dentistry for the disabled (or the lack of...)
This very special lady was almost in tears yesterday, because the dentist who helped her last summer when she was in terrible pain told us that he NO LONGER accepts Medicaid for payment. He was the only private dentist in our area who would treat Donna. There are no longer any dentists in our area who accept Medicaid, and Donna has a broken molar that needs to be extracted, and a tooth in the front that needs a root canal and crown. I'm sorry, but I feel this is a terrible disgrace. These dentists really should to be ashamed to let her suffer like this. They can easily afford to take one or two medicaid patients. I know the insurance on the two Mercedes' is high, but with the fees that they charge the rest of us, they can somehow manage to scrape by...ha! (compared to most of the people we know they are more than well off!) There is a dental clinic at the hospital that will take Medicaid patients, but Donna received very poor treatment there last summer and is afraid to go back. The people who do the work there are still in training. They are dental residents...NOT licensed dentists. Shouldn't Donna have the right to be treated by a private dentist of her choice? Don't the disabled deserve the same quality of dental care as anyone else?! If you feel that they do, please let us know. (The rest of the story can be found below).
posted by jaz at 9:03 PM
8 Comments:
There is a lot more to this story that I haven't had a chance to post. Donna had to have 3 teeth pulled on Jan. 8 and we had to pay the full fee or else they would have sent her home to suffer in pain($875.00... and this was done in under one hour). I hope to be getting back to posting soon.
Please no spam! I will just delete it before anyone even gets a chance to see it so you are wasting your time.
There is no such thing as a "dental resident". They have all graduated from dental school, gotten their license, and are in a specialty program to earn an advanced degree (such as orthodontics, pediatrics, periodontist, ect...). They are just as qualified as ANY other dentist in the country.
I am a senior in dental school in NC. Have you considered going to the dental school in your state? They offer dental treatment at a third of the cost, sometimes free.
I would suggest prevention to deter future dental disease. Brush twice a day, floss, stay away from sugar (soft drinks, sweets). Use a flouride rinse such as ACT. Make sure she is drinking tap water with Flouride, not bottled water or juice/soft drinks.
anon,
Thank-you for your interest. Perhaps they are interns. I am almost certain that there are no specialties practiced at the clinic where Donna used to go. What I DO know is that the care she received was terrible! It doesn't matter whether you call them licensed dentists, or interns, or swiss cheese for that matter...the care she received was pathetic. If a dentist(or dental intern) cannot spot a broken down tooth that even I could tell was broken(and she suffers miserably for several WEEKS because of their error), they shouldn't be allowed to practice. You are certainly right about preventive care, however this won't take care of all the damage that has already occurred. I don't want to belabor my other point, but if this was your child or loved one, and you were not happy with the care they received, you would put them in your car and take them elsewhere...to the dentist of your choice. Donna doesn't have that option. She doesn't have the same rights as anyone else in America with insurance(because private dentists just don't accept Medicaid). Shouldn't Donna should be free to choose the best dentist she can find, not be restricted to a dental clinic or a dental school(much too long a trip for her to visit the one in the state where she lives)?
This is the dental student again.
I am not sure WHY they missed a broken tooth. That is a basic task that any second year dental student could have diagnosed. Perhaps the tooth was not fractured enough to warrant extraction. In any case, they should have given pain medication. You could also try to contact your local dental school. During the summer, we do rotations all over the states we live in at free dental clinics. May and August are great times to find free dental care in your area. Give them a call and they could put you in contact with someone who could tell you more. We even go to other countries to help those in need! I went to Malawi last year.
She does have a right to dental care. The question is, who will pay for it?
The reason that almost all dentist will not accept Medicaid is that they are reimbursed at such a low rate, they actually lose money on each patient they see. To run a dental office and pay your staff, it cost about 60% of your gross income. That means if you pay the dentist $100, he makes $40. If you send stuff to the lab, that cost even more money. Let's say that $40 is all profit for that $100 patient charge. Medicaid will give the dentist $50 for the $100 charge. That means the dentist will lose $10. $10 may not sound like a lot, but when you have 3,500 patients on average, it can add up.
I just didnt want you to have the understanding that the reason dentist's dont see Medicaid was that they didnt want want to deal with it, they just cant afford to. A practice can cost $500,000 to buy, plus the dentist is paying off $150,000 in student loan debt.
Get the state to pay out more money for services and more dentists will accept it. With a shortage of dentist looming in the next few years, the problem is only going to get worse.
I would be happy to answer any of your questions concerning dentistry if you have any.
anon,
Thanks again for your continued interest in Donna's story. I don't mean to portray dentists as the culprits here. I understand what you wrote about the very low rate that Medicaid pays out for the reimbursements. This is an issue that congress needs to address...and soon! It is not fair that a certain segment of the population is not treated equally with regards to health and dental care. As you probably know, physicians also will not accept Medicaid patients either, and the patient must to go to the ER, or the Medicaid clinic at the hospital and wait for three hours or more just to be seen for a simple complaint.
Still, I feel that most private dentists could probably afford to take on a couple of Medicaid patients. My grandfather was a dentist during the Great Depression, and he often took on patients who could not afford to pay. It's a matter of will...and heart. If the heart's in the right place, one will find a way!
In regards to the broken down tooth, that's a puzzling story. When one of the head dentists at the clinic finally had a look at that tooth(on our third or fourth return visit) he remarked to the 'intern', "How could you not see this. This tooth has to come out!" The tragedy is that Donna told them from the first visit to do something about that tooth, since it was cutting a huge sore into her tongue. Yet, all they prescribed were topical emulsions that wore off after five or ten minutes. I was putting them on her tongue about 20 times a day! Six weeks of our summer were ruined because of this. There are private dentists within walking distance of Donna's apartment. Of course they would not see her because of the Medicaid issue. Apparently her pain was of no concern to them.
I agree with you about the funding. More needs to be done to at least get more funding for at least children and special needs Medicaid patients.
The sad fact is, if the government said tomorrow that they would offer higher payouts to dentist for all Medicaid treatment, this would cause an even greater potential problem. The US has 150,000 dentist and 300 MILLION people. The entire system would then become overloaded like the current healthcare system is. Sadly, I dont see a true end to the struggling oral healthcare problem in the US anytime soon. And it is just impossible to create more dentist at a rate that could serve the country. In my state of NC, we turn out 81 new dentist a year, that is it! It cost almost a million dollars of taxpayer money to send each of us to school for 4 years (and we have to foot $150,000 out of our pocket). Some counties in my state dont even have a dentist. They have to drive hours to get to one. Of course, the larger urban areas have plenty, but even those who can afford it sometimes cant get access to dental care. The situation will be getting worse as the baby boomer generation gets older and seeks dental care. Couple this with the fact that like 12% of the dentist in the US are going to retire between now and 2016. We are looking at large numbers of people who will not be able to get access to dental care.
Our class made an oath to provide at least some service to the underserved. If every dentist would see just a few Medicaid patients, be it only children and disabled, we could at least make a dent in the problem. I just dont see how you could turn your back on a patient in pain just because they had medicaid. It is just such a huge undertaking, I dont even know where to begin trying to fix it.
I wish you and Donna all the best and I hope you find a good dentist that will treat you with respect and professionalism.
anon, thanks for the eye-opening statistics. It seems like a hopeless situation unless we move to some form of universal health care. I have some online friends in Europe and they can't believe that someone like Donna can't get the same health(and dental) care as anyone else in America. A friend in the Netherlands told me that a dentist over there gets something like 45 euros for a simple extraction(he thought that was a lot!). It's more than double that here, of course! Perhaps their expenses are less, but I also think they probably manage to make do with smaller incomes and less luxurious lifestyles. Everyone has to be willing to chip in and do their part to make this world livable for ALL its citizens.
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