In response to one of the most common scenarios we encounter in most dental offices, we will discuss the notion of treatment plan recommendations based on clinical findings and diagnosis versus insurance-based treatment plan. Dentistry, just like the practice of medicine and optometry, treat their patients based on their health condition. From the findings, dentists can then derive an ideal treatment plan and possible alternative treatment plans for each and every patient. Insurance is simply an adjunct for patients in order to receive financial benefits for their treatment based on what the plan covers.
As trained healthcare providers, our sole interest is to plan what is best for our patients in order to have a healthy mouth, which, in turn, ultimately helps our patients to reach the goal of having good health. This means that if there were any pathology we see, we would recommend treating them. Or if there are any early signs or symptoms that can potentially cause complications, it is our duty to catch it early enough while they are still easy to correct. At our office, it is a matter of our comprehensive examination that helps us create a personalized treatment plan that best fits our patients. More importantly, comprehensive dentistry allows us to look at things on a grand scale and ensures us to practice dentistry the correct way from the beginning, whereas reparative dentistry is only problem-focused which can then be more costly in the long run. Insurance does not and should not influence our patients’ treatment plan, nor should they govern or dictate what the patients should receive as their treatment. Patients or practices that are insurance-driven consequently tend to focus on the insurance coverage and overlook what is truly important: healthcare. Doing so can easily compromise the quality of healthcare they receive. Would you rather have insurance companies or a qualified professional to treat your mouth?
For any reason, when there are truthfully difficulties in making a commitment to the treatment plan, we try our best to provide alternative or interim treatment plan. This way, we are at least able to eliminate any ongoing disease that is in our patients’ body, put them in a stable state, and allow them to be in a better situation where they can buy time to eventually complete the treatment that is ideal to them if necessary. On the other hand, doing any superficial treatment that does not eliminate the source of the problem as a substitute does no help but rather leaves a false impression that treatment has been done. This is actually a disservice to our patients. That being said, it is definitely acceptable for patients to decline treatment. Patient should have the autonomy of deciding what they want to have done with their own body, but they cannot force practitioners to alter their recommendations based on what they want, especially when there is no alternative or “next best” option.
It is regrettably unfortunate that during this era of time, health insurance is the dominant market. Whilst health insurances do provide financial benefits, they are too relied upon by patients. Remember, dental insurance should really be thought of as a monetary benefit and not a guideline to determine which procedures should or should not be done based on what is covered. In the end, you are only gambling with your well-being, a bet that is too risky to take.