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.
