Bob McPhail 12:30 p.m., April 26
U.S. Dentist Fears Patient Safety, Income Loss From Cross-Border Competition
American dentists are feeling pressure from their Mexican counterparts, an article in the magazine RDH, which caters to the industry, seems to suggest.
Titled Dental Tourism: Is the risk of ‘foreign’ dental treatment worth the savings?, the article first cites the cost savings that lure savings-seekers across the border. Dentists in several border towns, including Tijuana, were surveyed and a cost matrix of offered procedures was presented. For Tijuana dentists, porcelain crowns averaged $365, molar root canals $235, and dentures $495. By contrast, a bracesinfo survey of dental costs just north of the border in San Diego reports average costs of $1,044 for the crown, $1,114 for the molar root canal (plus $101 for an initial consultation), and $1,189-$1,693 for dentures.
Marcy Ortiz, an Arizona dental hygienist and author of the article, details the problems American dentists face in trying to compete in an environment where insurance, wage standards, and regulatory agencies don’t allow them to come close to matching prices found in Mexico. She complains of patients that visit her practice for regular care and diagnosis of serious problems but then cross the border for more expensive procedures, returning to her to purchase follow-up care. She argues that Mexican dental firms, since they’re not licensed to practice in the U.S., shouldn’t be allowed to advertise their services in media that reaches U.S. consumers. She also warns dentists that many domestic insurance companies will cover Mexican treatment, causing her office to be denied payment for providing duplicate services she was unaware her patients had already received.
“It is our duty as dental hygienists to inform patients of the possible risks they may encounter when traveling to a third-world country for their dentistry,” writes Ortiz. “They need to know what these specific risks are as well as alternatives that are available for them to receive their needed dental work in the United States.”
Ortiz goes on to offer tips on how U.S. dentists can discourage their patients from seeking to save money across the border. A list of several negative experiences with her own patients she cites include a patient who received two crowns that appeared “average or slightly above” in quality, though the dentist performing the work didn’t X-ray the patient before providing service or require medical records, missing the fact that she required antibiotic treatment. Another patient had two crowns placed in Mexico, though he visited a San Diego dentist to have them seated, not feeling comfortable with having the surgery done across the border. Ortiz argues that since he vacationed for a few days in San Diego while waiting for the crowns to be produced, he didn’t really save any money, as the cost of paying her and not taking the vacation would’ve been comparable.
Other suggested tactics to get patients to avoid Mexican dentists include telling patients that while 90 percent of U.S. dentists receive Hepatitis B vaccinations, only 21 percent of their Mexican counterparts do. “Several infectious diseases are more prevalent in Mexico compared to inside the United States,” Ortiz writes, “such as hepatitis A, B, and C, typhoid fever, amebiasis, shigellosis, and tuberculosis.”
Mexican dentists, Ortiz says, have no uniform standards of practice, and there is no regulatory agency consumers can complain to, nor any recourse they can take if they’re dissatisfied with services received. “What ends up happening [when a procedure goes wrong] is obvious. The patient returns to the United States to have their problem fixed and repaired, whether it is botched dental work or a medical problem resulting from Mexican dental care.”
In addition to using scare tactics, Ortiz recommends that U.S. dentists consider offering a three month interest-free payment plan to help patients afford their care. She also suggests that patients requiring a large amount of work receive it incrementally, unless there are direct health risks to delaying treatment, saying “It is surprising how this makes the patient seem less overwhelmed compared to receiving a treatment plan in the tens of thousands of dollars.” Another option is receiving care at an American dental school, where the cost of having procedures performed by students supervised by experienced peers is less costly. Finally, as a last resort, she recommends referring patients to community health clinics that will provide low-or-no-cost treatment to children, elderly, and low-income individuals.