Saturday 23 November 2013

Menu card Dentistry - Sign of our times!!

         The emergence of social media and marketing has resulted in a paradigm shift in the manner in which a doctors services are now sought and utilized.
In the days gone by it was all about word of mouth referral from happy patients and their extended families, or based on vicinity and who provided the best services.
         The current trend of chain clinics and overzealous marketing leaves the patients spoilt for choice and confused with regards to the best treatment options for them.The trend in marketing is totally based on providing low cost treatment and literally hawking treatment and services solely based on the price point.
 To be fair im all for creating awareness, although advertising is still not accepted under the aegis  of the dental council of  India , unless there has been a change in location of the clinic.
           But what im against is the growing demon which i choose to call - MENU CARD DENTISTRY.
Where in patients are literally handed a menu of the services and materials and asked to choose solely based on their budget. Sometimes the most expensive or the cheapest option may not be right for the patients specific dental condition. The onus of guiding the patient to make the right choice keeping individual budgets in mind should be at the discretion of the dentist based on through examination and diagnosis which simply cannot be conducted over emails or telephonic inquiries.
            Iv had to refuse dental implants in some of the richest patients due to several medical conditions such as kidney disease or uncontrolled diabetes which can only be detected once a through medical and dental history is sought from the patient.
             In the last decade there has been an influx of restorative material in the form of dental crowns and veneers which can give a life like appearance and change in the smile of an individual in a matter of  hours or sometimes just a few days.Many patients seeking aesthetic work are once again handed over these said menu card or price lists without conducting a smile analysis or problems in the patients bite, thus resulting in failure. To quote one example a patient who was a model walked in for ceramic veneers and insisted that i give her the price quotation without allowing me to examine her. when i refused, she relented and to my surprise she had a severe case of flourosis , a condition when the enamel is soft and compromised. She was therefore a candidate full coverage crowns which would last her as well as give her the smile she desired for her modelling profession.
        Also there is a tendency to misrepresent and misinform patients by way of advertising, such as a whole walnut with the shell intact being bitten by complete dentures which would barely survive the impact without causing damage to the false teeth.
       Another emerging trend is of warranties and guarantees. All the material that are processed in the laboratories or companies which manufacture dental implants have now started issuing warrantee or guarantee cards. This is in the best interest of the patient when it comes to damage to the material per say especially in cases where extensive dental restorations have been undertaken. However the patients must be discerning enough to understand that the human life and the human body itself  comes with an expiry date. An implant patient laughed his head off when i told him that what good was the implant warantee unless he maintained oral hygiene and looked after his implant. What good would be a warrantee if he had to roam with his replacement implant in his pocket rather than his oral socket!!
         It is the duty of every dentist to customize treatment plans based on the patients oral condition and guide him into making a choice with regards to treatment options by creating a balance between cost versus benefit ratio.In my humble opinion those who ask for discounts even before a diagnosis or discussion are those who do not account for good work. At the end of the day its all about building trust via honest communication and concern for the health of the patients. Smiling patients are indeed the best testimonials!!