Asked for Dental NHS Scale and Polish.Told "Go to Hygienist at £25 extra"

boozercruiser

welshdent wrote: »

Denticare are notorious for doing the following ... buying a practice out. Cutting the existing dentists earning potential by approx 30% to "encourage" them to leave. They then fly over stacks of EU dentists from places like eastern europe and portugal. These dentists have little if any idea about how the NHS works and go on what they are told by practice managers etc. They are told that they can not do x y or z and that a b and c needs to be done privately. They are paid significantly less than they should be earning while the corporate that owns the contact creams off the rest for the shareholders. As an example. In a normal practice where a local individual owns the contract - they may have an associate working for them and the agreement is that the associate works towards a UDA target equivalent to £X.

The associate keeps 40 - 60% of the gross depending on the agreement. It is usually around 45% - 50% minus lab fees.

The principal would get the rest i.e. 60 - 40% to meet their costs and run the practice by providing staff and materials etc. Any profit is kept by the principal who may chose to invest in the practice or buy themselves a new kitchen! Either way the money is reinvested locally.
Corporates on the other hand do not do this. They would pay around about 30% to the associate and then the rest goes to share holders.

They IMO abuse the dentists they bring over because a lot of the time the do not know any better.
THis didnt happen on the old system as many of these corporates didnt exist. Also the contract itself was wholy different and MUCH clearer as to what could or could not be done. This new one is horrible but I believe is due to be changed in 2012. I promise you its no scam though. Also if you ARE seeing a hygienist at a corporate then I very much doubt that the individual dentist is getting anything out of it.

Thank you for all of your very illuminating information and for your valuable time spent giving it Welshdent. Very appreciated, even if we don't exactly see eye to eye on this general matter.:T

Since I have lived near Machynlleth for six years we have had no fewer than FIVE different Polish or similar (no disrespect meant to them of course) Dentists. As we have not had one at all for the last six months then my Wife and I are having to travel to Newtown, and last week I saw...yes a Polish Dentist for a check up.

She said "You need two fillings, an extraction (Of a back tooth) and a separate visit to the Hygenist". No explanation as to why I needed the extraction (I have had no pain).
She was rough, curt and off handed....obviously not a happy bunny who enjoyed her work.

However, when I challanged her that I was requesting a scale and polish under this particular course of treatment...she did not answer. Perhaps she didn't know how to?

I mentioned my thoughts about her to the Practice Manager who said she would have a word.
God help me at the fillings and extraction in January 2011.:D

welshdent

booze they bring them in because they are cheap to employ, easy to take advantage of and easy to move along when things start getting sticky. What you see at these corporates is not IMO quality dentistry and being brutally honest I feel you would be better off finding a private practice regardless of entitlements and overall payments in tax. There are some excellent private dentists that are very reasonable. I do know for a fact that there are a LOT of honest legitimate NHS practices and GDPs that practice to the best of their abilities and as ethically as possible. That is in Wales too. There are major concerns over the import of these eu dentists. They have not had to do the same post qualification training pathways that we have had to do although that is set to change ... due to EU law and freedom of movement etc. We had to do a scheme called vocational training after qualifying. Most EU dentists do not have to. There are some countries where they do not train their under grad dentists to carry out extractions. I used to look after exchange students and we had some come from lithuania. I was told by them that they tailored their course to what they wanted to do i.e. if they did not want to make dentures they didnt do the course.

Regards scale and polish I wont lie. I do from time to time recommend my patients see the hygienist privately. she doesnt work for us on the health service terms because she would be too expensive frankly. I usually send my patients needing what would be a band 2 course of treatment to her that are over 60 as it is cheaper. She charges £20 compared to 39 for a band 2. Actually sometimes I send my under 60s to her as it is still a bit cheaper with her even with the band 1 charge from me. I also have some patients that WANT to see her. I wont send my band 1 scale and polishes to her because it would cost me more for them to see her than I would make for the whole course of treatment including the examination. We get one or 2 wanting an NHS scaling with her but I usually politely explain to them its NHS with me or private with her. I would be better off handing them a fiver and saying go elsewhere as it would cost me less LOL.
I am not really one that quibbles over a "cosmetic" scaling unless they are genuinely spotless and I see no need to scale them. If they are insistent they are welcome to see the hygienist but its so rare they fall in to this category where I work that its barely worth a mention.

From the story building up from you my inclination is to say go easier on the dentist because they are probably just doing what they have been told. In lithuania, poland and all the other countries the corporates recruit from the dental services are all private. They do not initially grasp the concept of our daft system or understand its finer points. They have the briefest of inductions and are told to get on with it and do the UDAs that are required. If you want to make a stand then its the people employing them that are the problem. However LHBs like corporates (well they thought they did) because its one big body that will offer to give them lots of dentistry cheaply. Following shipman there is an inbuilt idea that we are all like him. They also do not like the idea that there is a lot of independent practices which means a lot of different people to deal with. Corporates have a lot of money and have big contracts and many of these abuses have a blind eye turned to them

But I guarantee you we are not all crooks trying it on. I also guarantee you that I do not know anyone earning the massively high incomes quoted!! Dentists in general practice quite literally earn every penny because if they didnt they would get nothing.

welshdent

Someting to bear in mind - make sure you get an FP17DC (IIRC) outlining proposed treatments or at the very least a computer generated quote showing what is proposed and what is NHS and private. I issue one with all band 2 and 3 treatments and any band 1s that involve mixing or additional private treatments. Lack of pain is not a good indicator of needing an extraction or not ... however you are entitled to a diagnosis to justify the proposed treatments. If I am doing an extraction or root filling I always include a specific diagnosis in my consent forms and outline briefly alternative treatments if any. I am always happy to explain or demonstrate my findings and reasoning for treatments. It is no less than you are entitled too anyway

mandi

welshdent wrote: »

Calling something a scam in the context here and from a poster with "previous" implies to me that this scam is something we have all dreamed up to screw an extra few quid out of people. It implies this is big conspiracy all us evil dentists do. I just get a little battle weary so to speak of having to continually defend myself and the others that I know do things by the book.

I admire the fact that you don't take advantage of your patients welshdent, but I think some dentists do mine included .

It's a little like taking your car to the garage for an MOT really .:)

leppy_2

My dentist said that I could have the nhs clean and polish but my teeth and oral hygene were so bad I needed a £25 appt with the hygenist. Being rather upset by this I agreed. At my appointment with the hygenist, (same surgery) I sat in the chair, she examined my mouth, and said 'not much to do here, your teeth and mouth are in really good shape'!!!

So tell me its not a con? They couldn't even get their stories straight.

welshdent

leppy wrote: »

So tell me its not a con? They couldn't even get their stories straight.

Whats the point? You wouldnt believe me anyway. Have you not read any of what I have written??

I have never said there are not dodgy dentists out there. Just like there are dodgy builders, plumbers, doctors etc etc.
Sitting there are branding us all con artists is grossly unfair.
I can not possible hope to comment on anything you have been told. I can not see your mouth and I can not see your notes.
When I refer patients to see my hygienist I do not go in to "get the story straight", I make a diagnosis based on my examination and I ask her to carry out the treatment I feel is needed. Simple as that. If anyone feels the need to question diagnosis there will be at the very least a basic periodontal examination and a comment on oral hygiene outlining need

welshdent

mandi wrote: »

I admire the fact that you don't take advantage of your patients welshdent, but I think some dentists do mine included .

It's a little like taking your car to the garage for an MOT really .:)

some do indeed take the mick. I think also many people would be surprised to hear that a dentists biggest critic is another dentist. There is very little backing up of mates that I have seen during my practice. I am the first person to say what has been done wrong when I believe it has been. What we do try and do on here is to provide a balance with the other viewpoint. The viewpoint that with all due respect, the average joe on the street will not appreciate or understand.

But what is not occuring is a giant conspiracy to defraud the public. Allegations made here may be a practices employed by individuals but I can assure all on here we do not attend courses on how best to con money out of people.

Toothsmith

Another thing to bear in mind is that the 'Denticares' of this world are also the prefered providers of the local health commissioning boards (PCTs at the moment, although they're abut to be abolished).

The PCTs would much sooner deal with one 'head office' when negotiating a contract for dental services than lots of individual practice owning dentists. Plus, the big corporates have an whole department dedicated to 'governance' - so it can produce lots and lots and lots of written protocols and proceedures and policies which tick all the boxes so that the PCT can 'show' they have commissioned a 'quality' service.

They then turn a deaf ear to the complaints of the patients who are being ripped off by them.

Yes - there is a huge conspiracy within NHS dentistry.

But you have to dig a little deeper to find the REAL people operating it.

Practice owning NHS dentists trying to provide a decent service for their patients are as much a victim of the process as the patients.

boozercruiser

Dear Toothsmith and Welshdent in particular. Thank you again for all of your very valuable input to my original thread, and now to the restart due to my going back recently to the EU Dentist!:T

I am finding your 'insider' views and thoughts on how you both see this very interesting indeed. I have read every word and gratefull advice has been given, not just to me but to all who have viewed the reply's.:A

When all is said and done on this subject I am happy I did this post because the direction I have come from in a nutshel is.....

We are all giving opinions on a very respected 'Money Saving' Web Forum. If I have saved just one person from having to pay £25 and upwards extra for a trip to the Hygenist, rather than the usually available Scale and Polish under the relevant band...then I am happy.

Welshdent....I hear what you say that it might even be better for me to seek out a Private Dentist. Actually here in Machynlleth there is a Private Dentist. People also tell me the he is very good indeed.

However, the possibly runaway cost I may have to face frighten me off!

At the moment I still have most of my teeth....but say at my now age of 68 I was to run into bad problems, possibly ending with me needing Dentures. Bearing in mind that the Dentist did say that I had some gum disease.

I think the most I can pay under the NHS is £179...God knows what a Private Dentist situation would be.

Too much for a 'Poor Pensioner' I bet!:rotfl:

Best Regards

Boozercruiser.

welshdent

boozecruiser it may interest you to know that every fully private dentist I know has very few emergencies. That may not mean a lot to the average joe on the street but to the dentists here it may cast a different shadow so to speak.

I know the biggest concern to a lot of people is cost however cost is only expensive if you need much doing. Almost all dental problems are in effect self inflicted. That means that the better you are at managing cleaning and diet the less likely it is you will need anything doing. I once saw an 89 year old patient that had all their teeth and had never had any work done. When I saw them they didnt even need a clean.
What SHOULD be happening in a private practice is they have more time to spend with you working on prevention and as a result they can hopefully reduce the problems you get and as a knock on ... have fewer unexpected emergencies.