by Marek Batra
I have done my best to keep healthy and stay away from the doctors, most of my life. My last family doctor retired from his profession about 17 years ago. He had done my last preventive medical examination: Checking blood for cholesterol, urine, heart and so on. My health passed with no warnings. Unfortunately, I never had any other urgency to seek a further medical examination. Family and friends always remind me of necessity to have regular checkups. My wife has occasionally visited the walked-in clinic, just to treat her cold. I always like to put off unpleasant things and; therefore, there were always higher priority tasks on my list. Few months ago, I walked in into a family medical office close to my home. The immediate impression of the office was not exactly very cheerful! I enquired about being accepted as a new patient. A receptionist who must have been hired for the job because of her lack of smile handed me a new patients’ application form. She asked me if I feel sick and if I have any urgency to see a doctor. I replied no. She said that my application would be reviewed by a doctor. They accept some new patients and the office will phone me to set up an appointment. The promised phone call never came. I assume that my reasons for seeing a doctor were not deemed important. Therefore, they just do not want me as a new patient. Many medical clinics in Toronto just do not accept new patients, and the signs are clearly posted on the door. If I can find a time and courage, I will try another medical office.
Although I do not like doctors, I do not fear dentists, and we do have a family dentist. He is our second family practitioner since the retirement of our first one. My wife has more frequent reasons for her visits, but I stick to about once a year. Unlike my wife, I do not have a dental insurance and each visit usually empties my wallet. Dental offices have adopted marketing and know how to compensate taking money by making the visit more pleasant than it was in the past. There is a big difference between now and just twenty years ago. Their offices used to be located in places with low or economy level of rent, but never in prime retail locations. The second floors of the malls were littered with these professional offices. Doctor’s names were always on the signs and the doors. There were no dental trade names in use yet. My first experience was with an old school dentist on Bloor Street West near Jane and Bloor subway station in Toronto. It was a second floor of a low-rise building at the major intersection on Bloor Danforth Subway line. It was a one-man office him serving patients and handling the phone calls. Sometimes his wife showed up to help with his administration. I think she prepared the patients statements on old Olivetti electric typewriter and mailed them to patients for payments or to the insurance companies. Credit cards were just not accepted at their offices, yet. Our bill to pay never exceeded $100.00. The dentist alone provided cleaning, but I recall asking for it. It seems that cleaning was not a standard procedure yet, the way it is emphasized today. I never heard about whitening. The only exception was his recommendation to see a periodontist who was located in a similar simple looking office few buildings away. I felt no pain from his actions, but have to acknowledge that the environment in his office increased my level of nervousness, while sitting in his waiting room. The place just had a stigma of place where the pain is inflicted. He retired number of years ago and his office was closed for good. There was no family member to carry the professional office under the same name. Advertising at the time was non-existent, not allowed by the governing dental college. Only exception was to mail the flyers in the neighborhood at the time of office opening.
Now, we go to a new family dentist for about a dozen years. It is a quite different experience now. His style and the office are quite typical for today’s offices. They are in prime retail area, where the rent is no longer an obstacle. Decoration, furnishing and equipment, is nothing like in the past. The office is also full of staff, hygienists, assistants or administrators. When you walk in, you get an impression of coming to a spa with the expectation of great enjoyment. It is more about the offices or businesses now, rather than the dentists alone. It is branding, marketing and advertising all the way. Nobody would ask a friend or relative for recommendation anymore since all kinds of advertising is always in your face. Flyers, newspapers, tv, radio and of course the Internet searches and ads. The dentists have become business people, and it is not uncommon for the doctor to enroll in MBA program. Fear of procedures can no longer be justified, but fear of the bills for those with no insurance is real. I suspect that people who do not like dentists are people who simply can’t afford their services. The prices have simply shot up all the way. When the cleaning was just about $35.00 in late eighties and performed by a dentist, it has gone over $300 per session now. It is provided by the hygienist now. It is not just the inflation factor. The hygienists are very proficient, but as they suggest that cleaning should be done 2 or 3 times per year, it is a real expense to budget for. Many people just can’t afford to pay these types of bill for many reasons. Anxiety of dental bill will exceed anxiety of visiting a dentist.
If, general medical profession is more rewarding than a dental one is debatable. During my recent conversation with one, a friend of mine, he confided me that he should have been a different type of doctor. In this profession, your are in financially stress-enduring position. My friend has sold his practice. Now he works for another office as an associated doctor. Apparently it is far more desirable. He has more family time, less stress and about the same money as the owner. He was caught in that dream of having several offices and having other dentists to do the work with patients. New professionals would rather become successful business owners than successful dentists. It means operating several offices in different parts of the city. It requires long driving and always worrying about marketing to generate enough of new patients for their clinics. Their fixed expenses go up with opening of new offices, but bringing new patients can be tricky business. Very few succeed, but the majority of those who started become frustrated and forced to sell their practices. New yardstick for success is measured by financial rewards from operating several offices, rather than from being the best profession-practitioner you can be.
Medical clinics and dental offices seem to be on the same path for part of the process. They both have goal to improve and keep our health. The dentists are paid entirely out of patient’s pockets or by private insurance companies. Highest dental bills are for cosmetic procedures that are clearly avoidable and never reach catastrophic proportions. Our medical bills are paid Government run insurance and we never see them, regardless of their size. US based customer of our company, recently asked for delay with paying of their bills. A family run company was stricken by a serious illness of the company’s president, founder and owner. The family had to pay a large amount of $ for transplant operation and consequently was unable to pay our bill on time. Our basic medical care seems to be rationed as I have experienced myself. Perhaps they had more serious patients than me to take care of. I am sure that I will receive great care, if I have to go to an emergency department of our hospitals.