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This months opinion is a posting from the Internet Dental Forum that I found to be so well written that I had to put it up as an article on the BITE-IN website. The post is a response by Dr. John Jacklich to one of the IDF members in regards to a suggestion that continuous new technology just increases the equipment investment of the dentist, which in turn forces the dentist to hike up costs. Dr. Jacklich is one of pioneers of endodontic technology and is currently in a time period where a total paradigm shift of endodontic techniques is about to take place, courtesy himself. Dr. Jacklich very beautifully answers this poser and brings out the logical flaw in this argument and in fact makes a fool proof case of how tehcnology rather works to reduce costs. I personally agree in totallity with Dr. Jacklich's contentions and propositions. The entire basis for Dr. Jacklich's argument is an objective and rational sense of life based on facts of reality. This is just one of the concrete examples of a very strong underlying philosophy. The same principle would apply to technological progress in any other human endeavour. The section just is a reprint of the post made by Dr. Jacklich. New Technology in Dentistry
Hi Guy, I appreciate your comments but I have to disagree with you on some of your assumptions.It is not the introduction of new equipment that causes fees to increase. If a new piece of equipment enables a dentist to do a procedure in half an hour instead of an hour, he has several choices. He can lower his fees by half and do twice as many procedures. But this would be marching in place wouldn't it. If he were a true altruist he could in effect donate the cost of the new equipment to his patients feeling he had done some good for humanity. Of course, it would penalize his family to do so. He can keep his fees the same, still do twice as many procedures and make twice as much money. I fail to see how this hurts the patients. They still get the same procedures done with less chair time and discomfort at the same fees as they always did. The dentist provides his family with more security. If the ease with which he does them translates into a greater willingness to do them then they both benefit Or as an option, he can do a combination of these. Lower his fees slightly, do more procedures which benefit his family's security, saves the patient money, and makes the procedure less uncomfortable. If this happens then the general level of fees decreases because of the natural process of competition in a free economy. The only way that I can envision your scenario of raising costs to patients is if the dentist does the same procedure in the same amount of time and raises his fees. If the purchase of better equipment can be paid off in terms of saved time, it benefits the dentist, the patient and society at large. If the equipment does not deliver on it's promise of increased efficiency then you would be right but if that happens we should spread the word that the equipment is a loser and let it fade into history. We should be on the lookout for false promises but try to keep growing in wisdom and knowledge with the goal of better service both to our families AND to our patients. And we should not proceed from a basis that all advances are adding expense to the patient.Look at air turbine handpieces, high volume suction, indirect restorative work, chrome-cobalt castings, better anesthetics, and a whole host of other advances that have made dentistry better. We are now looking at IO cameras to better spread the good word, yes, to sell dentistry. Air abrasion technology to make preparations easier. Better forms of anesthesia. Advertizing to get the word out. Sharing of ideas on the internet to better educate ourselves. etc Of course there are some technologies that don't prove out in practice. I've seen many in my career. But there have also been some that 95% of the dentists shunned that the other 5% have adopted and used successfully. We all practice differently. Thank God that we can because that is how new ideas develop. Life is not a zero sum game. It is indeed possible to spend lots of money on new technology AND lower the fees that we charge patients AND do a better service.I'm no seer at operative or C&B but I can tell you why fees in endo have gone up. It is because we have NOT advanced the technology. Dentists are still hand filing and filling with gutta percha. That's like using slow speed handpieces, hatchets, hoes, and chisels to do preps. And I'll bet there are still some using K-files and wondering why they have to recapitulate to avoid ledges. Fee schedules are set by the insurance companies and by tradition so that even the slowest, most incompetant of dentists can make money at endo. If every time a new technique came out, they would lower their fees, some dentists would quit doing endo. Since the TPRs don't want that to happen, they save money other places. Others would adopt the technology, adapt or lose out. We are going through a phase right now where we have educated the public to we expect teeth to be saved but have not yet trained enough dentists to do it...endo I mean. I began making automated endo respectable only in 1976 and have so far only taught about 20,000 of the some 150,000 dentists. Sargenti awakened them. Rotary NiTi and others have trained a few more. But it takes a promise of a reward, namely higher income or easier work, to move some people off their a**. There is nothing wrong with a dentist making more money if he provides a better service. We should be proud of our profession for the advances we have made and holding the line on fees. My new handpiece makes it possible to prep a canal in just a few minutes. The Fine-Cut Hand Files make probing some seemingly blocked canals probe-able. And now the new syringe is going to make it possible to fill a much smaller canal in just a few seconds. And this means that it will no longer be necessary to over-enlarge and weaken teeth to get our pluggers in. Sure some dentists are going to make lots of money with it. I doubt if many are going to increase their fees. And if every dentist who avails himself of my additions to technology does even one more endo a day, we'll save a lot of teeth. Dr.
Jack Jacklich, 102 Western Court, Santa Cruz, CA
95060 Automated Endo on the Internet http://www.BetterEndo.com "A
single wave may recede but the tide inevitably rises and
when it ebbs,
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