2 answers
Neomi
Student
Nashville, Tennessee
1
Question
Asked
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How do dentists balance providing essential care and necessary treatments while considering patients' financial limitations?
As an aspiring dentist, I have shadowed dental practitioners in their practices and observed firsthand how they navigate treatment plan discussions with patients. One challenge that stands out is the financial tension that often arises.
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2 answers
Steven Bornfeld
Owner, Mark and Steven Bornfeld DDS
51
Answers
New York, New York
Updated
Steven’s Answer
By "financial tension", do you mean stress to the patient, or potential conflicts of interest between choices in developing a treatment plan and financial remuneration for the dentist?
I cannot remember seeing anyone ask this question on this board before. That is understandable, because the people asking questions here are students concerned about BECOMING a dentist. That you ask it shows that you are thinking seriously about decision-making that dentists have to consider every day of their working clinical lives.
The answer sounds very simple--you do what is best for the patient. But it is not simple at all. The dentist will naturally think this is what would clinically lead to the best result. This is often one of the more expensive treatment plans.
Replacement of teeth is a prime example. When I became a dentist in 1976, that generally meant deciding between a fixed bridge or a removable appliance. Implants were not on the radar. Because implants were not in general use, that meant a decision between a removable bridge (partial denture) and a fixed bridge, which was generally more expensive. There were specific situations in which one or the other was obviously called for; in others either might be appropriate. NOT replacing lost teeth of course was an option too, though in most circumstances dentists did not consider this acceptable. Now implants are often the first thing dentists will think about.
Of course replacing teeth will not be the only consideration for the patient. They may have a child about to enter college; they may need a down payment for a home; they may have other serious health problems that need to be addressed first.
The point is that when you have a new patient sitting in your chair, they have concerns other than what you as a dentist think is the best way to replace an upper first molar. You have an obligation to discuss all the ways their dental issues can be addressed. You may think one way is better than the other. The patient has other concerns. So after you discuss ALL the options, you need to have a full and open discussion about how the patient feels. The patient may have ideas that you find totally unacceptable. This is fine--no patient can tell you to perform treatment that you feel is unacceptable, just as the patient is free to reject any treatment plan to which THEY disagree.
The unspoken part is whether that big juicy treatment plan that will mean tens of thousands of dollars to your production will influence what you present to the patient as the "best" treatment. That is on you--to think of the patient as a complete person, and to think how you would like to be treated were you in that dental chair.
Good luck to you!
I cannot remember seeing anyone ask this question on this board before. That is understandable, because the people asking questions here are students concerned about BECOMING a dentist. That you ask it shows that you are thinking seriously about decision-making that dentists have to consider every day of their working clinical lives.
The answer sounds very simple--you do what is best for the patient. But it is not simple at all. The dentist will naturally think this is what would clinically lead to the best result. This is often one of the more expensive treatment plans.
Replacement of teeth is a prime example. When I became a dentist in 1976, that generally meant deciding between a fixed bridge or a removable appliance. Implants were not on the radar. Because implants were not in general use, that meant a decision between a removable bridge (partial denture) and a fixed bridge, which was generally more expensive. There were specific situations in which one or the other was obviously called for; in others either might be appropriate. NOT replacing lost teeth of course was an option too, though in most circumstances dentists did not consider this acceptable. Now implants are often the first thing dentists will think about.
Of course replacing teeth will not be the only consideration for the patient. They may have a child about to enter college; they may need a down payment for a home; they may have other serious health problems that need to be addressed first.
The point is that when you have a new patient sitting in your chair, they have concerns other than what you as a dentist think is the best way to replace an upper first molar. You have an obligation to discuss all the ways their dental issues can be addressed. You may think one way is better than the other. The patient has other concerns. So after you discuss ALL the options, you need to have a full and open discussion about how the patient feels. The patient may have ideas that you find totally unacceptable. This is fine--no patient can tell you to perform treatment that you feel is unacceptable, just as the patient is free to reject any treatment plan to which THEY disagree.
The unspoken part is whether that big juicy treatment plan that will mean tens of thousands of dollars to your production will influence what you present to the patient as the "best" treatment. That is on you--to think of the patient as a complete person, and to think how you would like to be treated were you in that dental chair.
Good luck to you!
Thank you, this is really helpful.
Neomi
Nicole Mitchell-Toth
Private Practice General Dentist
7
Answers
Tampa, Florida
Updated
Nicole’s Answer
Hello! I've been a general dentist for 23 years, working in different settings. When talking about treatment options and costs with patients, I've rarely faced financial tension. My strategy is to educate patients, offer multiple options when possible, and keep the pressure low. I know some places have a high-pressure approach, but that's not my style. I hope this advice helps, and I wish you the best in your dental career!