Are We There Yet?

“Mommy, Daddy, are we there yet?” Those of you who are parents recognize this question all too well. We also know the quick standard responses, rotated as needed: “Five more minutes!” “Almost there!” “Just around the corner!” “You’ll have to hold it!” It is amazing how easily we lie to our kids.

It really doesn’t matter the age. As adults and grown, seasoned professionals, we still ask the same question: Are we there yet? Do we really expect a straight answer? Our profession and our country face many problems and issues, and many of us expect truthful adult answers. Unfortunately, today’s culture does not always reward honesty. Television, social media “influencers,” apparently everyone in Washington, even top brass in our military. We all sense how brazen the lying has become.

Is dishonesty beginning to creep into our profession? Is there more temptation to oversell treatment plans? Heaven knows financial pressures have ramped up considerably in the past 15 years with servicing loans for skyrocketing tuition as well as static or even decreasing reimbursement from even more intrusive insurance companies. Add to that the rapid of ramping up of inflation effects to supplies and labor costs as a inevitable result of wildly out of control congressional spending, there is no doubt that dentists – and our physician colleagues – are certainly feeling a financial squeeze more than ever.

Dentistry and medicine may be businesses, and it is true that we are not exempted from the laws of economics, but we are special kinds of businesses. The Hippocratic Oath, while allowing to “thrive and prosper in my fortune and profession,” also admonishes that “my visit shall be for the convenience and advantage of the patient,” requiring to first and foremost to take care of our sick patients. As doctors, we feel this economic and ethical push and pull by which most competitive commercial businesses are not as tightly bound, and sometimes that can place us in an agonizing position. Nevertheless, it is our professional duty to fiercely defend this conflict to all who challenge us. No one, especially an insurance company or a government entity, is as able to guard our patients health as the doctors bound by this oath, just as no one – not insurance companies, government entities, practice owners, or even patients demanding health care as a right – must be allowed to control doctors by manipulating the fiscal means by which patients are properly treated.

But wait! There’s more! In the continuing Washington siren song that everything should be free, Congress was recently on the brink of imposing Medicare on dentistry. Since 1965 when Medicare was first born, there is a reason why physician are so envious that dentistry managed to stay out of the Medicare quagmire. Our forefather dental leaders were very prescient and clearly understood how any federal program expands and exerts even more control as costs rise. Sometimes even our dental leadership does not see that as clearly as they should. History is ignored, and the future is short sighted. “Aw, but it will not affect me,” you say? “I just don’t have to participate in Medicare?” Perhaps. But ask your physician friends what happens. In medicine, Medicare takes over and private insurance disappears at age 65. The fees are fixed and there is no balance billing. Private insurance for earlier ages set their fee schedules using Medicare schedules as a strong guide and vice versa. Guess who comes out short in that little arrangement.

Don’t fall asleep on this, folks. We barely won this time. Trust me, this is not over. The political temptation is far too powerful. Nothing is for free. Proponents sell it as a benefit. But the dishonesty by omission is that it will be you who pays the bill and you will not have a choice. Once in place, it will be like any other government program: far more costly and fraught with fraud than predicted, impossible to eliminate and nearly impossible to modify, all by design. You and your American Dental Association called out the deceit this time, but another push could be “just around the corner.”

As parents, it is our obligation to be truthful to our children and set the example for when they are adults. As doctors and professionals, our patients trust us to be truthful in every way. Dentists are vested with high trust and respect in a sea of frank dishonesty. This is why our predecessors, and now you, are the great leaders our society, our patients and our children seek more than ever. Speak up, defend and practice your integrity. And don’t lie to your kids.

Dr David Boden Today’s FDA