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Letters: DR, fees

April 23, 2012

I have been in a small group private practice now for almost 13 years and consider myself to be an average dentist. Over the years I have maintained my national and local ADA membership and had moderate involvement volunteering for both. During that time, there are two things that have perplexed me, but I have yet to receive a satisfactory answer for either. So, at the risk of seeming naïve, I am curious if the readers of ADA News could enlighten me.

1. Why isn’t promoting direct reimbursement a primary focus of the ADA? It seems to me that if DR was the norm rather than the exception, it would be beneficial for both patients and dental providers, allowing patients and dentists to focus on the care of their choice without all the distractions of fighting the insurance companies. From what I understand, the net cost to employers remains about the same.

2. Why all the secrecy about dental fees? Doesn’t it make more sense to be able to post your fees on your website so that patients can make an informed choice? Even better, why don’t we charge an hourly fee plus material costs like other professionals? That way, patients can make a more transparent decision on which kind of office will suit them best.

Blair Waldron, D.M.D.
Marietta, Ga.

Editor’s note:Some states regulate advertising of fees and discounts in connection with dental services, for example by requiring certain disclosures. Truthful and nondeceptive advertising of fees is permissible under the ADA Principles of Ethics and Code of Professional Conduct. For more about advertising, the ADA offers Advertising Basics for Dentists: A Guide to Federal and State Rules and Standards (a members-only resource) on

With regard to direct reimbursement, the ADA started promoting DR in 1986 and in 1996 began allocating funds to see how successful DR could be in the dental benefits marketplace through an advertising campaign targeted at specific employer groups. However, the number of insurance professionals selling and administering DR plans paled in comparison to the thousands of licensed agents working for the dental benefits industry.

When return on investment (number of DR plans implemented) was compared to the dollars spent on the campaign, the ADA decided to continue ideological support for direct reimbursement but discontinue funding the campaign. Today, the ADA promotes the use of direct reimbursement plans to employers and brokers through the ADA website and staff is available to answer questions for these groups. The ADA is aware of more than 4,200 DR plans that have been implemented covering more than 1.4 million lives (employees plus dependents).