NHS Hygienist

KARO

welshdent wrote: »

Think you will find it was you that was doing that karo. I have better things to do with my time. I was just pointing out that not all dentists are "maximising their income" (your words not mine) by referring to the hygienist

Do you?

You were caught out, making an assumption (in favour of the dentist, naturally) that you couldn't substantiate.

selement

I find the dentist advises me to visit the hygeinist most appointments, which would be private rather than nhs (of course they dont mention that until you go back to reception that it'll be an extra £30 or whatever).
So if the dentist is recommending it surely that should technically be covered in the band 1 treatment? I strongly suspect its more money for the dental practice. I dont normally go.

welshdent

you really do interpret things oddly Karo. Ah well have a nice day and enjoy that chip on your shoulder.

welshdent

The problem is we cant see you so it is hard to gauge your needs. The NHS "scale and polish" is technically to just remove calculus. If it is solely to remove stain then the dentist is allowed to carry this out privately or refer to a hygienist.
My point re maximising income on Karo was not as they seem to think to defend all dentists. It was to illustrate that a lot of misinformation is out there. Most dentists get nothing for referring to a hygienist because someone else is doing the work. We only get paid for what we do. All it would serve to do is free some time up for other work.
When you pay for a band 1 you are not paying for a check up a clean. You are paying for a course of treatment of which a clean MAY be provided based on your own personal need.
It is complicated and open to interpretation which is exactly what the architects of the contract wanted it seems - otherwise they would have clarified it by now.

What you SHOULD be getting is an assessment called a BPE - if they call a number 2 or higher then you have a clinical need and thus it should be provided. If you get zeros or 1's then a scale and polish is not indicated. ... in fact if you have 3 or 4 you need more than a scale and polish! Occasionally a hygienist privately may be cheaper than the NHS fee if you have 3s and 4s.

KARO

welshdent wrote: »

you really do interpret things oddly Karo. Ah well have a nice day and enjoy that chip on your shoulder.

And you welshdent. Glad to see you're not so busy practising dentistry that you can't post on an internet forum. Got one hand in the patient's mouth and the other on the keyboard have you? :rotfl:

mal4mac

welshdent wrote: »

Most dentists get nothing for referring to a hygienist...

What about the dentist who owns the practice? I bet he gets a large cut, and the other dentists need to keep in his good books.

What you SHOULD be getting is an assessment called a BPE - if they call a number 2 or higher then you have a clinical need and thus it should be provided. If you get zeros or 1's then a scale and polish is not indicated. ... in fact if you have 3 or 4 you need more than a scale and polish! Occasionally a hygienist privately may be cheaper than the NHS fee if you have 3s and 4s.

She did call out a lot of 3s, and at least one 4. So shouldn't that be Scale 2 NHS? After my exam I asked the nurse/receptionist what the charge was and she said Scale 1 £18.80, then I asked about the hygienist, and she said £64. And she was there when all the 3s were read out, so she knew I had a clinical need. Scale 2 is £51.30 so they appear to be trying to game me out of £21.50.

Given the bad state of my teeth & gums I might expect to pay scale 2 four times a year (max.) Which is fine - £200 I can live with - but if I get a band 1 check plus £64 hygienist each time that's not fine!

welshdent

mal4mac wrote: »

What about the dentist who owns the practice? I bet he gets a large cut, and the other dentists need to keep in his good books.



She did call out a lot of 3s, and at least one 4. So shouldn't that be Scale 2 NHS? After my exam I asked the nurse/receptionist what the charge was and she said Scale 1 £18.80, then I asked about the hygienist, and she said £64. And she was there when all the 3s were read out, so she knew I had a clinical need. Scale 2 is £51.30 so they appear to be trying to game me out of £21.50.

Given the bad state of my teeth & gums I might expect to pay scale 2 four times a year (max.) Which is fine - £200 I can live with - but if I get a band 1 check plus £64 hygienist each time that's not fine!

Still no on the keeping sweet allegation you make. It just doesnt happen. I hear anecdotes that sometimes corporate practices "encourage" the use of the hygienist but not in normal privately owned practices.

If you do indeed have 3's and 4's then yes you would have a clinical need. I have not examined you obviously so do not know the state of your mouth but if you are concerned call the practice and ask

mal4mac

welshdent wrote: »

I hear anecdotes that sometimes corporate practices "encourage" the use of the hygienist but not in normal privately owned practices.

How do you know? Have you gone undercover to investigate several practices?

Dispatches have and they found:

"They went in as NHS patients but six out of seven came out having been recommended to have some treatment privately - the most common being hygiene treatment."

http://www.channel4.com/info/press/news/dispatches-investigation-reveals-dentist-overcharging

welshdent

Look. I've told you what to do. Speak to them. If you have periodontal disease and thus clinical need you can have it on the NHS. We are not all a bunch of con artists despite almost all you say hinting that we are. I became a dentist to help people and do the best job I can. My friends and colleagues by and large are the same. Believe what uou want it makes no odds to me as you aren't my patient. My advice is speak to them and find out what is happening. Take it or leave it it's your choice.

mal4mac

welshdent wrote: »

Look. I've told you what to do. Speak to them. If you have periodontal disease and thus clinical need you can have it on the NHS. We are not all a bunch of con artists despite almost all you say hinting that we are. I became a dentist to help people and do the best job I can. My friends and colleagues by and large are the same. Believe what uou want it makes no odds to me as you aren't my patient. My advice is speak to them and find out what is happening. Take it or leave it it's your choice.

I will speak to them. Thanks for the information on periodontal disease. I'm certainly not saying you are "all a bunch of con artists". But that despatches report, and other serious investigative journalism, indicates that many dentists are "gaming".

Given your responses here, I think you are probably one of those dentists whose primary motivation is to help people and do the best job you can. As for your friends, well, "birds of a feather flock together". Do you have any research figures to contradict the dispatches report that found 6 in 7 dentists gaming?

P.S. That "by and large" is telling, I would say the same about my academic friends and former colleagues; but I know there's an awful lot of "gaming" goes on academia (flights to conferences paid for by high student fees, fancy hotel jaunts for meetings, excess time spent on private consultancies, etc., etc.,...)