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I went to 50 different dentists: almost all gave a different diagnosis (1997)

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Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#271
I’ve always suspected this was the case, but this result is kind of astounding. I would expect, generally, dentists agree on mouth health. Indeed, the ones he sees initially that lack financial motive have general agreement on his treatment plan.

A very generous interpretation of the results here are that none of these dentists have a good context for the reporter’s overall dental health, hence such variation, but I suspect it is the far more banal profiteering that is driving the differences.

My own experiences mirror this when I go to a dentist. A gleaming office with several very expensive cars parked out front makes me immediately suspicious.

This industry had better tighten up or it’s going to have real problems with trust.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#272
Yeah, if you find an honest dentist in 2023 in the United States, never, ever go to anyone else. Thank GOD I found one recently. After a cross country move I put off going to the dentist for FIVE years because my previous dentist was amazing. The first one I tried was a bizarre Christian cult with a bunch of chi-chi crap in the lobby, and contemporary Christian music that -the dentist hummed along to while working on my teeth-. And then the calls started "You need X, Y, Z and probably A, B and C." and I was like "Nah. Fuck right off." Two more years without, and FINALLY found a guy who was like "You're teeth are fine. We'll keep an eye on some of these, but only worry about them if they cause you pain or have sudden changes." Guy is a gem.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#273

Earlier quoted context omitted.

>> I’m not a conspiracy nut. I believe in listening to experts (but ultimately making an informed decision). I believe in modern medicine. But that experience shook me and forever changed my trust in the dental industry. Ask anybody who’s experienced a “chronic” illness about the “experts” and they’ll tell you a tale or two. The experts are great until they have a case that is unusual. The don’t have the time or know…

Same experience here. My analysis is it's a money milking scheme between groups of doctors. Pass you around so everyone gets a cut and they cross refer people to scratch each other's backs. Surgeon refers you to pain management and pain management refers you to surgeon. Add in a physical therapist, testing facility, and chiropractor and you got a pretty lucrative meshnet of referrals going.

Read HIPAA when you get the chance; Specifically how to calculate cost.

Everyone who talks to the patient, who touches them, and who is consulted by the doctor, gets to charge. Yup, that means if another doctor happens to walk by, and confirms what he just told me, he gets to charge me again (double).

Feels like theatre every time I go to the doctor, so I just tell the secretary "I'm talking to you and Doc, no one else", and just quietly stare at anyone else who pops in.

Usually insurance covers this stuff, but I was uninsured when I discovered it .

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#274

>What, then, can Americans do to protect themselves from overtreatment and overcharging? Says the ADA’s Dr. Seldin, “We encourage patients to seek out—certainly if there’s a lot of work to be done—second or third opinions so they can have comfort with the practitioner’s recommendations.” Actually, the article already identified the prime protection mechanism -- insurance. The data in the article is nearly meaningless…

Isn't dental insurance kinda a scam itself? They pay for a couple cleanings and give you maybe a slight discount on major work, but the payout limit is so low that you might as well pay out of pocket for all of it (and just save your premiums for operations) or use the clinic's own subscription program.

When would dental insurance actually be cost effective for any major operations?

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#275

Earlier quoted context omitted.

This is very true. I had a SO with severe chronic gastric pain and they got passed around by doctors for years. One jerk wrote "drug seeking behavior" into her file and that made things even worse. Finally someone took her seriously, got imagery done, and discovered surgery was necessary. In US healthcare you have to be your own advocate and be willing to push. The system breaks down if you don't have a routine and o…

Now imagine doing this on Canadian healthcare, having to wait months or years for each appointment, and nowadays they try to talk you into MAID to save resources…

Yeah that's a hyperbolic exaggeration.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#276

Earlier quoted context omitted.

>> I’m not a conspiracy nut. I believe in listening to experts (but ultimately making an informed decision). I believe in modern medicine. But that experience shook me and forever changed my trust in the dental industry. Ask anybody who’s experienced a “chronic” illness about the “experts” and they’ll tell you a tale or two. The experts are great until they have a case that is unusual. The don’t have the time or know…

This is very true. I had a SO with severe chronic gastric pain and they got passed around by doctors for years. One jerk wrote "drug seeking behavior" into her file and that made things even worse. Finally someone took her seriously, got imagery done, and discovered surgery was necessary. In US healthcare you have to be your own advocate and be willing to push. The system breaks down if you don't have a routine and o…

How is this problem specific to the US? I live in Germany and hear exactly the same problem of needing to be your own advocate in northern Europe.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#277

Earlier quoted context omitted.

For the same reason you don’t brush 10 times a day. It isn’t significantly more effective than once a week and we all have better things to do.

Was wondering if you knew any RCTs or solid studies...

Dentistry in general seems averse to doing RCTs.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#278

Earlier quoted context omitted.

This is very true. I had a SO with severe chronic gastric pain and they got passed around by doctors for years. One jerk wrote "drug seeking behavior" into her file and that made things even worse. Finally someone took her seriously, got imagery done, and discovered surgery was necessary. In US healthcare you have to be your own advocate and be willing to push. The system breaks down if you don't have a routine and o…

Now imagine doing this on Canadian healthcare, having to wait months or years for each appointment, and nowadays they try to talk you into MAID to save resources…

I know HN is a privileged place but people should recognize that the “worst case” of Canadian/European healthcare wait times is already the reality for many if not most Americans.. You shouldn’t base your understanding of American health care on personal experience if you work for a big company that provides a nice health insurance plan.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#279

Earlier quoted context omitted.

I think the “do your own research” label conflates two categories: people who are shopping for a comforting answer, and people who want to be informed and make conscious decisions. I don’t have to be a dental expert to know that something isn’t adding up and to seek a second opinion.

It strikes me as unfortunate that for a lot of things like home repairs/renovations its pretty normal to get 3+ different opinions/bids.. but for our health its usually your regular doctor, and at most a 2nd opinion in some cases. We'll make life changing decisions based on the opinion/advice of 1 individual, while shopping around on a home project or car repair that's +/- $5k. It seems again like a combination of sh…

> Further, the next step after figuring out the cost of getting options would then e getting a quote for the actual resulting medical care recommends is opaque due to differing payment %s & co-pays by procedure, etc.

There’s nothing more quintessentially American than “not knowing how much you are going to pay for something until you owe it.” You go for a hospital visit and nobody has even a remote, order-of-magnitude idea of what you are going to pay. But you have to sign a doc right away that says “you agree to pay whatever number we eventually come up with!” And then you slowly get dozens of bills from individual doctors and hospital workers over the next 4 months. It’s absurd.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#280

Earlier quoted context omitted.

Same experience here. My analysis is it's a money milking scheme between groups of doctors. Pass you around so everyone gets a cut and they cross refer people to scratch each other's backs. Surgeon refers you to pain management and pain management refers you to surgeon. Add in a physical therapist, testing facility, and chiropractor and you got a pretty lucrative meshnet of referrals going.

Tbf in my case this was NHS so no money to be made by referrals afaik. It mostly seems to be a lack of up-to date knowledge paired with a reluctance to take the initiative and research the latest information for a specific case. As a substitute they refer you up the chain where the same problem also exists.

> NHS so no money to be made by referrals afaik

I wouldn't assume that - just because the money isn't coming from your pocket directly, it's inevitable there are doctors that milk the system. But you'd think bureaucrats whose job it is to assess the legitimacy of requests to the NHS (or equivalent institution in your own country) for payment might be harder to swindle than your typical patient.

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