Tuesday, April 2, 2013

Supply and Dental Demand

Maybe the graphic is a bit over the top, but give it time. A story on the front page of the National Post last week - "Too many dentists, too few mouths" highlights an interesting development. The supply of dentists across Canada exceeds the demand. As the article suggests patients will have "more purchasing power than ever." Thats how supply and demand works.

It seems Dental schools are graduating more dentists than ever and "price wars and discount offers" have started in "hyper-competitive markets like Toronto." Good news if you have bad teeth - or just teeth in general.
“Over the next few years, these numbers (dentists and hygienists) will grow. This means that competition within the profession will become more intense and individual dentists are going to try to find ways to attract and retain patients.”
What a shock for those young people - they're going to have to compete for patients on price and quality.

In Ontario, every single health practitioner is regulated in minute detail, right down to who may use what instruments and into which human orifice the instruments can be inserted.

Dentists, however, must also be business people. They fend for themselves mostly, they are self-employed. So when it comes to billing, overhead expenses, and ultimately trying to make a good living they are on their own. Many people have dental plans through employment, and that is a great help to dentists as well as their clientele. Of course thats what the issue is about in the Post story, too many dentists. By-the-way, the private group insurance plans are no doubt pleased that dental prices may come down, or at least not rise because of this competition. Strangely, in Ontario, dental care is not considered vital to one's health, and is NOT covered under the "universal healthcare" plan called OHIP.

While dentists and dental schools have some leeway, physicians are regulated to death. Every physician in Ontario is effectively, by law, an employee of the provincial government through OHIP. All their bills are paid by OHIP through agreements with the Ontario Medical Association. And every physician is granted the right to practice by the College of Physicians and Surgeons of Ontario (CPSO). CPSO and the provincial government together play a role in how many physicians are graduated each year. The supply of physicians is controlled, the prices they are paid are controlled - so it's no wonder that Ontario (and all the other provinces) have shortages of physicians, long line ups at emergency wards, and among the longest wait times for medical care in the world.

Have you ever had to wait for dental work? I once broke a tooth on a Saturday morning, it was repaired by 1 pm that same day without a lengthy wait in a waiting room and I was able to enjoy a dinner meal. One quick phone-call was all that was required.

So lets dream for a moment, lets pretend that medical school graduates were NOT regulated in numbers, so that those who wished to be a physician and had the grades and the money, could enter medical schools. Lets pretend that physicians could be part of OHIP, and they could also accept patients privately if they wished, even charge them the OHIP fee (for residents of Ontario) and more (or less for non-residents). In other words, imagine if the government did not set the price or control the supply of physicians. Don't you think that might be a move in the right direction toward better service? Like my dental experience above.

A tiny move like that, a simple start, could change the whole supply-demand thing for physicians. It's your health.     

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