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I just had a conversation with a friend who's a dentist, that I need to share.
She was complaining about how in the (corporate) dental office she's in, there's a new dentist who's billing insane amounts of money (up to $3,000 in dental bills an hour, paid by insurance). This new dentist recommends and installs crowns when a regular filling would have worked, and "finds" multiple cavities where there are actually zero cavities. It's mostly unnecessary work that destroys people teeth, and there's no limits on this kind of unethical behavior. Apparently there's zero checking by the insurance companies. The corporate managers love it, because the revenue per hour is huge.
Anyway, I've experienced and heard of situations at dentist's offices that seemed fraudulent and sketchy. But this is first-hand evidence from another dentist.
I'd never trust a dentist. I think that whole "go to the dentist twice a year" thing is just to give them an opportunity to extort you. I haven't been to a dentist in about 4 years.
That's why I have no dental insurance and my dentist is the same for the last 15 years. She never overbills.
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I was thinking for a long time about healthcare incentives i different systems. If the doctor is paid by an hour, he is incentivised to slack and skip some necessary procedures. If he is paid on work done, he is incentivised to do unnecessary procedures. I don't see how this is fundamentally solvable.
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You could pay a doctor/dentist to keep you/your teeth healthy. (Kinda like a subscription, but you only pay when you are healthy) When the patients are not healthy, the doctor makes less money. A doctor with a lot of healthy patients makes more money.
This way, the doctor is incentivized to keep you healthy in the long term.
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I've only heard of this but has it actually been implemented? It seems to suffer in that it incentivises letting hard to treat or chromic cases die, as they will never actually be healthy. Type 1 diabetes will surely not be incentivised to be treated that way.
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Also - the health of your teeth is extremely tied to your eating habits. If you don't eat sugar, and not many carbs, you will have zero cavities, flat out.
If you're bathing your teeth in sugar multiple times a day, your teeth will suffer greatly.
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In most people not cleaning the teeth at the dentist at least once a year will lead to loss of alveolar bone leading to loss of teeth. This will happen even without cavities. It was significant mechanism of tooth loss throughout history and many wild animals today lose their teeth by this mechanism (which in their case obviously leads to death).
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I disagree on this one. I just listened to a podcast with Dr Kevin Stock (https://www.kevinstock.io/), a dentist who's also on the carnivore diet.
Apparently there's tons of archeological evidence that before agriculture, people, people had close to perfect teeth and jaw development. Cavities are mostly something that happened post agriculture, and then REALLY took off when sugar became cheap in in the 1850's.
I've only heard of this but has it actually been implemented?
Not to my knowledge
It seems to suffer in that it incentivises letting hard to treat or chromic cases die, as they will never actually be healthy.
Yeah, I guess such a system cannot be applied universally.
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I remember reading somewhere that in China, there was a system whereby a doctor was paid, but only as long as the patient was healthy. This may have been only for emperors, though.
Incentives are REALLY hard to get right.
I wonder how bad the US health care system would be, if there were a robust system of alternatives to regular care? In other words, if the American Medical Association had not been able to act the way it acts currently - basically a giant corrupt union supported by the government, that kills all potential competition?
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48 sats \ 0 replies \ @398ja 7 Feb
There's a dentist I used to visit on the high street Kensington in London. You'd pay crazy prices there, especially after COVID. I brought my son for a checkup, left with a 90£ bill, after three minutes of counting teeth and poking around... WTF I thought. Not mentioning the two expensive crowns that fell off after a short while, the useless, disappointing, and expensive teeth whitening stuff they sold me... I'm so annoyed when I think about it. I need to calm down now, 😂
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Yes that twice a year thing was probably invented around the same time as the food pyramid and we all know how true that one is
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Second opinions are a good idea. Yes there are horror stories of unnecessary dental work because of unethical dentists
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Twice a year is just because that’s what insurance covers.
Some go three times a year and pay themselves.
Get second opinions!
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The privatised US Health system is the most expensive, inefficient and corrupt in the world. The incentives are just all wrong. Public health systems are more efficient and honest.
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