What is the industry standat of ceramic production?

[Al.]

John, why do you think single crown prices are plumetting and who do you think is responsible for that?

Part is insurance companies, I know several drs getting under 700 for crowns.

 

[JohnWilson]

Actually the biggest factor is technology. It remains to be seen if there will be viable options for the small lab to produce sub 100 units in a cost effective profitable manner.

I choose not to gamble on technology when it gets into the 7 figure range its just way too much liability.

There are always the type of clients out there that will want something higher end but the broad range of clients out there wants something that is:

1 Cheap
2 On time
3 Predictable
4 Cheap

Glidewell is an amazing example and have in the past 10 years really elevated their game. I among many of you would always feel that we could and did produce a superior product. In most cases we were correct but their growth and their market share sure didn't diminish did it?

As the machines catch up with the cheap labor that outsourcing has had on its side its only a matter of time before we all cut out own throats as it relates to simple quadrant dentistry. It will be at this time when our biggest fears may be realized. Thats when our vendors decide to grab OUR piece of the pie as well as the consumables we purchase every month.

Take a close look at what you produce each month, look for trends, stop blaming the economy, and start looking for things that you can do that can not be replicated easily. Then look at your market and really consider if those skills are in demand by enough potential clients to have growth and you will then and only then be able to make a plan for the future.

 

[charles007]

So much insight from you guys I will never get any work done if I keep reading this thread......
Keep posting......its Fri......

 

[Mark Jackson]

Part is insurance companies, I know several drs getting under 700 for crowns.

Then they should not participate in those insurance plans. THAT my friend is a cop-out, and exactly the way dentists who use Chinese labs justify this to you and their colleagues.

"Well, what can I do? After all, I only get $700 for a crown. I HAD to use the Chinese lab!"

No, you have the right to say that you will not participate in managed care plans that do not pay a decent fee for the work you do. May dentists choose to participate in capitaion plans that pay them a fixed amount per month. They take the cash and hope that NO patients come in. Then they get bent when they don't get paid for a crown.

It's just like labs who accept crappy products from manufacturers or who use off label, unapproved materials. It erodes the infrastructure of everything we do, and give us an easy scapegoat when we need to justify our bad behaviors.

Don't let them fool you Al! The erosion of prices is primarily driven by cheap off shore work, counterfeit products and lab owners who peddle the stuff.

We made our own beds.

 

[rkm rdt]

"Then they should not participate in those insurance plans. THAT my friend is a cop-out, and exactly the way dentists who use Chinese labs justify this to you and their colleagues.

"Well, what can I do? After all, I only get $700 for a crown. I HAD to use the Chinese lab!"
Or the Dentists could say to the insurance companies," fine, $700 is fair but don't expect me to pay for the lab bill out of that."



Our association went to the insurance companies with our fee guide . They were happy to have tangible costing related to their coverage.They have no problem raising their premiums do they?

 

[Mark Jackson]

Our association went to the insurance companies with our fee guide . They were happy to have tangible costing related to their coverage.They have no problem raising their premiums do they?

Price fixing by any dental lab association is an antitrust violation and will win you a quick trip to jail in the US. In fact, every meeting we have begins with a written statement, read aloud to all in attendance, that the discussion of fees is not allowed, and as I recall may have even been one of the reasons contributing to the shutdown of the NADL forum.

 

[rkm rdt]

"Take a close look at what you produce each month, look for trends, stop blaming the economy, and start looking for things that you can do that can not be replicated easily. Then look at your market and really consider if those skills are in demand by enough potential clients to have growth and you will then and only then be able to make a plan for the future. "

You make a good point here.If you look at other industries or trades you can see how they have evolved over time.

I like to use your local garage/mechanic as an analogy.Look how the "grease monkey" has become a highly trained (and well paid i might add) service technician.They are computer savy to meet the demands of the high tech cars of today.They are the money makers for the dealerships as well.
What is their hourly rate these days?

I think the dental technician will evolve as well if we can become recognized for what we do and know.

I sense a real disconnect( almost animosity ie Dental Town) between the Dentists and the Techs in the US. Am I correct?

 

[Mark Jackson]

I sense a real disconnect( almost animosity ie Dental Town) between the Dentists and the Techs in the US. Am I correct?

Absolutely. Especially amongst DentalTown dentists, who represent the younger sector. It's a scary trend.

 

[charles007]

Many of these younger dentist look at Cerec/e4d at being the end of having a lab bill. Wait till the older dentist start selling their practices and retiring . Its going to be a new world for the remaining labs.

When insurance companies are paying out $700. and less for crowns, with lab prices getting lower, and or stable, why would an insurance companies pay more.

 

[rkm rdt]

So the dentists don't have a fee guide ?

 

[rkm rdt]

So fee gudes are price fixing? That is so over the top that I'm beginning to see who is really at the root of all your problems.

 

[doug]

I think it's important to remember that two dentists sitting and having lunch talking fees is vastly different than 200 of them talking fees in a meeting. One is an anti-trust issue, the other is pleasant conversation on the state of their business. Talking fees here may be a problem, doing it in a private email, not so much. Percentages are always a good way to get around the issue.

 

[Mark Jackson]

So the dentists don't have a fee guide ?

Absolutely NOT!

Dentists should exercise caution when contemplating any collective negotiations of contract terms with insurers or health plans, and should consult legal counsel with expertise in antitrust matters before undertaking any such discussions. For more information read:

http://www.indental.org/uploads/antitrust_booklet.pdf

 

[Mark Jackson]

So fee gudes are price fixing? That is so over the top that I'm beginning to see who is really at the root of all your problems.

Here in America, we have free trade and the law of supply and demand rules the day. As long as everybody is playing by the same rules, it is the best way on earth to do business.

I don't want anybody telling me how much to charge any more than I want the dealers having someone tell them how much to charge me for supplies.

It must be free and clear all the way up and down the supply chain.

 

[Hal2a]

"I like to use your local garage/mechanic as an analogy.Look how the "grease monkey" has become a highly trained (and well paid i might add) service technician.They are computer savy to meet the demands of the high tech cars of today.They are the money makers for the dealerships as well.
What is their hourly rate these days?"

When a auto tech does an oil change, changes tires or swaps a carburator he has a book that says oil change-1 hr, change tires-1/2 hr, or carb swap 2hrs. Its been defined within their trade, the allocated times for specific tasks. The hourly rates are negotiable and rightly so, but at least there is common ground with respect to the time/procedure.
It provides a starting point for fair compensation.

 

[rkm rdt]

From what I can see,it's the insurance companies that are doing price fixing down there .

I was surprised to find out that Alberta D A has dropped their fee guide.Apparently there was also a misconception that they had fixed prices which was not so.

To say that a fee guide is price fixing is misleading. Our fee guide for example is based on a time study using our standards of practice.By following the proper manufacturers and the minimum technical proceedures for each task ( ie denture fabrication) a time study was developed.By inserting an hourly labour rate,material cost, overhead , etc EACH INDIVIDUAL can determine THIER OWN fees .

Having said all that, very few labs that I know charge anywhere near our fee guide.When you input the actual costs with a fair hourly rate( I used the rate of my local auto garage) you get a number that is probably 50% higher than what the average lab charges.

A far cry from price fixing.