By Andrea Shepperson - 9 Mar 2011
Has dental care become so prohibitively expensive in NZ that we chase dental deals in Asia, under the misapprehension that quality dentistry can be purchased between a boob job and a rhinoplasty?
And when did we become a nation of suckers, hood-winked by
dental tourism operators to believe that they were really
interested in our health and well being, in addition to our
vanity.
Yet another patient sat in my chair recently, arriving in my
office for news they knew, but didn't want to hear. An
implant bridge placed in Thailand was causing bleeding and
inflammation, risking the loss of the implants themselves.
Many of my cynical colleagues would argue that this a case
of 'buyer beware', that the client got what he deserved - a very
expensive cocktail by the pool. It broke my heart to say
"I'm sorry, I can drive a truck through the gap under your
implant supported restoration. It doesn't fit and will need
to be remade".
So who owns the problem here? The patient who should have
done the maths: Quality + Dental Tourism =
Oxymoron.
The tourism operator?... somewhere in their business plan, as
they clip the ticket, there is unlikely to be an unspoken
code of ethics, something embedded in the psyche of any NZ or
Australian health professional.
What about the dentist providing the care? We don't know
the circumstances regarding the delivery of care - the timeframe is
certain to be limited - but somewhere along that treatment path the
dentist would have known that the outcome was compromised.
Either their impressions were inaccurate, their technicians lacked
attention to detail, they didn't take a verification xray to check
the fit before cementing. These are all standard protocols
that any reputable dentist undertakes to deliver a successful
outcome. This was clearly a case of geographical
success. The patient hops on a plane to another country and
the dental failure disappears with them.
One of my mentors said "do the right thing at the right
time for the right reasons". Every dentist is trained with
this motto - an ethical virtue that stems from the conscious
desire to do the best work possible for the patient. An
ethical dentist will halt a procedure that is not going
according to plan, or where time and biological constraints limit
the delivery of quality care. When financial limitations
prohibit the best care the patient will be carefully advised so
that they can make a choice to accept a limited outcome.
It's a wonderful balance of scruples and competence that gnaws
away at every doctor or dentist. While competence and
experience can vary, and every dentist should know their
limitations, most understand the difference between scrupulous and
unscrupulous decisions. When financial reward drives the
treatment decision the outcome is invariably compromised in some
way.
Quality comes at a price - that price is a dentist with an
ethical backbone. So does the peace of mind that,
when failure occurs, comeback is available in a
developed society in the form of consumer legislation and peer
review outcomes. I can't compete with a business model that
provides questionable care in a part of the world that is hardly a
model of consumer rights. But I can keep doing the right
thing at the right time for the right reasons.