Crisis. Why dentists think outside the box

When the pandemic began, 32-year-old dentist Victoria Lozano was encouraged to make a decision she had been thinking about for some time: to ditch prepaid cards and social work and attend exclusively in a private way. Today, almost a year after this decision, he has no regrets. “I work less but I am much better “, synthesize.

What prompted her to make this decision is the same thing that prompted many other dentists to abandon prepaid and associations: the almost irreconcilable gap between what is paid for services and the cost of biosafety supplies and equipment. No one has an exact number, but below it many say that three in ten dentists have already left the system.

It is estimated that in the country there are approximately 55,000 dentists. Even so, these days getting an appointment to see you can be a headache.. Nora Flores, 54, has known that for two weeks, she has called all the dentists on her card, without success. “They tell me that they are not present, or that now they only attend in private. I don’t understand why I have such an expensive prepaid and have to pay separately, ”the woman said indignantly.

This is not the only one. Many patients these days call the office where they have always been treated and receive responses that baffle them, such as: “no, the doctor no longer takes care of his prepaid “, or” he only takes care of himself “. It is also explained to many that attention is still limited, even at this stage of the pandemic, to emergencies, although since last September other practices have been allowed. Before dentists’ claim for social and prepaid works to cover the cost of the biosafety kit and increase the fees to cover materials, many companies have chosen to limit care to emergencies only, with a maximum of ten cases per provider. This further delays the allocation of teams.

Ideally, when you call the office, the response will be there is a lag in two months. Because the suspension of care for several months at the start of the pandemic increased demand at this time. And, on top of that, dentists explain, only two patients can be seen per hour, because the office must be ventilated and the surfaces disinfected before resuming care.

“It’s a reality. Many dentists decided during the pandemic to leave the system and treat only in private. This will be a turning point for the profession. The problem is not new, it comes from a situation that has dragged on for a long time but which has exploded this year, ”he explains. Pablo Rodríguez, Dean of the Faculty of Dentistry at UBA. “Today, what is paid for consultations and practices is less than the cost of materials and supplies,” he explains. “It probably means a failure in the future. In other countries, dentistry is treated in private. In Spain, there are dental plans that are paid for separately. In Argentina, as it is included in the compulsory medical plan (PMO), it has become unsustainable, ”he explains.

What should happen? “I think that dentistry should leave the prime minister’s office and this comprehensive coverage only applies to children, the elderly and pregnant women. And for the economically active population, to set up a co-payment system, ”explains Rodríguez.

Ricardo Lilloy is President of the Argentine Chamber of Private Medical Companies, which brings together the main providers of the country and confirms the critical situation that exists today in terms of dental care. “There is a legitimate claim on the part of dentists, due to the delay in the amounts of fees which during the pandemic were increased. In addition, many of the inputs they use have seen sky-high increases, far above inflation. We denounce this situation and We are also asking health authorities to allow an increase in prepaid fees, which are frozen by political decision, ”he emphasizes. “Freezing rates in an inflationary environment is like being forced to cut rates. The benefits suffer. In some cases the copayment was authorized and in others payment by the member of the biosecurity kit, but the situation is far from resolved, ”says Lilloy.

THE NATION He consulted with the main private medical companies to find out what the situation was with the resignation of many dentists, or the decision not to treat patients for the moment, but at the end of this edition there was no of answers.

Nahuel Márquez is President of the Circle of Dentists of District 2 of the Province of Buenos Aires. “The situation is complicated. A good part of the job of dentists today is to explain this to their patients, trying not to break trust and understand that it is not bad will. Today, What prepayments and social work pay are not covered, even 25% of the minimum fees set by the College of Dentists“, dice.

It exists a meme which circulated among WhatsApp dentist groups during quarantine. Yes I compared the values ​​prepaid payers pay with the price of a Big Mac. In most cases, I couldn’t afford the iconic menu of burgers, soda, and fries.

Today, private medical companies and social works They pay a dental consultation between $ 150 and $ 450 pesos, while in a special way they are charged between $ 1500 and $ 2000explains Marquez. The pandemic biosecurity kit costs around $ 1,500 and not all companies cover it. The repair of a cavity, is paid between $ 250 and $ 1200, in the prepaid which pays better. In particular, it is billed from $ 2,500.

Exit the system

When she decided to stop participating in prepaid and social work, Victoria Lozano knew that a difficult stage was beginning. Many dentists continue in the system because they believe that in the long run they provide them with a flow of people and a monthly income based on the accrued fees. But, most companies pay three months late. The costs therefore devalue with inflation.

“To leave, I had to spend three months without working, to get back everything they owed me. All of this is money that has been put into the purchase of equipment, the payment of office costs, and the professionals end up financing the companies. In exchange, now my relationship is direct with the patient. Of course, there were people who decided to look for another dentist and others understood this. and continued in private. I have fewer patients than before, but in economic terms I am better and calmer, ”he says.

Nahuel Márquez has his office in Banfield and has always worked in private. “There are two ways in dentists. Those who work with prepaid and social works see many patients per day and compensate for the low costs with the number of patients. Others decide to work without intermediaries. This modality is the one I chose. They are less patient, but this makes it possible to offer a different quality of treatment, from the type of equipment to training in new techniques and the incorporation of equipment, ”he explains.

UBA’s dean of dentistry explains that what happened during the pandemic is that for many professionals it has ceased to be profitable. “Some have devoted themselves to something else, the older ones have stopped dating and have withdrawn prematurely. And others have left the system. As there are fewer dentists on the market and we have to space out the care, we explain why getting an appointment can be so complicated, ”he says.

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