Pirate clinics: Who is to blame?

Advertising information everywhere. Dental clinics that close leaving hundreds of patients unattended. Or directly pirate clinics. And a slightly less visible reality: that of patients who come to our office to solve problems that have been badly treated, if not caused by other supposed specialists.

The patient, the unprotected patient

I often wonder who protects the patient and who regulates private health services. I don’t know, but what is clear is that they have done nothing in recent years to protect the user or to regulate the centers.

It is considered that there are more than a thousand clandestine clinics in Spain, without permits and outside the law. This data is very significant of the risks to which a patient is exposed when selecting a dentist.

At a less extreme point are the low quality services. Have you ever wondered why a medical insurance gives you a dental coverage for only 3 € per month? Very easy, because it pays nothing to the clinic. The benefits for patients are free services, such as cleanings, check-ups or X-rays, and reduced prices. Perhaps someone might think that “of course, then the clinic gets paid by the insurance”. Years ago this was the case, but not now. The clinic will not receive anything, and in addition it will be subject to the prices imposed by the insurance company. Result: a real fraud in the health care of these patients.

It often happens when the main factor that is valued when making the decision is the price, but the patient cannot know to what extent his or her health is really at stake.

Cheap services are expensive

But franchises, private insurance centers, dental clinic chains… What are they really? What is their mission in this society? Many people who have gone through them could say so. They are unqualified centers or without the capacity to work at the service of the patient, of the person, of his or her needs, priorities, expectations and economic possibilities. The result is usually poor because they look for a high economic profitability, and if it can be and it is tightened, very high.

Okay, stop. Is it always like this? No, certainly not. Sometimes there is a professional who can work well, with quality materials, a person assisting at his side, and even with time to be able to execute the job correctly. But only sometimes.

Paradoxical as it may seem, health is not the profitable part of medicine. Treating a gum infection or dental caries does not bring in much income. What’s more, it is always the treatment hook (like the yogurts on sale at the supermarket): free gum cleaning, filling 25 €; total time spent for both treatments, fifteen minutes.

We dentists owe it to our patients; we are health caregivers, counselors, healers and rehabilitators. And of course, our clinics, built on effort and hard work, are not an NGO. They are companies that have to be profitable, otherwise it is clear that they would not continue. Let us not deceive ourselves as users, let us not want to think that a quality service has its fair price in a quarter of the usual.

Fraud by large dental chains

In recent months we have witnessed an unusual number of news items related to dental clinics: massive closures of chains and tax crimes of one of the best known franchises nationwide.

But while the media focus more on the criminal aspects, money laundering, tax fraud and a long etcetera (unfortunately, we are already desensitized to these terms…), health professionals, those of us who chose this profession by vocation, can’t stop thinking about how many times we have attended and treated a patient who had the bad luck to fall into one of these “pirate” dentistry centers. This is not what the media talk about.

For those who do not understand the term, these clinics are dedicated to approaching patients to steal from them. This is undoubtedly a serious accusation, but when someone pays for something, service or product or both, and does not receive what was previously agreed, that is a swindle, theft, robbery, or whatever you want to call it. And when a salesperson both entertains and cajoles to lure the patient into the trap, that’s a style of boarding. And that, unfortunately, is what happens in many of these clinics.

If the patient has a cleaning and the tartar remains inside the gum, that is fraud. If a filling is done and the caries remains inside the tooth, that is fraud. If the teeth of the prosthesis do not allow the patient to eat, that is fraud. If I tell you that I do something and I don’t do it, that is cheating. And if I do something that the patient does not need, that can be called a scam. In short, Patients are exposed to what? To the rules of the market .

How does it sound to mix market and health in the same sentence? Is our health being traded? Is it possible that there are economic interests in our oral health? Yes and yes.

It is not surprising that the population has a feeling of lack of protection, distrust and even detachment from this profession. That is why it is so important to have recommendations, word of mouth, positive previous experience, good results, regular good “sensations” every time a visit is made… In short, to perceive time and again that we are in good hands, that they look after our interests and that this relationship is nurtured on the basis of a large dose of trust.