We shouldn’t be making decisions for our patients by offering reduced prices for dental treatments, Alif Moosajee says.

I’ve become aware of the term ‘MFD’, first introduced to us in 1992 on the Paul and Posner courses ‘Developing the Private sector in NHS Practice’.

I‘m afraid this is not a new qualification like ‘the Membership to the Faculty of Denture wearers‘ or anything quite as spurious as that!

A body that makes you sit an exam to allow you to wear your dentures and then charges you every year so that you are allowed to put the letters on your business card and indeed take your dentures in and out!

This is a phenomenon known as ‘Mental Fiscal Drag’.

It occurs when dentists (in particular) are presenting the fees to their patients for the treatment that they propose.

What happens is that you know that the treatment is worth a certain value and your brain is very aware of the cost, yet by the time that figure travels down from your brain to your mouth the figure has changed into something smaller, and that lower fee is the fee we classically present to the patient.

Costs

MFD costs dentists thousands and thousands of pounds every year in lost earnings.

MFD happens because in the split-second when we have to discuss the cost of treatment to another human being we forget our worth.

We forget how hard we worked to get into dental school, and how hard we worked when we were at university and on clinics, and we forget how we had to make sacrifices, we forget how hard our job really is.

We also forget all the ridiculous and exorbitant overheads there are when providing dentistry.

I became a principal almost three years ago and my practice, Oakdale Dental, is a large private practice in Leicester.

I have been taking a closer look at my accounts – looking at how much we grossed and how much the overheads are.

And I can assure you that if every dentist looks in to how much it costs to run a practice it will cure MFD and keep it cured for a long time!

The only fear I have is that if you’re fresh from looking at the invoices for a month, then in that second when you have to look the patient in the eye and present the fee it may have the opposite effect and you may find yourself over inflating prices instead of reducing them as is the norm.

Treatments

On a more serious note though, I really do try to reflect on different aspects of my practice and I am aware of instances where I have failed to present certain treatment options because I assumed that they were too expensive for the patient.

So if a patient comes in with no teeth I will discuss the options of conventional full dentures, lower implant supported dentures and finally upper and lower implant supported dentures, but I may neglect to offer the option of a fixed full arch reconstruction knowing that it will be a massive jump in cost for the patient and that I may alienate them by presenting a treatment plan with such a high cost.

The bottom line is that this is wrong and now I appreciate that.

I am not the patient’s financial adviser or financial planner, I am their dentist, so my job is to look after their dental health and to provide them with all the options that are available, regardless of my judgement with respect to their ability to fund the treatment or not.

If they can’t afford it, they can’t afford it, but sometimes with the plethora of finance options we have available, the ability to spread the cost allows the right treatment for the patient to be within their reach.

I never again want to be the person who stands in the way of that process.

After all, if I was having a ‘scruffy day’ and a salesperson had judged me, I‘d be very angry if I missed out on the ‘finer things’,or indeed the opportunity to reject them, just because they thought that I ‘wasn’t interested’ because I couldn’t afford it.

Who are they to make that decision for me?