Contemporary Orthodontics & Dentofacial Orthopedics
James
R. Waters,
DDS, MSD , PA
Board Certified Treatment for Children, Teens and
Adults
Is the “One-Stop-Shop” right for my
children when it comes to Orthodontics?
With today’s changing landscape of insurances and high
overhead/taxes, it is becoming more and more common in larger areas and cities
for doctors to not only offer more services (some beyond the scope of their
education and experience) to increase profit, but also for doctors to share overhead
or even work as an employee of another to reduce responsibilities. And although this may seem logical, there are
many pitfalls to this arrangement which directly and indirectly affect patient
care.
For my field the new trend is to see either newly graduating
orthodontists or older semi-retired orthodontists working a day per week in
multiple Pediatric Dental offices. They
do this to have immediate and guaranteed referrals (and usually to cut off a
competitor in a different area of town).
This is sold to the patient as a convenience; a one-stop-shop for all of
their child’s dental needs. In reality,
it takes away the “ownership” of the patient by the orthodontist since the
patient is really the patient of the pediatric doctor and the orthodontist is just
visiting as a part time employee (or more likely a contractor) that may stay or
go at any time (and for any reason). The
patient is never given a referral based on their specific needs (many
orthodontists are experienced in sub-specialties such as early
treatment/aligner trays/traditional and more complex treatments/adult
treatments) and the pediatric dentist has a financial benefit to keep the
patients within the practice even when the orthodontist is very new or
semi-retired. This almost never benefits
the patient and if there is a problem with the appliances, the orthodontist
will not be around. Almost always it is
a temporary relationship, lasting 1 to 3 years and then another cycles through;
this may sound fine but since most treatments take 2 years and many early cases
are watched over 3 to 5 years, there is no continuity of care.
“This is sold to the patient as a
convenience; a one-stop-shop for all of their child’s dental needs. In reality, it takes away the “ownership” of
the patient by the orthodontist since the patient is really the patient of the
pediatric doctor and the orthodontist is just visiting as a part time employee
(or more likely a contractor) that may stay or go at any time (and for any
reason).”
Does the “one-stop-shop” save money? Absolutely not; there
will be little to no savings by staying within the same office, only a
reduction in comprehensive care and likely a lack of “ownership” by the
doctor. Why is this always a transient relationship? Because no specialist will work “for the man”
after 20 years of school and debt; they are only at the pediatric office for
one of three reasons: they have sold a practice and are winding down, they are
newly graduated and cannot afford to start a fresh practice (or buy into one), or
they are paying a pedodontist to cut into another competitor’s area because
they cannot bring in their own patients with their own reputation. Also, foreign dentists many times cannot
start or own their own practice and must therefore work for another doctor.
“ … there will be little to no savings by staying within the same
office, only a reduction in comprehensive care and likely a lack of “ownership”
by the doctor.”
So are there exceptions?
Yes, there are reasons some may work together; spouses may share space
or perhaps a doctor does not want to work full time (of course some
pedodontists decide they can also do braces and just start offering
orthodontics without specialty education, usually and conveniently leaving this information out
when offering such to their young patients).
But the majority of one-stop-shops will fit into the initial criticism
which is bad for the patient and bad for the profession.
You as a patient have a choice, but you have to use common
sense, you should question a referral to the in-house doctor by asking for
credentials; How long has “your” doctor been in practice? How long have they been with you at this
office? Do they work for you or are they
just coming into the office and paying rent?
Do you refer everyone to this in-house doctor? Are there any independent orthodontists
nearby for another opinion?
“you should question a referral to
the in-house doctor by asking for credentials”
It is unfortunately a reality that patients can be treated
as property in the dental field without even realizing they are being bartered
or even sold. It is the reason in my
state (Texas) that only a dentist can own a dental office so businesses that
focus on profit alone cannot affect treatment.
Of course this means the dentist, pedodontist and orthodontist must have
an ethical philosophy that places the patient above all else. It is the reason I practice in my own offices
without financial allegiance to anyone but the patient. I prefer to be a real part of the communities
I serve and I want to show the commitment to the patients so they know I am
re-investing in their communities for their long-term care and the care of
future generations.
As always, if you have questions or comments concerning this
or any orthodontic question, please feel free to make a complimentary
new-patient appointment at either my Steiner Ranch location or my North-central
Austin location on West 35th street and MoPac.
 |
| Steiner Ranch |
 |
| 35th Street |
Dr. James R. Waters is
a 1996 graduate from UTHSC Dental School in San Antonio, 1997 graduate of
Advanced Dentistry from the UNMC in Nebraska and the 2001 Valedictorian
graduate from the prestigious Saint Louis University Orthodontic Program
receiving the J.P. Marshall award for clinical excellence in 2001. He holds a Bachelor’s Degree in Science,
Doctorate in Dental Surgery, a post-doctorate certificate in Advanced
Dentistry, post-doctorate Degree in Orthodontics & Dentofacial Orthopedics
and a Master of Science Degree in Orthodontics.
Dr. Waters and his wife of 19 years live in Austin, TX with their 4
children where he has a thriving, multi-faceted Specialist practice with
locations in Steiner Ranch and North-Central Austin. You can learn more about Dr. Waters at
BracesAustin.com.
1814 W. 35th
Street
Austin, TX 78703
(512) 451-6457
Steiner Ranch
4302 N. Quinlan Park
Austin, TX 78732
(512) 266-8585
BracesAustin.com
No comments:
Post a Comment