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Letters: Disappointment in direction

May 12, 2017 I'm writing in response to Dr. James Lynn Davis' letter on overtreatment in the April 17 ADA News. For many years, dentists were counted among the most honored and admired professionals. Our patients were treated with respect; we dealt with their needs, and we were available to them at a moment's notice. We placed a high value on the doctor-patient relationship and we were well compensated for treating and diagnosing disease. Often we had the privilege of treating multiple generations of a single family.

Unfortunately, the attitudes of some dentists towards their patients are changing radically, and rapidly. Sadly there are many excuses as to why things have changed. "The graduates are buried in debt, corporate dentistry is taking over, etc., etc."  In my view, there is no valid excuse to justify any of the following situations.

One dreadful trend includes offices that have daily sales quotas in place for dentists and hygienists. Since when did selling and quotas become the new norm in dentistry?  We are not selling used cars; we are ministering to the health needs of the public. We should be better than that. Our patients deserve the best care we can deliver based upon their needs; they are not ATMs.

When a 14-year-old comes to our office for a second opinion with a treatment plan for eight restorations, with only one carious lesion, I am disturbed. We should be better than that. Our patients deserve better.

How do we defend our profession when a patient is told she needs four quadrants of scaling and root planing, and she has no bleeding on probing and no pocketing? Tailoring treatment plans based upon insurance coverage, to increase reimbursement is becoming a pervasive trend. When did a routine, thorough prophylaxis become a "deep" or "periodontal" cleaning that you charge more for? We should be better than that. Our patients deserve better.

Clearly not every crown needs a core buildup. It is especially suspicious when the treatment plan is to replace crowns. No one can see the tooth structure underneath the crown to know that a buildup is needed. I am disturbed. We should be better than that. Our patients deserve better.

When patients with HMO insurance go to an office that had contracted to do resins at no or a very low fee and the dentist tells the patient that he needs to place a special liner under the resin for $195, which is not covered by insurance, this is just wrong. We should be better than that. Our patients deserve better. If you are not getting a fair fee for a procedure, stop taking that insurance, don't take it out on the patient by committing fraud.  

When I mention going in on a Saturday to see a patient in pain, to a colleague and he asks, "Why did you go in, was it a close friend?" I answered, "No, it was a human being in pain who needed help." I am disturbed by the question, and I worry where the profession is heading.

When a former patient who has moved away calls to ask why her new dentist wants to replace all of her crowns for the sole reason that they are 5 years old, I am disturbed. We should be better than that. Our patients deserve better.

Yes, dentistry is not easy. There are difficult patients, cases that don't go well, even in the most skilled hands, and staff challenges and events that you cannot control. However, if you treat people fairly, you will love dentistry, you will be gratified, you will be appreciated by loyal patients, and dentistry will be good to you in return.

Lee M. Friedel, D.D.S.
Weston, Florida