prices to public

Gdentallab

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Why the prices we take for restorations are being kept from the patients.
Well ,dentists say that prosthisis prices are high (too high) because dental technicians take a lot of money to fabricate the prosthisis.
Shouldn't the public be aware much more about the prices? Isn't the public's right to know exactly how much he paid for a restoration, and how much the dentist earned?
 
rkm rdt

rkm rdt

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We have full disclosure here.
Separate lab fees from the Dentist.
Patients are able to make informed decisions.
We are self regulated professionals.
I don't cut down my fellow professionals with discounts or coupons.
 
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charles007

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About 25 years ago while I was customs staining the patients crown, or taking a shade, the patient ask what I charged the doctor. I told her the price and she was very surprised. Several days later my doctors wife gave me a very unfriendly telephone call..........hehe

Edit........I no longer tell patients and haven't since that wake-up call....
 
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amadent

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this is just my opinion but for the most part patients are not concerned with lab price,
they are only concered with the price they are paying the DR.
who of us hasnt heard from a patient I just want my teeth to be right, i am paying the Dr. alot of money.
for the most part it is assumed that the Dr. is paying the lab a fee in- line with price he/she is charging the patient
 
dmonwaxa

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We have full disclosure here.
Separate lab fees from the Dentist.
Patients are able to make informed decisions.
We are self regulated professionals.
I don't cut down my fellow professionals with discounts or coupons.

HeHehHehe...;)
 
rkm rdt

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Standards Respecting Conflict of Interest
College Guidelines contain practice parameters and standards which must be taken by all Ontario dental technologists in the provision of their services. It is important to note that these Guidelines may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained.
INTRODUCTION
This document attempts to summarize and explain in simple language the College's draft Regulations on "Conflict of Interest for Members" which was circulated to members for information in July 1994. It should assist members to better address a range of potential conflicts arising from their practices and business arrangements. Members should always refer to the pertinent sections of the August 1994 draft regulations for specific details and further clarifications.
According to O. Reg. 798/93 s. 11, it is an act of professional misconduct for a dental technologist to practise the profession while in a conflict of interest.

CONFLICT OF INTEREST SITUATIONS
Simply put, a conflict of interest is created when you put yourself in a position where a reasonable person could conclude that the dental technologist is making arrangements that may compromise, or affect his/her professional judgement, or that of his/her client(s). In this context, a "client" of a dental technologist would include the referring health professional. Where a member directly, or through an affiliated corporation, offers financial or other inducements to a dentist to make a referral to the member, the interests of the patient(s) may become secondary to the self-interest of the referring dentist, the client. It is the College's function to protect the public interest by the elimination of arrangements of this nature. Whether actual or perceived, conflicts of interest give the public the impression that their care or the cost of their care may be compromised by you. It is for this reason that conflicts of interest must be avoided. As a result, acting while having a conflict of interest may constitute professional misconduct. 1.
Inappropriate "Arrangements" or "Business Relationships" with other health professionals

Dental technologists are entitled to profit appropriately from the use of their training and experience in providing professional dental technology services. Attempts to enter into any "arrangements" or "business relationships" with other regulated health professionals or providers or health care facilities for the purpose of inducing referrals, generating service volume, or any type of financial profit or material gain are likely to constitute conflicts of interest. For example, the following actions must be avoided:
◦offering quantity discounts or discounts for prompt payments to dentists;
◦offering gifts, airline tickets or air miles as incentive programs to dentists;
◦offering rebates, credit or other benefits to dentists;
◦making special arrangements to finance dentists' purchases of equipment, facilities and supplies;
◦providing benefits that do not directly benefit patients.

2.
Fee or Income Splitting

Dental technologists may not fee or income split with anyone other than
◦a dental technologist who engages in the practice of dental technology as an employee of yours;
◦another dental technologist who, while not employed, comes to your office to provide services as an independent contractor for your laboratory;
◦a dental technologist who engages in the practice of dental technology as your partner.
As a result, contractual arrangements, such as a lease or use of premises or equipment which provides for fee or income splitting, create a conflict of interest. This would prevent a dental technologist who rents space or equipment from paying rent based on his/her billings.
3.
Self-referral

In the process of a dental technologist's involvement in the treatment of a patient, it is a conflict for a dental technologist to refer a patient or a regulated health professional to individuals, facilities, services, or supplier without disclosing his/her ownership or controlling interest or from which the dental technologist, his/her family or corporation derives any financial or material benefits.
It is also a conflict for a dental technologist to exercise influence to promote the sale of materials, devices, products or other supplies without disclosure of his/her ownership or controlling interest and disclosure of the interest of a related person or corporation.

(To avoid problems that might arise from self-referral, members must ensure full disclosure to the prescribing health professional prior to providing the services; and that use of the product, device, facilities etc. is in accordance with the standards of practice of the profession and, in the circumstances, is appropriate.)

4.
Personal, moral or philosophical conflicts

A dental technologist's personal, moral or philosophical beliefs or practices must not impede patient's appropriate and timely access to services.
DEFINITIONS
For the purpose of understanding the scope and applicability of the guidelines and regulations relating to conflict of interest, the following definitions are used: BENEFITS "Benefits" means any benefit (financial or non-financial),gift, advantage or payment of any kind, whether direct or indirect, and, without limiting to the generality of the foregoing, includes:
a.any monetary payment;
b.any rebate, credit or discount on or reimbursement of the cost of goods or services;
c.the receipt of goods or services at no charge or at a cost which is less than prevailing market rates;
d.the payment or reduction of any amount of any debt or financial obligation;
e.the receipt of any consultation fee or other fees for services rendered;
f.any loan except in accordance with stipulations in the draft regulations of August 30, 1994;
g.the acceptance of credit unless the credit is extended in accordance with stipulations in the draft regulations of August 30, 1994.

RELATED PERSON "Related person" means any person connected with a member by blood relationship, marriage or adoption, or a business partner.
CONTROLLING INTEREST "Controlling Interest" means the interest that a member has in a corporation. The ability to control 10% of the votes of equity shares is deemed to be control.
 
Mark Jackson

Mark Jackson

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Why the prices we take for restorations are being kept from the patients.
Well ,dentists say that prosthisis prices are high (too high) because dental technicians take a lot of money to fabricate the prosthisis.
Shouldn't the public be aware much more about the prices? Isn't the public's right to know exactly how much he paid for a restoration, and how much the dentist earned?

I don't think it's any of the patients business. They negotiated a fee for the work with the dentist, not me. I don't know what the restaurant charges for the steak I paid $30 for, and in most cases when I buy something retail, I don't know what the dealer paid for the item. Sure there are exceptions to this rule, but the bottom line is, the professional is doing the work, and providing a service, and the crown is just a small part of it.
 
rkm rdt

rkm rdt

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"I don't know what the restaurant charges for the steak I paid $30 for, and in most cases when I buy something retail, I don't know what the dealer paid for the item."

I don't consider making a dental restoration to be at par with cooking a steak.

I guess that's the difference between a manufacterer and a Dental Technologist.
 
Mark Jackson

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"I don't know what the restaurant charges for the steak I paid $30 for, and in most cases when I buy something retail, I don't know what the dealer paid for the item."

I don't consider making a dental restoration to be at par with cooking a steak.

I guess that's the difference between a manufacterer and a Dental Technologist.

Your chances of being made sick, or choking on a piece of steak are much higher than that of a crown, both of which go in your mouth, but it was just meant as an example of things that carry a 100% markup or better.
 
kcdt

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I don't think it's fair to compare how things work in Canada with the US. Apples and oranges, IMHO.
I would be uncomfortable telling a patient what the dr pays for the restoration because,
A. The patient isn't REALLY interested in the dr's clinical overhead costs, which DO drive the price of the restorative procedure, rather, they tend to be less than honorably motivated to ask, and,
B. Stirring said **** in the pot is interfering with a dr patient relationship.
C. I have enough godd**n problems.
 
rkm rdt

rkm rdt

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Actually your analogy does not make any sense.

If you choke on that steak it's your fault not the chef's.He didn't feed it to you.If the steak has salmonella then that's the restaurent's liability.

The dentist places the crown in a controlled act.You give consent based on an informed decision.Big Difference!

Again I will point out:

" Dental technologists are entitled to profit appropriately from the use of their training and experience in providing professional dental technology services. Attempts to enter into any "arrangements" or "business relationships" with other regulated health professionals or providers or health care facilities for the purpose of inducing referrals, generating service volume, or any type of financial profit or material gain are likely to constitute conflicts of interest. For example, the following actions must be avoided:
◦offering quantity discounts or discounts for prompt payments to dentists;
◦offering gifts, airline tickets or air miles as incentive programs to dentists;
◦offering rebates, credit or other benefits to dentists;
◦making special arrangements to finance dentists' purchases of equipment, facilities and supplies;
◦providing benefits that do not directly benefit patients."


The patient should benefit directly from any incentives NOT the dentist.Bottom Line!
 
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charles007

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I agree with Mark, "Its not any of the patients business what we charge". If you put yourself out there giving out prices to the public or patients, you may easily lose an account......I gave out my price to one patient that asked, and realized I'd may a big mistake as the words came out of my mouth...
To be fair, doctors have an extremely high overhead cost in the 70-75% range...Having to explain to patients why the high markup would not be easy for all patients to understand........and impossible for many.....
 
Mark Jackson

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The patient should benefit directly from any incentives NOT the dentist.Bottom Line!

I disagree. I also would HATE to have to collect money from the patients. I have a hard enough time getting labs and dentists to pay. I send out about 600+ statements a month. If I had to collect from patients, that would be between 3500 and 4000 individual people I'd be trying to collect money from, or have to generate paper for.

No way, not in my lifetime.
 
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patmo141

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@ rkm rdt

Just out of curiosity, do you disclose to dentists what the price of the porcelain or other materials you use are?

@Mark

You analogy is very well taken. When you buy the steak, you are buying the meat, and paying for the service to skilfully prepare it and for the overhead to get if from cow to mouth. If the cook is skilled, and the meat comes from asia and has to be handled with care, we don't mind paying for it.

Same when we purchase a crown from a lab

Same when a patient pays for a restoration.

as long as everyone understands what they are paying for disclosure shouldn't be a huge deal but I don't think forcing the issue is going to be a productive one.
 
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patmo141

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@ rkm rdt

"The patient should benefit directly from any incentives NOT the dentist.Bottom Line!"

There is some definite truth to this. If you found a new lab process which was ____% less expensive, it should correspond to a ___% decrease in that part of the price to the patient not a __% increase in the dentists margin. I'm with you there.

-Patrick
 
Clear Precision Dental

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@ rkm rdt

Just out of curiosity, do you disclose to dentists what the price of the porcelain or other materials you use are?

e.

I was thinking along the same line. If I charged $185.00 for an eMax crown, but I had to disclose that I pressed 2 crowns and 2 veneers from an ingot that cost me $20.00, then some idiot would wonder why I am not charging $4.00 per crown and they would be mislead into thinking they were getting ripped off.

It is all related to the service provided. The patient is getting the package deal price of all related treatment. The scheduling by the office staff, assistant time, Dr. time, reusable and disposible supplies, office rent, actual or implied warrantee, office fees (licensure, malpractice insurance, benefits, continuing ed, etc..),, oh, AND MY LAB FEE. The Dr. is the coordinator and presenter of the treatment, and collects the related fees. It would be a nightmare if every provider of the package had to charge the patient for their individual slice of the process !!!!
 
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patmo141

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In fairness to the patients, who have little idea what goes on from porcelain press to crown seating, if they saw just the lab bill and just their dr. bill, they would probably assume they were getting ripped. I think it's a valid assumption when you look at how the rest of america works. I don't think disclosure should be the standard because of the rigmarole (as others have stated) but I do think if a patient asks, they deserve a full explanation. IF the dr. has nothing to hide, it should be no problem. The option to know should be freely available. Kinda like a credit report. You don't get one in the mail unsolicited, but if you ask for one they are required by law to disclose.
 
rkm rdt

rkm rdt

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So when you get your car repaired what does the bill look like?

I think the insurance companies will dictate the terms of their compensation more critically in the future.

The patient is given the Dr's estimate and the lab estimate for the work required.
The insurance companies can see the breakdown as well.


@ rkm rdt

Just out of curiosity, do you disclose to dentists what the price of the porcelain or other materials you use are?


I disclose my total crown fee. I am allowed to make a profit from my work.

"I disagree. I also would HATE to have to collect money from the patients. I have a hard enough time getting labs and dentists to pay. I send out about 600+ statements a month. If I had to collect from patients, that would be between 3500 and 4000 individual people I'd be trying to collect money from, or have to generate paper for."

I invoice the dentist,he collects from the patient. If I offer a discount then the patient gets that discount.

It's that simple.
 
araucaria

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When the patient goes for treatment and asks "I want the best teeth you can get" you'd expect the doc to inform the patient of the options available.
When I go the garage for new tyres I'm asked which type or budget I'd like, and if needed I'll be given further information. eg - Pirelli, Goodyear, Firestone, etc etc...
If i gave a trusted person $60k to go buy me a top quality car then I'd be expecting just that and nothing less - eg a Merc or BMW etc etc..... and if that person came back with a basic (eg ford small) and pocketed the rest I'd be alarmed and cheesed off bigtime.
In our industry it is the skills, service, backup support, knowledge, artistry etc that is the thing up for sale and not just the end-product. If the doc pays my fees and keeps returning for more then I don't really care what he's charging 'cos it's his choice how he sell's himself. I do get miffed when I see poor or cheap labwork being sold off as Top-end stuff and the patient's ignorant to what's going on. Don't think there's a 'best' answer to this subject.
 
rkm rdt

rkm rdt

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"I disclose my total crown fee. I am allowed to make a profit from my work."

Actually I disclose my crown fee plus the alloy charge.

Anyway it's good to know you guys are happy the way things are down there!

Good debate!
 

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