According to reports, half of all spending in the U.S. midterm elections focuses on healthcare spending. What the ads miss is that doctors are losing their grip on their role as our primary healthcare providers. So those ads shouldn’t be talking about doctors.
They should be talking about dentists.
M.D.s have dominated the healthcare conversation in our society for more than a century, but their prestige and power is rapidly giving way to a new breed of dentist.
A new breed of dentist? Seriously?
You better believe it. This reflects not just a shift in health care, but a shift in socioeconomics, in terms of who’s up and who’s down.
Doctors typically come from upper middle class backgrounds. They are often the children, nieces and nephews, or grandchildren of other doctors, and the prestige of a medical career often appears to be transmitted from one generation to the next.
By contrast, dental school students often come from blue-collar backgrounds, and are frequently the first members of their extended families to attend professional or graduate school of any kind.
Economics plays an important factor. Medical school is considerably more expensive than dental school. Unless you’re ready to subject yourself to a gazillion dollars worth of student loans, you’re more likely to go to dental school than medical school, simply because of cost.
Doctors’ families can often just write a check for medical school for their progeny. It’s a great deal for the son or daughter of a doctor. Not only did you grow up in an environment where medicine was “topic A,” but there was always an expectation that you would attend medical school as well. And the financial resources were there to support you if you made that choice.
By contrast, in the past, aspiring to medical school was often beyond the wildest dreams of a typical student from a blue-collar background.
“It’s not just the money. It’s the psychology. If you’re from the upper middle class, there’s an expectation that you’re going to stay there, probably doing the same thing that your father, or perhaps your mother, did to make a living.
But if you come from a blue-collar background, you’re less likely to swing out that far and think about becoming a doctor. Somehow, dental school was the safe harbor for upwardly mobile members of the working class.
Today, M.D.s, with all the prestige of their titles, are finding it harder and harder to earn the kind of income previous generations of doctors took for granted.
The wheel has turned. Doctors have caps on their income that neither they nor their parents or grandparents ever faced. They’ve got limitations in terms of what Medicare will reimburse them for. They literally cannot afford to spend as much time as they might wish with any given patient, because their model doesn’t permit it.
They are dominated by the pharmaceutical companies and have so little time with patients that often all they can do is push a prescription instead of really getting inside the patient’s true needs.
And they have to spend every spare minute constantly going over their charts, making sure they didn’t miss anything, because the fear of a financially devastating malpractice lawsuit always hovers over their thinking.
Dentists have plenty to worry about as well, from the health of the overall economy to ensuring that patients don’t break appointments, leaving the dentist or a hygienist just sitting there with no way to fill the lost hour.
But today, dentists are in the ascendancy. They’re making more money than ever, they are independent, they have all the time they need to see patients, and their lives are not controlled by pharmaceutical firms and insurance companies.
It used to be that the dentists were feverishly trying to keep up with the economic lifestyles of the doctors, and always falling short. Today, the situation is reversed.
The M.D.s will never admit it, but they’re jealous as hell of the dentists. And given the huge and intractable morass that health care has become, they have every reason to be jealous and every reason to be concerned.
If there were ever an era that favored the dentist, this is it.