The Benefits of Dentistry Unhurried

And Medicine, too?

[By Kellus Pruitt DDS]

1-darrellpruittThe hidden truth about managed care dentistry: Unhurried dentistry is generally of higher quality than hurried dentistry; anyone up to challenging this economic law?

Dental Handiwork

Dental care includes intricate handwork performed to exacting tolerances in sensitive mouths of nervous patients. When dentists compete on discounts (fast dentistry) instead of quality (slow dentistry), fear of bankruptcy fuels the race to the bottom with clueless, vulnerable patients.

 “‘Slow medicine’ strikes a chord – Nearly 500 people — doctors, nurses and ordinary people with an interest in health care — attended a forum Thursday to hear Dr. Victoria Sweet, a physician and author, talk about how ‘slow medicine’ could improve the quality of life of patients. Sweet is Associate Clinical Professor of Medicine at University of California, San Francisco.”

Melinda Morales for the Visalia Times-Delta

[Visalia, California – October 16, 2014]

http://www.visaliatimesdelta.com/story/news/local/2014/10/17/slow-medicine-strikes-chord/17400861/

Morales writes: “When Sweet told the audience she had once wondered to herself, ‘If I could do one thing to improve the quality of health care, what would it be?’ and then followed it up with her solution, ‘I would put time back into the hands of physicians,’ the audience burst into applause.”

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Insightful or clueless dentist?

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Enjoy the Teeth

Dentistry is far more enjoyable for all concerned when it is not rushed in order to squeeze out a profit from unsustainable pay offered by unaccountable, conniving discount dentistry brokers … like CIGNA.

“Cigna to launch rating system that ADA calls scientifically flawed – Cigna will launch in 2015 what it calls a cost-effectiveness designation program that rates in-network dentists based on cost and utilization patterns. These ratings will appear as stars within Cigna’s provider directory. According to Cigna, dentists who receive a three-star rating have a fee schedule that results in greater potential cost savings within their geographical area.”

Kelly Soderlund

[ADA News, October 13, 2014]

Good reporting, ADA News

This isn’t the first time CIGNA has been busted for selling intentionally misinformed, captive patients discount healthcare with no quality control – depriving Americans of the opportunity to choose providers which most patients prefer. Seven years ago, CIGNA and other insurers were reprimanded for employing Ingenix, UnitedHealth Group’s wholly-owned ranking algorithm designed to drive clients from out-of-network providers to cheaper in-network providers:

“Attorney General Cuomo Announces Agreement With Cigna Creating A New National Model For Doctor Ranking Programs – NEW YORK, NY (October 29, 2007) – Attorney General Andrew M. Cuomo today announced an agreement with one of the nation’s largest health insurers, CIGNA HealthCare (NYSE: CI), as part of his industry-wide investigation into doctor ranking programs. Under the agreement, CIGNA will enhance its doctor ranking program, fully disclosing to consumers and physicians all aspects of its ranking system. Additionally, CIGNA will retain an oversight monitor known as a Ratings Examiner (‘Rx’) who will oversee compliance with all aspects of the agreement and will report to the Attorney General every six months.”

Eric T. Schneiderman

[Office of Current NY State Attorney General]

http://www.ag.ny.gov/press-release/attorney-general-cuomo-announces-agreement-cigna-creating-new-national-model-doctor

See also, “UnitedHealth Group Shenanigans – Ingenix’s Lack of Independence”

Dr. David Edward Marcinko MBA

[Medical Executive-Post, January 16, 2009]

https://medicalexecutivepost.com/2009/01/16/unitedhealth-group-shenanigans/

As you can see, history reveals that Cuomo fruitlessly reminded CIGNA that price is only one variable in “cost-effectiveness.” As dentists and their patients know, correcting careless mistakes is always more costly than doing the job right the first time with the best materials for reasonable pay.

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slow down

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CIGNA Speaks

Cigna spokeswoman Karen Eldred tells ADA News,

“Cigna remains committed to introducing enhancements to the mycigna.com’s dental network directory that provide customers with cost [but not quality] transparency and insights when using their dental benefits.”

If anyone in the ADA is allowed to consider non-member dentists’ advice, I would recommend publicly confronting CIGNA with an easy to document comparison of the popularity of CIGNA’s one, two and three star, cost-effective dentists with competitors using doctoroogle.com – arguably the most transparent dentist-rating site in the nation.

http://texas.doctoroogle.com/

Anyone who is interested in performing the simple, consumer-friendly study is almost certain to discover a direct correlation between the amount of time dentists can afford to invest in their work and their preference by patients in the community.

More:

Assessment

Have you ever experienced a cost-effective injection of local anesthetic?

Hurried Care?

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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More on the Art of “Slow” Medicine

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And … Slow Dentistry, too!

By Ann Miller RN MHA

[ME-P Executive-Director]

BOOK REVIEW

We don’t know exactly when, but the practice of medicine has morphed into the delivery of health care.

Of course, if healthcare has become big business, we at the ME-P through our publication, text and handbooks, advertisers and sponsors, as well as speaking and consulting engagements may be partially to blame. But, hopefully not to the extreme it has become in some cases.

For example, did you know that Medicare has a CPT® medical payment code for a ten minute “treadmill” office visit?

God’s Hotel – The Book

So, if you aren’t sure – or are too young to know – of what’s happening today, the new book “God’s Hotel” is for you. It’s an engaging book by Dr. Victoria Sweet, a general internist from Laguna Honda Hospital that chronicles her perspectives from the last almshouse in the United States.

IOW: She is off the insurance grid and has discovered a way to benefit patients, not necessarily medical providers, by practicing something called “slow” medicine.

THINK: Marcus Welby MD

Slow Dentistry

Of course, our own ME-P investigative reporter Darrell K. Pruitt DDS, has been commenting and opining on this issue vis-a-vie the dental insurance industry treadmill of “fast” production line oral care.

For example, he often asks his colleagues: Are you fed up with successfully doing intricate handwork to exacting tolerances in mouths of anxious patients and then having to fight to get the patients’ insurance company to pay what they rightfully owe THEIR CLIENT.

IOW: Working faster and faster, for less and less compensation.

Assessment

“God’s Hotel”: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine

Link: http://www.amazon.com/Gods-Hotel-Hospital-Pilgrimage-Medicine/dp/1594488436/ref=sr_1_1?ie=UTF8&qid=1337177871&sr=8-1

More from the ME-P: The Emerging Discipline of “Slow Medicine” and Professional Liability

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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The Emerging Discipline of “Slow Medicine” and Professional Liability

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Examining the Heuristic Relationship between Face-Time and Medical Negligence Lawsuits 

By Dr. David Edward Marcinko MBA CMP™

www.BusinessofMedicalPractice.com

[Editor-in-Chief]

Our colleague and blogger Kent Bottles MD has been thinking and posting about the emerging philosophy of “slow medicine”. Of course, health economists realize how complex and difficult it is to transform American health care so that we will enjoy lower per-capita costs along with increased medical care quality in our lives. Unfortunately, grass root practitioners have done just the opposite these last two decades or so. In other words, practicing “faster medicine” with assembly line efficiency relegating office visits to 15, 10 or even 7 minute increments etc, in order to compensate for diminishing MCO/HMO reimbursement. And, this may have been a financially acute perspective for modernity until now!

Defining the Obvious

Slow medicine is practiced by a small, but growing subculture whose pioneer and spokesperson is Dr. Dennis McCullough, author of the book My Mother, Your Mother [Embracing “Slow Medicine,” The Compassionate Approach to Caring for Your Aging Loved Ones].

In other words, slow medicine is a philosophy and set of practices that believes in a conservative medical approach to both acute and chronic care. However, I believe there may be more to it than first perceived.

Link: http://www.thehealthcareblog.com/the_health_care_blog/2010/12/slow-medicine.html#comments

My Experiences

After serving as a medical expert witness in hundreds of malpractice cases [consulting, chart review, discovery depositions, trial appearances and sworn testimony] – both directly and indirectly and for both plaintiff and defendant doctors [predominately] – thru almost twenty year of private practice, my gut tells me the following:

“Patients do not sue doctors they personally like – they do sue doctors they do not like.”

In my opinion and experience, great clinical doctors are often sued while their lesser adept souls are not. Moreover, I believe this pleasing reduced liability relationships is enhanced by more patient face-time; not less. This is not a function of competency, but one of human relationships and “connectedness” with one’s caregiver. It will not be changed by eMRs, or more diagnostic tests [malpractice phobia] or procedures. It will be improved by intense physical examination, touching, eye contact, sympathy, empathy and time [aka: a TRUSTING relationship and pleasing bedside manner forged by TIME]. Period!

And so, for our business managers, CEOs and medical executive readers, let us compromise on terminology and call it “slower medicine.”

Assessment

Link: http://www.amazon.com/Insurance-Management-Strategies-Physicians-Advisors/dp/0763733423/ref=sr_1_3?ie=UTF8&s=books&qid=1275315795&sr=1-3

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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