I finally got around to calling my traditional dental office about a cracked filling. Normally non-emergency bookings took a couple of weeks. The receptionist asked if I could come in at 1730. I could … but then she asked which of their dentists I preferred … seriously! I couldn’t even remember their names so I told her I would take whichever one would tolerate me. They are all independent other than sharing a receptionist, not sure how the dental assistants get paid?
I ended up with the same young lady dentist that had been doing my dental work in the past and she seemed very happy to get the business. She booked wife and I for cleanings in November but assured us we could cancel if we were uncomfortable.
Oh, Public Service Dental Plan has gone back to the old billing system. I paid the full bill (C$327) with my credit card and by time I got home they had reimbursed me with 90% of that in my account.
Nova Scotia is at least acting like it is post COVID … case counts are very low and most mandatory restrictions have been dropped but they are expecting an increase in the fall. We are expecting a third booster to come out shortly though the good doctor Strang is suggesting seniors wait a couple of months to make sure they have the best one.
We wear masks when out and about and continue with social distancing.
Oh … when I arrived there was a sign to drop my mask in the garbage and pick up one of their non-surgical el cheapoes … the receptionist raced out to tell me I could continue wearing may KN95.
How odd. I just got back from my trip to England and our “traditional” get together with my two besties from dental school…quite literally just about 3 months shy of our first meeting as classmates half a century ago!!! (sounds like a long time when I put it like that) We’re all retirees now but the most recent of us to retire…somewhat belatedly thanks to Covid… sold her practice just under a year ago after a major expenditure on post Covid infection control strategies.
Anyway, it seems that over there, the backlog of work that built up and progressed during the actual lock down period together with the decreased ability to treat a high volume of patients because of the infection control procedures (always a potential bottleneck but much greater now) has gotten much worse. This appears to be the case for private-only as well as the increasingly rare NHS practices. In my neighbourhood (west of Denver, CO) not quite so bad according to colleagues and our dentist, but appointment books for any sort of comprehensive treatment are fuller than most are comfortable with.
. but then she asked which of their dentists I preferred …
I go to an independent dentist, same guy for 25 years. I started to wonder about when he might retire, and I’d have to find a new dentist. Then his son graduated dental school and joined the practice. Problem solved.
In 2020, I was in for a cleaning in March, only a couple weeks before the first case was found in Michigan. Next cleaning was in September, in the tail of the summer attenuation, and just before case rates soared with “back to school” and the fall 20 religious rallies.
He caught the plague tho. Seems to have recovered OK.
VeeEnn: Anyway, it seems that over there, the backlog of work that built up and progressed during the actual lock down period together with the decreased ability to treat a high volume of patients because of the infection control procedures (always a potential bottleneck but much greater now) has gotten much worse.
Yeah, the problem is not a shortage of dentists or needed work but rather a shortage of customers willing to sit in a chair with a couple of people hovering over their open mouths. Almost nobody shows up for cleanings that can mostly wait?
Interesting side note: Our family doctor is a Brit NHS doctor that was looking at moving to Toronto and got intercepted by Nova Scotian recruiters. She quite likes it here as they get paid for services rendered including (since pandemic) telephone call back appointments.
So, are your GPs paid totally fee for service, Tim? (just presumably caps on their fees?) Historically…i.e. dating back to the dawn of the NHS in 1948…GPs have been paid a capitation fee with a few fee for service items as add on. Dentists, on the other hand were originally reimbursed by fixed fee for service and that was still the case up until we came to the US in 1985. Contracts have changed quite dramatically thiugh, it seems, and as far as I can tell it’s darn near impossible to know how much you’re earning with treatment on any given patient. Really hard to find an “NHS dentist” these days because of this.
So, are your GPs paid totally fee for service, Tim? (just presumably caps on their fees?) Historically…i.e. dating back to the dawn of the NHS in 1948…GPs have been paid a capitation fee with a few fee for service items as add on. Dentists, on the other hand were originally reimbursed by fixed fee for service and that was still the case up until we came to the US in 1985. Contracts have changed quite dramatically thiugh, it seems, and as far as I can tell it’s darn near impossible to know how much you’re earning with treatment on any given patient. Really hard to find an “NHS dentist” these days because of this.
Dentists are not part of our National Single Payer healthcare system. Each province runs the show as long as they meet the federal minimum standard. Costs are split between the provinces and the Feds who use financial transfers as the club to ensure compliance.
Family Doctors are the heart of the system as they make the decisions as to what it needed and arrange for specialist, testing or any other necessary actions and steps.
Billing is not an issue, the receptionist enters the appropriate code and the money arrives … as one of my fav docs joked, before I leave the parking lot.
I think the fee per procedure is fixed and re-negotiated every two years at the provincial level. Along with Family Docs that work on appointments, clinics often had a “Walk In” service but COVID seems to have reduced that.
In truth I’m a bad one to ask as I’ve done only a couple of actual appointments since COVID hit. The rest have been phone callbacks for prescriptions that she faxes to Costco. She had booked me for a “PULMONARY FUNCTIONS” at the hospital test on my birthday but a letter arrived yesterday delaying it nearly a week due to “UNFORSEEN CIRCUMSTANCES”.
There are a few medical services not covered such as cosmetic (skin tag removal) or exotic travel vaccination. The docs will usually do them for cash payments.
Dentists are not part of our National Single Payer healthcare system
I think you could probably say that about the UK nowadays…but no one will say it.
It seems like medical care is a somewhat similar set up to the NHS…reimbursements excepted. Presumably GP/family doctor being first point of contact with specialist services hospital based? It always looked so odd to husband (a hepatologist) and me when we were younger and maybe on va-cay in France or somewhere “European” …that walking around business communities you would see random name plates announcing the various medical specialties on doors of quite tiny looking offices.
Goes to show that “Universal Coverage” doesn’t mean a universal system of delivering care or reimbursing or ultimately financing it. Healthcare systems around the world are as different from each other as they are from what we have here in the US.
Dentists are not part of our National Single Payer healthcare system
I think you could probably say that about the UK nowadays…but no one will say it.
It seems like medical care is a somewhat similar set up to the NHS…reimbursements excepted. Presumably GP/family doctor being first point of contact with specialist services hospital based?
Dental has never been mentioned alongside healthcare in Canada. Most people can afford at least a basic level of dental care. I’m not sure how many have private insurance but mine is 90% covered by my retired federal employee benefits.
I’m currently waiting for a letter from an eye surgeon that specializes in zapping cataracts.
What has been mentioned … nay “promised” by our Feds is some form of Pharma coverage for the unwashed masses. That seems to have gone quiet since COVID took the spotlight and a whole lot of funds that would be needed to implement it.
What is pharmacare? Canada's health care system covers visits to the doctor and medically necessary hospital care. Once someone goes to fill a prescription, universal public health insurance ends for many Canadians. Pharmacare or universal health care aims to fill the gaps to improve access to prescription drugs.