Dentists and the reimbursement boom

. . . dental fees have risen much faster than inflation. In real dollars, the cost of the average dental procedure rose 25 percent from 1996 to 2004. The average American adult patient now spends roughly $600 annually on dental care, with insurance picking up about half the tab.
Dentists’ incomes have grown faster than that of the typical American and the incomes of medical doctors. Formerly poor relations to physicians, American dentists in general practice made an average salary of $185,000 in 2004, the most recent data available. That figure is similar to what non-specialist doctors make, but dentists work far fewer hours. Dental surgeons and orthodontists average more than $300,000 annually.

Comments

Anonymous
I hate doctors, but actually like dentists. As someone with really bad teeth, I’ve at the dentists alot. Over the last decade, there has been tremendous improvement in materials and methods. Dentistry hardly ever hurts anymore. Newer materials have eliminated certain problems. Indeed, in doing research on various procedures I’ve had, it seems as if dentistry is far more evidenced based.
Medicine, in which consumers are NOT in control has lagged, I think–certainly in customer service.
Put consumers in charge and good things will happen.
Anonymous
I’m glad you feel that balance billing by your dentist for procedure costs which have outpaced inflation, and the fact that you can’t get a hold of one after hours or on weekends fits your bill.
I’m all for consumer service if the consumer pays handsomely for it.
Let Hillary know you want Doctors to be compensated and live the same lifestyle as your beloved dentists.
Anonymous
The good days for dentists are coming to an end.
hillarycare is going to force dentists to work with the govt, because like doctors they will ahve no choice once the govt starts offering “free” dental insurance coverage thru the next healthcare plan.
The dentists will have no choice but to become govt whores like doctors because a huge chunk of hte population will opt for the “universal dental coverage” by the govt. A few dentists will be able to escape it by working in swank areas with cosmetics, but the vast majority will have no choice but to become govt slaves because it will be the govt who has captured 99% of the patients.
Anonymous
Hey, this article just has to be wrong since all the non-physicians who comment here insist that docs are the highest paid profession in the US.
Anonymous
Non-dental surgeons average $250,000 a year. Sounds like surgery is where the money is.
Anonymous
Covering my Medicaid patients, and when on-call covering other primary care docs who in turn are at community health clinics, I find a substantial amount of my time is dealing with dental pain from patients who can’t get into a dentist in a timely manner.
Once, I had a patient with dental pain, who was in the middle of dental treatment at the Medicaid dental clinic. Asked her why she wasn’t calling her dentist, she said she did, and no one was covering. I took her numbers and called the number for dental on-call emergencies from her Medicaid care. She was right. The operator, tapping on the screens, found a blank screen when she tried to identify the on-call dentist. Further inquiries into the system, there had never been an on-call dentist in the Medicaid system.
Of course, they were getting the PAY to be on-call. And the services the physicians provided to do the dentist’s work, including the ER visits and all that…….it came out of budgets for medical care, while the dental budgets sat nice and fat. The dentists never got called, so no hits to their budget.
Anonymous
THis is quite the hit piece. I think we should stand up for our dental brothers and sisters because it was only about a month ago that the hit piece was on physicians in the article sending the bill back or whatever it was called. When they conveniently leave out and distort facts about dentistry like this article it makes me queasy. They are trying to ruin another field by bringing it under control of the US government.
Happyman
comparing doctors to dentists is absurd.
There are relatively few dental “emergencies”, insurance is almost a non-issue, and much of the care can be considered optional. That’s why so many (even middle- and upper-middle-class folks) opt to not pay for dental insurance.
When one is sick, generally you’re not seeking a podiatrist, dentist, chiropractor, or anyone else who’s licensed to only practice on 5% of the human body. These groups also have FAR LESS liability than physicians.
The fact that dentists make as much as they do (especially in NY where they notoriously rip off medicaid) is just a crime.
One sure sign that there are so many dental & podiatric crooks ripping off medicaid: in NYC’s poorest of neighborhoods there is still a dentist & podiatrist on almost every other block.
For those who expect doctors to “serve the consumer” or “put consumers in charge” feel free to self-diagnose & order your meds online, or tell an NP at a minute-clinic to give you what you want. Just don’t go to a legitimate facility when that doesn’t work.
Anonymous
Oh gawd, don’t get me started about how the medical system has been subsidizing dentists since the dawn fo time.
As an otolaryngologist I’ve spent over 25 years covering dentists’ asses.
-Neck infection after an extraction? Go the ER. See an ENT.
-”My dentist told me this was MEDICAL issue.”
-Subcutaneous emphysema from forcing pressurized air under the gums into the neck? Go the ER. See an ENT.
-Pain after a dental procedure? After 5PM or on a weekend? Go the the ER.
-Fever after a dental procedure? After 5PM or on a weekend? Go to the ER.
I would love to able to ditch my patients like this and get away with it. Sleep in. Have ALL my weekends free. No beeper. Laugh all the way to the golf course.
Attention all bitter, self-righteous lefties: you’re screaming about the wrong profession!
Anonymous
No surprises here. Insurance coverage for dental services is extremely limited and dentists can charge free market prices. Contrary to popular perception, free market fees for medical services would be much higher than Medicare or insurance allowables in most cases. Considering the “copay” may be 50% of a physician’s reimbursement for an office visit, being contracted for anything but catastrophic coverage is a losing proposition for doctors and patients alike.
Anonymous
With all due respect Happyman, your contention that there are relatively few dental emergencies is ill founded.
It depends on what you call “dental.” As an otolaryngologist, I bear the brunt of managing dental complications. Almost all deep neck infections in adults are dental origin. All Ludwig’s Angina cases are dental in origin. t
The majority of facial cellulitis/abscesses are dental in origin. Guess who gets called in to take care of them?
I just love being scut boy for the dentists.
The rest of your post is spot on.
Anonymous
Attention hypocrisy central: OK ENTs, if you are so whiny about being called in to mouth issues that dentists can’t handle, why don’t you support eliminating ALL restrictions on the services/procedures dentists can perform, i.e., LET them do surgery and let them have full prescribing authority in all states.
UGH–how can you horrid, dirty guild monopolist criminals live with your greedy little selves.
Anonymous
The supply-restriction, anti-Flexner, guild monopolist arguments are growing tiresome. Largely because they are made in the context of a “special privilege” reserved for the “provider class” which is treated differently from any other profession.
Hogwash.
To get a license to sell insurance in California, for example, you must be sponsored for the exam by someone else who is already licesnsed.
Many labor unions restrict supply by using draconian measures to limit membership, and making membership requirements extremely onerous. e.g. Iron Workers, or Screen Actors Guild (At least they admit they are a guild).
Stage hands want to impose a certain number of workers per performance, regardless of the actual need. Interesting. I suppose they let too many people into the union, and now they have to find a way to get them all paid, outside of free market forces.
Anonymous
“Guess who gets called in to take care of them?
I just love being scut boy for the dentists.”
Actually where I work ENT does NO ADMISSIONS. They are all admitted to the hospitalist service with an ENT c/s (if appropriate). In reality the hospitalist is just as much of a scut boy, if not more. That stated, it is amazing that dentist’s can get away with washing their hands of their screwups and bad outcomes. One of the nice thing with medical surgical specialties is the conviction (among most anyways), that if “I operated on it then any complications are my problem”. I am not saying the dentist’s should be doing ENT procedures, but they should have the decency of taking ER call FOR THEIR PATIENTS and evaluating their handiwork when something goes wrong. Anon 9:40 also amazes me because when something goes wrong emrgently, it will be an MD fixing it not his beloved DDS.
Anonymous
Anon 8:41:
It’s your pill time.
Where is the public support for Lew Rockwell-inspired social change? Anyone? Bueller?
Anonymous
9:56- I think I’ll come work at YOUR hospital.
And Criminallopath (under whatever anonymous guise you choose today). What a collosal bore. Everything is about the evil Flexner, monopolistic stanglehold greedy whiny doctors have. Do you know any other tumes?
There are NO restrictions on dentists to come into hospitals to do their procedures. They pose no competition to me because I don’t DO any of the stuff they do. So your argument has no foundation. Furthermore there are oral surgeons running around doing lots of soft tissue facial surgery and even purporting to be able to do neck dissections BUT they never seem to be available to take care of the dental etiology head and neck infections which fall to people like me or the hospitalists. Oh, and these are FULLY privileged attendings at the hospital. So rest assured they are driving more nails into the coffin of the Flexnerites.
Does that clarify things? If not, I can repeat it using smaller words.
Happyman
anon 10:46 –
my apologies. I guess the more correct thing to say, rather than that there are few dental emergencies, is that there is rarely an emergency that requires a dentist.
kudos to the ENTs, who have a GREAT DEAL more responsibility, training, and emergencies (e.g. airways???) than some guy tweaking braces in a suburban office-spa for $500,000/year.
Anonymous
You’d think they could at least take care of their own antibiotic and analgesic orders.
I was impressed with how much Medicaid ER revenue in our Medicaid mangled care plan went to dental pain.
Anonymous
Anon 11:08
This is my first post on this topic. I have been watching the mayhem unfold and suspected that one of the pompous self-important allopaths or their worshipers would invoke my name. Perhaps you should choke back a bit of that self-important bile prior to engaging in your tirade(s) and perhaps ask the simple question as to the identity of the poster(s) in question prior to the a priori ascribing of the post(s) in question to me.
I know. It would deviate from the mindset that believes in the junk science that has given us “clinical causation (aka litigant told me a story and thus it must be the “mechanism of injury”) but you could at least try.
~Criminallopath~
Anonymous
Remember your rant when you need a dentist after hours or the weekend. You will be seeing on of those hated MD’s instead.

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