Dental Managed Care is Substandard Care

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Dental Managed Care [DMC] is Substandard Care – count on it!

1-darrellpruittBy D. Kellus Pruitt DDS

Have you noticed most employer-sponsored dental plans boast savings of 30% and more on dental care, without mentioning how unsustainable discounts harms their employees?

Dental Managed Care [DMC] is substandard care: Discount dentistry, like virtually all underfunded handwork, has always been substandard … Or perhaps someone would like to argue that intricate surgery in sensitive mouths of nervous patients is improved when rushed.

Discounts are popular

Those who market obscure, hard to understand managed care plans to clueless, perhaps non-caring employers, do not control the quality of the discounted dentistry they sell.

Think about it: Discount dentistry without quality control. Can you think of a worse idea in healthcare?

What’s more, not one Delta Dental, Humana or Cigna executive can be held accountable for causing harm to equally clueless dental patients through underfinanced dentistry they sell. Employees who must choose their dentists from preferred provider lists have forfeited freedom of choice, whether they realize it or not. Their underfunded, substandard dentistry is subsidized by tax payers as a special tax-free benefit, benefiting unaccountable third parties most of all.

For example:

  • Want to know what you get with managed care dentistry? Quick prophys. 
  • How many of you get your teeth cleaned in 30 minutes or less? Do they feel clean?

One Hour

l always allowed my hygienists 1 hour to clean patients’ teeth simply because it often takes that long to do the job right – regardless what insurers say hygienists’ time is worth. The economic climate is tough on fee-for-service.

As I am considering signing on as a preferred provider – not because I want to – I notice that the fees allowed by insurers do not cover the hourly rate of most hygienists… unless they can “clean” teeth, take x-rays, take blood pressure, go over patients’ medical history, allow time for the doctor to do a quick exam and turn around the room in less than 30 minutes.


retro dental exam room



The motto of my practice is “Dentistry Unhurried.” I don’t want to compete in a race to the bottom which uninformed dental patients always lose.


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3 Responses

  1. Transparency rules UPDATE 2.7.17
    [Transparency rules … eventually]

    How is dental managed care (Delta Dental, BCBS, Humana) like dental EHRs (Dentrix, Eaglesoft, and the ADA-endorsed The Dental Record™)?

    Nobody can defend their cost and safety – not even vendors and other conflicted third-parties with power and/or profit at stake.

    In fact, Delta Dental, as well as the American Dental Association, continue to encourage dentists to purchase dental software without responding to increasingly important consumer concerns about the cost and safety of EHRs compared to paper dental records.

    What should that tell dentists and patients – the principals in dentalcare?

    Dr. Pruitt


  2. What did I tell you? Delta Dental is immoral, and now the world knows

    “Dentists are feeling a sharp pain, thanks to Delta Dental” By Priyanka Dayal McCluskey for The Boston Globe, February 8, 2017.

    McCluskey: “A plan by the state’s largest dental insurer to sell new low-cost coverage has sparked an outcry among dentists, who fear the move will cut their incomes and force them to rush through appointments.

    Delta Dental of Massachusetts, which has about 2.2 million members, says the move is necessary to attract budget-conscious businesses and consumers amid a slowdown in its growth. But dentists are fighting back, arguing that the savings will come at their expense — and may prompt patients to change dentists.”

    There are already 50 comments following the Boston Globe article, and ALL are negative towards Delta Dental’s sleazy business practices.

    Delta Dental is immoral. Delta Dental has always been immoral

    The truth is, Delta Dental sells discounted dentistry to captive clients performed by the lowest bidders without quality control, and not a single Delta Dental official can be held accountable for causing harm to uninformed dental patients because of under-financed healthcare.

    For example, Delta pays less for cleanings than hygienists make an hour. And that is why Delta customers only get 30 minute cleanings. As you know, I schedule an hour for cleanings simply because a good job cannot be done in 30 minutes.

    The most insidious crime? Delta’s dentists are unlikely to be honest with patients about the harm caused by cutting corners to make a profit from unsustainable 30% discounts.

    Remember when Washington Dental Service (Delta Dental) CEO James Dwyer revealed what Delta executives really think of dentists, Doc? I’ve written about this before:

    A few years ago, KING 5 News in Seattle featured, “Executive pay soars as one of WA state’s largest non-profits makes cuts” – an investigative report about Delta Dental affiliate, Washington Dental Service, written by Chris Ingalls.

    According to Ingalls, WDS CEO James Dwyer earned $1.2 million in 2010 – topping off a 45 percent pay increase he has enjoyed for the previous 5 years…. Even as he made across-the-board 15 percent cuts to the fees Delta Dental pays their clients’ dentists in Washington. “WDS said the cuts allowed it to reduce the premiums it charges employers for dental insurance, a move that makes its service more competitive in the marketplace.”

    When asked how paying less for Delta clients’ dental care affects their dentists, CEO James Dwyer, who earned $1.2 million in 2010, responded: “They’ve lived in a wonderful, insulated world. God love ‘em. But it’s changing.” Then, just to aggravate me even more, CEO James Dwyer (remember that name) suggested, “Number one, they could start by working 5 days a week.” That dude is a sweetheart, isn’t he, Doc?

    James Dwyer is a CEO who takes $1.2 million healthcare dollars from clueless Americans by selling rushed dentistry at discounted fees with no quality control. He is just one more millionaire Delta official who cannot be held accountable to the dental patients they harm. And after cutting payments to his clients’ dentists, James Dwyer has the nerve to suggest that they start working even harder for him. Meanwhile, the market-dominating non-profit escapes taxes its for-profit competitors can’t.

    Seattle dentist Dr. Chris Pickel reveals what I have warned for years: “It’s the patient that loses.” He adds, “We’ve basically had to figure a way we can compress patient time.” He says, “It’s something we don’t like to do. We want to spend time with people. We like to spend time educating them.” Dr. Pickel didn’t mention that dentistry is also intricate handwork performed in sensitive mouths to exacting tolerances. As anyone can imagine, dentistry cannot be rushed without painful consequences… but rushed it is by Delta Dental’s unsustainable fee schedule. Ethics aren’t free.

    When Delta officials treat their clients’ dentists badly, it harms everyone – except CEO James Dwyer. He gets bonuses.

    D. Kellus Pruitt DDS


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