Dental Insurance: Few Fans Among Dentists (video)

Great comment by Griffin T. Murphey above!!! LOL!

I think dentists could also grab a larger share of their market if they offered in-house financing. There’s a company down in Texas that helps doctors do just that too, with only a 1% loss rate compared to 7-10% guaranteed loss with CareCredit.

Ask to speak with Ron Barnett
http://www.docpay.com/

John Barremore
Houston, TX

Dear Mr. Vito Dunkleman. I found your arguments challenging, and I have responded on DentistryiQ. If you are interested in replying to my opinion, you can find me here:
http://community.pennwelldentalgroup.com/forum/topics/why-dentists-hate-delta-ceo

Why dentists hate Delta CEO Thomas Fleszar

Three days ago, Julie Frey posted an article titled “Dental Insurance: Few Fans Among Dentists” on Dental Practice Marketing and Management Blog, hosted by Jim Du Molin.
http://www.thewealthydentist.com/blog/1083/dental-insurance-riles-dentists/

In a survey recently completed by TheWealthyDentist.com, It was determined that 90% of dentists consider dental insurance as “the enemy.” As is often the case, I learned more from the responses than from the article itself. In the comments which followed, Dr. Griff Murphey, a dentist from Fort Worth, said:

“Oh, they are awful. I was taught not to violate the oblique ridge of an upper molar and to treat pit caries conservatively (and THAT was 35 years ago!) and you’d think I was a THIEF. I was also taught to do perio charting and treat periodontal disease and they don’t allow that; really. I’ve taken to sending them photos of the calculus and they still don’t believe it. I’ve freely told my patients, ‘If your insurance carrier was a dentist, you could sue it for malpractice.’”

A few hours later, Mr. Vito Dunkleman took exception to both the results of the TWD study and to Dr. Murphey’s criticism of the dental insurance industry. This gives us the rare opportunity to better understand the mind set of those who lead dental benefits companies. Dunkleman’s response is worth dissecting simply because not many like him feel as free to open up on the Internet:

“These 9 out of 10 dentists should check and see how much of their income is generated because of and through dental insurance. If dental insurance simply vanished what do you think would happen to their income? Also, please keep in mind that for every honest dentist who gets the run around…and yes they do get jerked around by insurance companies…often…there are two others gaming the system. Take Dr. Murphey above. What does that picture of calculus mean? That you should get $1000 for a cleaning? A picture of calculus does not necessarily mean your scaling claim should be paid doctor! And please, let’s be honest, sure the insurance company is concerned with profit, and the doctors aren’t? HA!!”

I find Vito Dunkleman refreshingly transparent. It takes blind devotion to one’s employer as well as courage to defend an indefensible position. It’s called taking a hit for the team.

In the opening statement of his rebuttal to Dr. Murphey, it is easy to assume that Mr. Dunkleman represents an unnamed insurance company that 90% of us probably despise. This stakeholder’s groveling plea that my profession somehow owes something to the insurance industry for dentistry’s success is nothing new. In fact, this has been a traditional committee-approved talking point for at least 3 years. I personally have heard more than one dental benefits company executive say exactly the same thing at the ADA’s annual National Benefits Conferences. In 2007 and 2008, nobody in ADA Headquarters protested the statement, but it was after all, a benefits conference in ADA Headquarters. Vito Dunkleman is special because going into detail on the Internet is no big deal to him. He’s fearless. I like that.

“If dental insurance simply vanished what do you think would happen to their income?” Since 90% of the dentists who have to deal with insurers’ greed and unaccountability don’t like them, Dunkleman’s position is not unlike rationalizing an unfair landowner’s treatment of a sharecropper on land neither actually owns.

If all dental insurance disappeared tomorrow, by Thursday, Americans would still need dental treatment – not dental insurance. What the dental industry needs is fair pricing, and that will never occur as long as dental insurance actuary wizards are interfering with competition in the free market. Dentistry plus insurance premiums always costs more than just dentistry.

This summer, I read that Okemos, Michigan-based Delta Dental CEO Thomas Fleszar was paid $3.9 million in salary, benefits and expenses according to Delta’s 2007 tax filing as a “non-profit” corporation. I don’t think dental insurance executives are as important to dentistry as they think they are. And “non-profit” is deceiving.
http://www.lansingcitypulse.com/lansing/article-3144-the-enterprise.html

Mr. Dunkleman: “Also, please keep in mind that for every honest dentist who gets the run around…and yes they do get jerked around by insurance companies…often…there are two others gaming the system.”

As a dentist, I’m flattered by Dunkleman’s estimation that only half of dentists are dishonest compared with 90% of his colleagues. All I can say is, if Delta Dental, BCBSTX, United Concordia and others weren’t around, there would be no system at all to jerk us around in the first place when we attempt to collect payment already owed us. If a business is paid at the time of service as is natural in a free market, I am of the opinion that customers cannot be successfully gamed without being severely punished. On the other hand, dental insurance executives will always be deaf, dumb and blind millionaires insulated from accountability by their own bureaucracy and employees like Dunkleman – who thinks they invented dentistry.

“Take Dr. Murphey above. What does that picture of calculus mean? That you should get $1000 for a cleaning? A picture of calculus does not necessarily mean your scaling claim should be paid doctor!”

Did I mention that I consider Mr. Vito Dunkleman a very courageous man? Even if Mr. Dunkleman is playing the ill-advised part of a shill, he stepped over the line of civility when he accused Dr. Murphey of being a dishonest dentist. I know Dr. Murphey because we’ve practiced in the same town for decades. Mr. Dunkleman owes Dr. Murphey a humble apology. I wish I knew which sleazy company Mr. Dunkleman works for. I think I personally could do something about that unfortunate threat to the welfare of American consumers.

There is nothing I can say which would add anything to the transparency of Vito Dunkleman’s closing statement.

“And please, let’s be honest, sure the insurance company is concerned with profit, and the doctors aren’t? HA!!” – Vito Dunkleman.

D. Kellus Pruitt DDS

Well…not sure who, if anyone will see this, as it seems to be a three way conversation, but I do apologize to Dr. Murphy. I do not know him or the specifics of this case and looking back I can see how my comments read like a slam against him. My comment about his statement was meant more as a general one. A picture of calculus is meaningless when it comes to demonstrating what procedure may or may not be needed. At a recent study group, where we often go over cases, one doc brought in a case that had been denied coverage. It was for a couple of onlays. Now I know that since he got a cerac machine, he has become a one tool man, and every situation is a nail to be hit with that cerac hammer, but anyway, he showed us what he sent the insurance company, and they were photos exposed post-preparation. Well, if I show you a picture of a tooth prepped for an onlay, can you honestly determine if the tooth actually needed an onlay before treatment started? I made this point and was almost booed out of the room. Dr. Murphy, your comments about the gamers makes it seem like you are one of the ones who is getting screwed by insurers and your colleagues! Again, I do apologize that my comments read as a question of your skills or ethics.

I expect little from insurance companies, but much more from my dental colleagues. I assume that the insurance company is my adversary, but when I listen to how my colleagues plan to jerk the system around, or I see patients come in for a 2nd opinion with a treatment plan that is 75% or more bull, I wonder if as a profession we deserve MORE scrutiny. Just last week I attended a CE course where much of the discussion was about how to creatively code the services to get them paid. Why the heck are we doing this and why too are we then surprised when our games are met with other games?

As to the long winded response of Dr. Pruitt, your assessment of me is wrong, but I am confident from your arrogant and self righteous tone that your mind will not be swayed. Let me just say that your reply reminds me of that made by so many of my colleagues when that Reader’s Digest article describing overly aggressive treatment plans came out years ago. I was disappointed how so many in the dental profession instantly and fully absolved the dental profession of any culpability in the matter. My bottom line is that I fully agree that there are reasons to be unhappy with the methods employed by dental insurers, but as a profession we were eager, far too eager to bend over backwards to feed at the teat of these insurers and are now paying the price for letting ourselves become so domesticated. We are now in a hole we as a profession dug for ourselves. We have trained generations of patients to follow the lead of their insurance dollars and will now have an almost impossible task of changing that mindset. Dr. Pruitt you are either naive, dishonest, or a fool if you think acceptance of costly treatment plans would remain unaltered by the demise of dental insurance. Sure people would still need care, but the landscape of how that care is paid for and delivered would be altered as significantly as it was when insurance rose to prominence years back.