It’s been a while since I’ve written! Busy with life and uninspired.
Today I saw an emergency patient for a dentist-friend who is out of town. She’s a new patient for my friend. A veneer (on #9) that was done in another office (before my friend) just two months ago, came out. The office that placed it was what I call a “McDentist”…. a local multi-location corporate office that turns over staff regularly, including the dentists. But, hey…. these McDentists take any and all dental plans. Their waiting rooms are full, so “they must be good,” right?
So, they’re always busy, churning patients through the chairs. Quality and attention to detail? Bah! Churn and burn, baby!
It tooth #9 (a single central veneer case), and she’s leaving on an overseas trip Sunday.
Houston, we have a problem.
Here’s the thing… The veneer was done just two months ago (again, not by my friend and colleague). The FIRST time it came out was the DAY AFTER it was placed. Something is VERY wrong, if that happens. She went back. They recemented it. It came out again. She went back. Rinse and repeat. She finally gave up and called my friend (who has seen her husband as a patient for quite some time).
This was the FIFTH time it came out. After I cleaned out a THICK layer of cement (shouldn’t be that way), I was not surprised that it didn’t fit well at all. The tooth preparation? I’ll just say I wasn’t impressed. The restoration needs to be re-done.
Here goes somethin’!
I used all my tricks and rebonded it. I sandblasted all the cement off the porcelain. I re-etched it with Hydrofluoric Acid (Ultradent). Applied Silane (Interface by Apex Dental Products), Scotchbond Universal (3M), and Calibra (Caulk). Hopefully, it will hold up long enough for her to return from the islands and until my friend can do a new veneer for her. I didn’t take any photos.
You get what you get.
It’s frustrating for those of us (dentists) who work HARD to do our BEST for each and every patient… spending TIME with those patients… treating them like we would our own family… to see these “McDentals” treating patients like shit and making money hand-over-fist by doing huge volumes of treatment. They can afford to lose some patients who are unhappy with treatment or figure out the treatment was low quality. Most of their patients don’t know (any better) or are unaware of the problems until it’s too late. I recently wrote about the “Scourge of Corporate Dentistry.”
After many years in this profession, I can conclude that TODAY, the cultural trend is… the VAST majority of people (dental patients) TRULY do not care about quality. Sure, they pay LIP SERVICE to the notion of caring about quality. But, they really care about “cheap,” and they care about whether the dental office is “on their (crappy) plan.” SOME of them EVENTUALLY figure it out, after they’ve been treated like shit repeatedly. Or… their veneer falls out FIVE TIMES in a 2-month period. Some never figure it out, or perhaps they figure there’s no difference wherever they go.
Well… there IS a difference. Some patients DO get it. But, many… too many… don’t. Or, they learn the hard way.
“The bitterness of poor quality remains long after the sweetness of low price is forgotten” – Benjamin Franklin
You can’t provide nor receive the best dentistry (or service) on an HMO / PPO plan. You just can’t. The same goes for a corporate chain McDentist, where the non-dentist office manager directs treatment and high volume and production numbers reign supreme.
“But, it can happen in a private office, too!”
I have already heard this argument. While it’s theoretically true, I’m just not seeing it. In my 30 years of practice, when I get these problem cases, it’s ALWAYS from one of these clinics. Always.
What’s sad and, frankly perplexing to me, is that these McDentists don’t care, either. How does one get to that place, mentally?