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Old 02-12-2013, 03:15 PM  
tooge tooge is offline
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my healthcare soapbox

Ok, I really don't care what your political offiliations are, this isn't about that. I just saw a very sad situation this morning, and wanted to vent. This story is typical of what is wrong with our health care system.

As many of you know, I'm a dentist. I've been out of school for 20 years, so I've seen quite a bit in my profession.

This morning, a lady brought her son in for a consult. He is in his late 40's, has a dilapidated state oral health, including 8 or 9 non restorable teeth, advanced periodontal disease, and tooth decay in many of the teeth that are still salvagable.

He has a mental disorder and lives in a group home. His mother has recently moved her blind uncle into her home, and her husband has dementia. I'm not sure of the exact "diagnosis" they gave the guy that landed him in the group home, but I'm guessing its some sort of social behavioral disorder.

He was very pleasant, shook my hand, and asked alot of questions. It was like talking to a 9 year old.

Anyhow, so I give the consult, recomment removal of many of his teeth and replacement with a partial denture, some fillings, and a deep cleaning. His mom gives me a huge hug and tells me how pleasant I have been and how good I was with him. She tells me that medicaid will only pay for him to be in the group home and receive "psycological therapy", but no dental care because they are maxing out on the "psycological therapy".

So, I decide to do it all for half the cost. Yeah, I know, it makes me feel good, so there is something in it for me I suppose. But I'm pissed. How can we let the government pay to have a man get psycotropic drugs and "therapy", and yet his "therapist" don't even bother to see that he's a complete dental cripple. The guy can't even chew food. Our system is broken.

This guys overall health is suffering, he's in pain, he's unable to eat solid foods, and yet they gork him out on all sorts of drugs and pay some "therapist" to watch him interact with others. Gimme a break.

Thanks for listening. I'm done now.
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Old 02-12-2013, 04:39 PM   #16
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Originally Posted by mr. tegu View Post
And your point is what exactly? Other than stating what I told you which is that a therapist is not the same as a psyhciatrist or a psychologist even.
Nope, that wasn't it. I stated my point. Whoosh! It went over your head despite being obvious. Can't help ya' man.

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Old 02-12-2013, 04:40 PM   #17
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He only said the patient was on drugs and also got therapy not who prescribed the drugs exactly, 'cept that govt paid for both.
I don't think most people would have a problem with someone in their 40's with his disability receiving therapeutic help. The problem I have, and I would assume you and most others, is the drugs he is being given and the expensive psychiatrist he is seeing. A therapist is not that expensive on its own after all. In fact, the ACA Code of Ethics has a provision that therapist provide pro bono work.
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Old 02-12-2013, 05:34 PM   #18
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Oh, you are doing it for half the normal price? You are such a man for only making %70 percent profit on this. /Nutjobs that don't understand how businesses work
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Old 02-12-2013, 05:47 PM   #19
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Oh, you are doing it for half the normal price? You are such a man for only making %70 percent profit on this. /Nutjobs that don't understand how businesses work
TAX HIM!!!!!!
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Old 02-12-2013, 05:51 PM   #20
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Old 02-12-2013, 05:54 PM   #21
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Oh, you are doing it for half the normal price? You are such a man for only making %70 percent profit on this. /Nutjobs that don't understand how businesses work
Should have been pro boner work!

Oh wait, maybe it was???
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Old 02-12-2013, 06:05 PM   #22
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is there any way you can claim that unrealized profit as a loss?
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Old 02-12-2013, 08:18 PM   #23
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Isn't the group home at fault here? Can your report them somehow?
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Old 02-12-2013, 08:20 PM   #24
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Old 02-12-2013, 08:26 PM   #25
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Originally Posted by mr. tegu View Post
Well when he says therapists, it gives a bad name to therapists. Therapists cannot prescribe medications, thus they cannot benefit from drug peddling, thus they are not responsible for the person in this story not getting the dental help he needs.

I know what the big picture is and it is sad because far too many people receive medications from psychiatrists. His point his valid but that doesn't diminish the importance of the distinction.
My point is simply that if I showed you or anyone in Washington, this man, and his vitals and labs, you'd say he looks like a normal healthy American. Fact is, he's ravaged by disease and lives in constant pain, unable to eat. Yet, the govt will only help him get xanax
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Old 02-12-2013, 08:38 PM   #26
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My point is simply that if I showed you or anyone in Washington, this man, and his vitals and labs, you'd say he looks like a normal healthy American. Fact is, he's ravaged by disease and lives in constant pain, unable to eat. Yet, the govt will only help him get xanax
Serious question. Wouldn't he at the very least have high WBCs because of the periodontal infection? I wouldn't know, but isn't that a pretty serious infection if it starts to eat away at those ligamentous fibers?

Don't get me wrong, I think the dental service should be covered, but not at the expense of any medications he's taking. I wonder what the rationale is for not covering his dental care. That's ridiculous.
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Old 02-12-2013, 08:42 PM   #27
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...So, I decide to do it all for half the cost. Yeah, I know, it makes me feel good...
That was really half nice of you.
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Old 02-12-2013, 09:41 PM   #28
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My point is simply that if I showed you or anyone in Washington, this man, and his vitals and labs, you'd say he looks like a normal healthy American. Fact is, he's ravaged by disease and lives in constant pain, unable to eat. Yet, the govt will only help him get xanax
Do you know how long it's been since he has been getting mental help? It kind of sounds like they just started with the psychiatrist? Perhaps they just happened to go there first and didn't realize the cost they would face between both places? You said they were maxed out with those costs so it sounds like they could use those benefits on dental work should they choose now that they realize they may be able to have both.

But also, maybe he is going to live in a group home because the mother cannot properly take care of him and his father so she thought that would be for the best.
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Old 02-13-2013, 07:29 AM   #29
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My point is simply that if I showed you or anyone in Washington, this man, and his vitals and labs, you'd say he looks like a normal healthy American. Fact is, he's ravaged by disease and lives in constant pain, unable to eat. Yet, the govt will only help him get xanax
His WBC's would be slightly elevated,but not much. The infections are chronic and have been draining for quite some time. It would actually depend on when the labs were done.
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Old 02-13-2013, 07:32 AM   #30
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Do you know how long it's been since he has been getting mental help? It kind of sounds like they just started with the psychiatrist? Perhaps they just happened to go there first and didn't realize the cost they would face between both places? You said they were maxed out with those costs so it sounds like they could use those benefits on dental work should they choose now that they realize they may be able to have both.

But also, maybe he is going to live in a group home because the mother cannot properly take care of him and his father so she thought that would be for the best.
I stated that incorrectly. It's not that they are maxed out with medicaid, it's that medicaid simply doesn't cover any significant dental expenses. The whole point is that the guy has two major issues, a mental disorder, and a dental disorder. The dental disorders are more likely to lead to serious problems, and even the possibility of death if untreated, and yet medicaid ignores them. thats all I was trying to say. It's sad.
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