Real Issues in Private Practice

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Comments (7)

Anonymous in Naperville, Illinois

27 months ago

I am appalled by the many licensed dentist requiring registered dental hygienist to diagnose periodontal disease and treat periodontal disease without any exam prior to treatment. It is equally disturbing to work in dental offices where uncertified assistants are allowed to conduct coronal polishing.
These issues can be resolved and hygienist can see a rise in employment, but only with the help of our American Dental Hygiene Association, Illinois Dental Hygiene Association and also all dental hygiene blog websites. My colleagues and I need discussions and articles directing any dental employee who wishes to report these illegal actives to proper authorities anonymously.
OSHA protects our safety, but who protects patient from unlawful periodontal diagnosis, treatment and coronal polishing. These unlawful situations would not be an issue if we lived in another state. In fact we would see an increase in paid and be able to own our practice. But in the State of Illinois it is unlawful for a dental hygienist to diagnose and treat periodontal disease without a periodontal examination from the dentist prior to treatment. It is unlawful for adult/children to receive coronal polishing from noncertified assistant and charge out prophylaxis code.
Currently, I serve as a dental hygienist and have 4 years of experience in my current office. I am passionate about the dental field and I hope to see article and discussion boards discussing how to report these illegal activities. I hope insurance companies require periodontal exam prior to all Scaling and Root planning codes. I believe that it will only take a few dental fines associated with illegal periodontal diagnoses or coronal polishing. Before dental hygienist see an increase in employment and a decrease in periodontal production goals. Please, do not hesitate to let me know how t

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RDH in Vienna, Virginia

27 months ago

I agree, What can we do to change this. ? I

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Tom in Chicago, Illinois

27 months ago

Hello Anonymous in Naperville. I want to have a good dentist/hygenist in Chicago metro - the opposite of a prohy mill. They're hard to find. Can you suggest someone? Or how to find someone? twillia0@gmail.com thanks ps I'm a lawyer, and can perhaps return the favor. My last dentist had excellent hygenists, but charged a fortune for any procedure, and didn't do them very well. Current dentist appears to do procedures quite well, and for reasonable prices, but only hand-scales (himself) (no ultrasonic), and doesn't appear to be committed to calculus-free teeth. By "procedures" I mean fillings/crowns, etc.

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stephanie in Vienna, Virginia

27 months ago

Tom in Chicago, Illinois said: Hello Anonymous in Naperville. I want to have a good dentist/hygenist in Chicago metro - the opposite of a prohy mill. They're hard to find. Can you suggest someone? Or how to find someone? twillia0@gmail.com thanks ps I'm a lawyer, and can perhaps return the favor. My last dentist had excellent hygenists, but charged a fortune for any procedure, and didn't do them very well. Current dentist appears to do procedures quite well, and for reasonable prices, but only hand-scales (himself) (no ultrasonic), and doesn't appear to be committed to calculus-free teeth. By "procedures" I mean fillings/crowns, etc.

Here a few tips i learned just by observation:
call the office and ask how long they run, ask them how long is each new patient appointment and what you can expect in your first visit.
I only know of one place in virginia who does this, and she doesnt take insurance. New patients see the doctor first, they get a full evaluation, including a full mouth probing and radiographs, a treatment plan is then made according to the radiographic and clinical findings. Then you make another appointment to see the hygienist. I know this sounds like a wast of time but its actully the best way to do things. You will find that most dentist that accept inusrance run "prophy mills" because they feel they have to. Most dentist would love to give patients the time but due to money they feel they cant. Inusrance pays very little for these services so to make up for the poor pay out they need to increase patients. Its very sad, your a lawyer. How do you suggest we figure fight this, how can we change this entire dental insurance dilemma?

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Tom in Chicago, Illinois

27 months ago

2 solutions (me talking as a lawyer).
1. Deregulate the market in every state, so that people can hire hygienists, and hygienists can work independently, or
2. Single payer health care system (including dental care) with more copay (but still moderate) for dental care, so people have sufficient incentive to take care of their teeth. Or Obamacare with dental care included.
3. As it is now, my view is the most important thing for good dental care in the USA, besides people having good habits (good dental homecare, good nutrition) is good prophylactic care by dental hygienists. Currently, the latter is very hard to get because of pressure by dentists on the hygienist to do it "quick and dirty".

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Tom in Chicago, Illinois

27 months ago

Tom in Chicago, Illinois said: 2 solutions (me talking as a lawyer).
1. Deregulate the market in every state, so that people can hire hygienists, and hygienists can work independently, or
2. Single payer health care system (including dental care) with more copay (but still moderate) for dental care, so people have sufficient incentive to take care of their teeth. Or Obamacare with dental care included.
3. As it is now, my view is the most important thing for good dental care in the USA, besides people having good habits (good dental homecare, good nutrition) is good prophylactic care by dental hygienists. Currently, the latter is very hard to get because of pressure by dentists on the hygienist to do it "quick and dirty".

Also, should people who want thorough prophy care go to periodontists instead for their prohyies? Are perio hygienists generally better?

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Anne in Maryland in Maryland

27 months ago

Tom in Chicago, Illinois said: 2 solutions (me talking as a lawyer).
1. Deregulate the market in every state, so that people can hire hygienists, and hygienists can work independently, or
2. Single payer health care system (including dental care) with more copay (but still moderate) for dental care, so people have sufficient incentive to take care of their teeth. Or Obamacare with dental care included.
3. As it is now, my view is the most important thing for good dental care in the USA, besides people having good habits (good dental homecare, good nutrition) is good prophylactic care by dental hygienists. Currently, the latter is very hard to get because of pressure by dentists on the hygienist to do it "quick and dirty".

Tom: I actually enjoy your post. I hate to tell you this, but it won't matter if hygienists can practice independently as their overhead costs will be the same as a dentist, but a hygienist will not have the ability to "produce" as much income as a dentist and hygienist practicing together. A hygienist will have to produce twice as much to cover her overhead, therefore there is more liklihood of hygiene independents running prophy mills. We all think we can do it better, spend more time, etc., until the bills start rolling in and you cant get paid by insurance companies and your patients no show. Hygienists forget that there is more to all this then just seeing one patient every 45 minutes. Just Sayin......be realistic.....no one works for free and I am sure you don't either. I don't know many hygienists who would ever work in an office doing quick and dirty prophys. We have a reputation to uphold also.

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