Medicine and Dentistry Are Different When Insurance is Involved

There is a great article on CNN.Com about  how Insurance treats Medicine and how it treats Dentistry. You can read it for yourself here:

https://www.cnn.com/2018/05/28/health/dental-insurance-partner/index.html

Some Background:

In 1961, dental insurance came in existence and the limit was ONE THOUSAND DOLLARS. But....in 1961 $1,000 bought 8.3 crowns which was a heck of a lot of dentistry. By the time I became a dentist in 1977 the limit was still $1,000 but it only covered THREE CROWNS. Also when I began practicing dentistry in my first office at Tamarac Plaza in Cropseyville, NY, some of the insurance companies paid 92% of our fee.

Today, the limit is STILL $1,000 for the majority of insurance policies and $1,500 for the better policies.

How can YOU relate to this? It is like NOT HAVING A RAISE FOR 57 YEARS that you worked for the same company. Because people don't know and don't care, they blame the dentist for charging too much. THIS IS ABSOLUTELY NOT TRUE unless you are looking at full mouth rehabilitation which is extremely expensive and takes lots of skill, talent and education for the dentist and tens of hours for the patient.

An example: If you have a knee replacement (an implant) , the total cost is ~$65,000 and your insurance probably pays ~$60,000. If you have a dental implant the cost for the entire treatment is about $6,000 and your insurance usually pays little to nothing. Why?

YOUR employer is cheap and refuses to pay more for dental insurance.

My average long time patient can go 10 years without having me fix a tooth. Their out of pocket payment for two cleanings some bite wing x-rays and an exam is probably ~$500 a year with no insurance and $150 a year with insurance.

I Was Pleasantly Surprised

I am on several Dental Facebook forums which are limited to dentists. I was stunned to open Facebook this morning and see:

I consider Gerald Benjamin one of my mentors even though I have never met him in person. Over the course of our interactions (some very heated) he challenged me to become a better dentist through high quality CE in a google group. While the transition from a PPO practice to an out of network practice focusing on high quality dentistry doesn’t happen overnight it can be a fairly fast transition due to the financial strains placed on quality dentists operating in the PPO environment. 

Here is a direct example of how high quality CE can reduce the total amount of dentistry that is needed in your patient population. Had I been contracted with insurance companies with this pattern of practice I would have gone out of business due to the low reimbursement rates. 

From July 1, 2016- April 30, 2017 I placed over 120 single unit crowns. From July 1,2017- April 30,2018 I placed less than 25 single unit crowns. I have seen the total amount of Crowns+root canal therapy needed in my practice drop by 75%. 

What was the difference? Understanding the fundamentals of dentin bonding which is the cornerstone of restorative dentistry.

What’s the point of this post? To understand the financial constraints of dental insurance will drive your treatment decisions whether you realize it or not. Human behavior is driven by ‘systems’. If the ‘system’ in which you operate doesn’t lend itself to high quality dentistry then CHANGE the system in which you operate.

I am honored to have changed Matthew Gillespie's life when I asked him to see his (dental) world differently.

Real World Cases with Rave Reviews

First and foremost, I a clinical dentist charged with taking care of my patients. Many times a  year, I will post my work on a few dental forums for several reasons:
1. To show other dentists the excellent clinical dentistry can be done in a private office setting (as opposed to a University based practice.)
2. To remain relevant in the profession so that I am considered a serious clinician.
3. To encourage other dentists to pursue excellence.
This is a case that I completed 2 years ago. This is the 'Before' photo as the patient presented to our office for Cosmetic Dentistry. The problems:
1. A gummy smile
2. Small teeth
3. Unattractive porcelain

This is the completed case. The gum tissue is perfectly healthy and the teeth are the correct size.

So what does one of the finest periodontist/orthodontist in the world say about my work?

"Well planned and well executed. Real world Cosmetic Dentistry performed at the highest levels....thanks for sharing my friend. regards Maurice "

Inspiring Others

I am on several FACEBOOK dental sites that are only open to dentists. We discuss, we argue, we educate and we learn. And as you know, I have been on internet dental forums for 20 years. My position is to ALWAYS advocate for EXCELLENCE. I have 7,000 hours of high level Continuing Education so that I can provide the best dentistry that I can for you, my patients. I want other dentists, especially young dentists, to do the same thing for their patients. Sadly, many dentists have very little PASSION for dentistry but that does not prevent me from trying to make their lives better.

This is what a young dentist wrote on one of the dentist only FACEBOOK GROUPS:

"Chris Young Gerald Benjamin I love your confidence. If even half of dentists thought like you then people would start to treat dentists with more respect and dentists would do better work. I hope to be like you one day, FFS (Fee for Service) and doing excellent dentistry that I’m proud to show my colleges and charge an appropriate fee for the amazing service I provide. I love your passion for dentistry! Most days I forget how much we change lives but today I had a patient come back to me and I let her come back and all she did was thank me. I’m not gonna lie, for a relatively new dentist it felt good and I want to feel this way all the time."

I responded to the post by saying, "I am honored by your comments."

Every dentist should strive for excellence. Every dentist should love what we do. And every dentist should learn to always put their patient's best interest above their own.

I know that I am asking a lot but I believe every word of it.

I Am Always Amazed

I have been fired by thousands if not tens of thousands of patients over the last 40 years. The vast majority of people leave our practice because I don't participate with their insurance.Similarly, the vast majority will leave our practice recognizing that we pursue excellence.

Someone messaged me on Facebook yesterday after I consulted with his daughter about a dental issue that she was having. Prior to the consult, I was not aware that she is a physician.

54AM

Thanks for helping our daughter yesterday. She mention that you may not remember us. Chris and I were one of your first patients when you started in Tamarac. I still have the original bridge you did for me in 1983 I think. Anyway thanks for fixing Erins issue, I told her you are the best.

Hi M,

Yes I remember you. I hope that I helped your daughter

Yes...in her words you were awesome. You practice medicine the same way that she does. Thanks again.

These people have not been my patient for more than 30 years but what they remember is that they considered me 'the best.'

If they STILL think that I am the best and that my work has lasted THIRTY FIVE YEARS, don't you wonder why they are no longer my patient?

In the last year a young lady came to my office with a dental problem and she told me that her grandfather who was still alive told her that the best dentist that he had ever been to was Dr. Benjamin...

I have never understood this......................