Oral surgeons only on staff, and they share call with the ENTs and plastic surgeons for major trauma only. All hospitals have policies regarding conscious sedation, etc, and many dentisits do not do IVs and the like. The pediatric oral surgeon must be an angel from God, since he brings his own equipment to same-day surgery and does all the Medicaid kids. Adults have to go to the office for most things, since the equipment is all there. Start-up costs for a dental clinic with 2 dentists-$500,000 easy, as I was the medical director for our clinic and the government pressured us constantly to start one. And, they are huge money-losers. The dental clinic at the Anchorage Neighborhood Health Center had been known to lose $200,000 per year. The clinic where I used to work finally set up a dental clinic. There is a full-time clinic, a mobile clinic, and a part-time clinic. There are several dental hygenists. They have been teaching the physicians how to apply the flouride protection. Once again, they started hemorrhaging money. They had to change their policy ; they accept everyone, but self-pay patients, who qualify for a discount, have to have half the money up front. This sounds cruel, but I know of many cases where people would get their dental work, agree to make payments, and then not pay a red cent. (Sorry if this is not "PC"). In one glaring example, a patient I referred myself with a real sob story and her husband received $12,000 of work, including dentures (probably $24,000 in real price) and would not pay ANYTHING. Lest anyone think this is unusual- in any clinic that serves the underserved, you're lucky if you get 20% of your accounts receivable. I wish it wasn't so, but it is. The problem is even worse in the dental clinics.
I'm not justifying anything. I am upset over the treatment that Ross has gotten, etc. Since many people are out for only themselves, the problem will only get worse if folks don't start working together. A few bad apples have spoiled the whole bunch for the rest of us. The health care system worked for the country the way it used to exist; medicine was a higher calling, etc.
These bad apples- including those of my peers ripping off the system, people who sue at the drop of a hat, those who feel "entitled" and feel they should have access to the best of the best at all times, and those who "work" the system-have caused medical costs to escalate beyond belief. No one even wants to go to medical school any more, and I don't blame them. I used to really love my job. I mean, how great was it that people entrusted me with their health? I was given the gift of healing and the intellect to pursue it by God, and I felt humbled and privileged to share it. Now, I spend half my time on the horn with patients complaining about the bill or their meds, or with insurance companies, Medicare/Medicaid, or buried under a stack of paperwork. I order too many tests for CYA reasons. I have good clinical accumen and skills, but that would never stand up in court. And I graduated from medical school in 1989 and I am STILL paying off my debt, probably close to $400,000 by the time I finish, since I can't pay more than $2000/month toward the loans and I can't write any of it off.
The system is broken, and no one tells us how to fix it. I don't know myself. If we go to universal health care, how will I ever pay back my loans? I might as well smear dirt on my face and hang out in the street and beg, along with my family.
OK, done with the tirade.
Wound up in Idaho,
-Laura
