MPMD]

The hygenist recommends a "deep clean" that is conveniently not covered by my insurance and costs 1800$ out of pocket.

"it's a 'no' for me dog."
-Frank Reynolds, It's always sunny in philadelphia

[MaxPower]

Is the “deep clean” for periodontal disease? Hard to say if it’s a rip off without knowing the exact diagnosis and treatment plan.

[Lithium]

I’ve made peace with the dentistry experience by getting my care at the local dental school. It can take considerably more time, but I’ve never felt like they’ve spotted phantom cavities or pushed procedures I don’t need. The prices are pretty affordable.

[G]

wait, people still pay for dental insurance?

[jz-]

Beyond the $1800 laser and deep clean, the issue is trust. My non-MD friends are smart, definitely skeptical and question the profit angle.

[wideopenspaces]

I have the best dentist, I go every 6 months. He has never offered us anything besides regular cleanings. I will be SO SAD when he retires.

[Lordosis]

So this is stemming from my recent visit to the dentist and my reading the many discussions here about dental xrays and possible un-needed procedures. i would first like to say this is not a dig against only dentists as I trust my fellow MDs just as much.

First i will talk about my fellow MDs. Orthos have been the big culprit for myself and my friends. I know multiple experiences where myself and other people have gone to orthos with MRI results already done of either a shoulder or back for chronic pain and without even seeing the doctor, the office demands an xray. This is a complete money grab that even my non MD friends can identify and im honestly appalled. (one payed 300$ out of pocket for it bc he doesnt have insurance).

Now, onto my recent experience at the dentist. I am not the most compliant dental patient but have never had a cavity or any surgery. They did xrays and found an asymptomatic cavity(great! Fix it before it becomes a problem) Now here is where i become skeptical. The hygenist recommends a "deep clean" that is conveniently not covered by my insurance and costs 1800$ out of pocket. My initial reaction was wow, my teeth are disgusting and i should definitely do it, but then i thought about it. Medicine/dentistry is now a business. $$ trumps everything and they might be possibly trying to gouge me. That realization really bothered me and which is why im posting here. I truly did not trust her recommendation. Does anyone else feel this way?


Also, they are doing a laser clean next week. I have never heard of it but maybe thats the new standard and i dont go to the dentist enough to know.

They must go quite deep in order for it to cost that much :O

[burritos]

Is this healthcare or sick care?

[BruinBones]

At my Orthopedic office, the patient was always given the option to decline new XR if they are coming in with new MRI and wanted to discuss with me first whether XR was needed.
XR is still the superior screening study for serious musculoskeletal conditions for new patients. When I taught med students and interns, I always emphasized that nearly every orthopedic diagnosis was elucidated prior to the advent of MRI, so as primary care providers, I encouraged them to resist the urge, or think twice, about ordering MRIs on routine musculoskeletal care.
I do support the patient’s right to decline diagnostic study or treatment if that decision is well-informed. I think the problem is when patient does not know, or doesn’t understand, why something is being ordered for them. It is incumbent upon us, as the lead doctor/dentist, in trying to get them to understand the decision/risk/benefit for ordering.
(I don’t think it is all profit-driven).

[chucki]

Any places that can self-refer have natural conflicts of interest, simple as that.

[VagabondMD]

At my Orthopedic office, the patient was always given the option to decline new XR if they are coming in with new MRI and wanted to discuss with me first whether XR was needed.
XR is still the superior screening study for serious musculoskeletal conditions for new patients. When I taught med students and interns, I always emphasized that nearly every orthopedic diagnosis was elucidated prior to the advent of MRI, so as primary care providers, I encouraged them to resist the urge, or think twice, about ordering MRIs on routine musculoskeletal care.
I do support the patient’s right to decline diagnostic study or treatment if that decision is well-informed. I think the problem is when patient does not know, or doesn’t understand, why something is being ordered for them. It is incumbent upon us, as the lead doctor/dentist, in trying to get them to understand the decision/risk/benefit for ordering.
(I don’t think it is all profit-driven).

Coming from one who now works in UR for a health insurance company, an x-ray is required prior to advanced imaging with MRI for many conditions, including quite a few where it seems like it may have little bearing on the diagnosis and treatment.

[Zaphod]

There is unfortunately a certain amount of this in all practices and certainly some are more aggressive than others. The incentives can even grow insidiously over time. Radiation centers, imaging, etc..etc...not hard to find bad examples unfortunately.

Partner was just complaining about his ortho buddy giving him an xray before a steroid shot, no idea of prior studies. Im always complaining about Moh's as I think its vastly overused, but not always due to pay, often things are overused because you think you're doing good or its simply what you know.

[pierre]

Don’t forget about the pharmaceutical industry. Apparently generics are not as good as name brand and the FDA oversight seems pretty worthless.

https://podcasts.apple.com/us/podcast/low-carb-md-podcast/id1441557261?i=1000516723430

We do a lot of great things in mainstream medicine. Figuring out how to treat, much less prevent, chronic disease is not one of them.

[NumberWhizMD]

The majority of my life, my uncle was my dentist. There was never any significant work, and I trusted him implicitly.

Now that I don't live close to home, it's been hit or miss with dentists. We had a great one before moving. I do have a hard time trusting some dentists, as it seems like I go from having "great teeth" to needing a ton of work in 6 months despite no changes in lifestyle or brushing/flossing habits. Maybe I trust less because I mostly have to pay cash for the work that is recommended.