Cyrus Dugger

Offensive Medicine

The self-labeled tort “reform” often argues that our civil justice system results in a rise in defensive medicine. This assertion has been debunked on Tort Deform before (The Myth of Defensive Medicine, What about defensive medicine?, and also indirectly by Louisiana’s Medical Malpractice Cap Ruled Unconstitutional, as well as by CJ&D's No Epidemic of Medical Testing and other resources).

But what about “offensive medicine?”

What is offensive medicine? Well I just made the term up, but I use it to describe situations in which a medical care professional charges you or convinces you that you need treatment or procedures that you really don’t.

I never thought about this issue until I recently went to a new dentist. A couple of days before I went to the new dentist I was having headaches (probably related to dealing with the tort “reform” movement everyday at work).
When I got to the dentist I mentioned the headaches to her. Although it had only been happening for a few days, and had rarely happened before, my dentist started doing all of these additional procedures. She took an imprint of my mouth, told me I had an overbite, and said that the overbite was probably causing my headaches and that I should get braces to fix it.

She implied that I would always have headaches if I didn’t get the braces. She also made sure to tell me it wouldn’t cost me much at all because my dental insurance would cover most of it. Now I may have an overbite, but I rarely have headaches, and no previous dentist I have had has ever tried to make that case to me.

When I told her that I wasn’t interested and thought that the headaches would pass, she shook her head and asked if I was sure. I said I was. She sighed and continued.

Continuing she found a small chip on one of my teeth. She said "oh my go you’ve got to get this fixed." I can fix it right up for you and it will look like new. It won’t cost you much at all. She then asked her assistant how much it would cost me, and she shouted back something around fifty dollars, or perhaps even nothing. I said “thanks, I’m just not interested. I’ve had it for years now and it is what it is.”

You see I’m just not a vain person, maybe someday I’ll get it fixed, but there’s no fire on this issue.

My dentist then talked for five minutes about how cheap it would be for me to get the chip fixed, and how much she thought I should get it. As my appointment ended the dentist actually followed me out of the dentist’s room saying you “know you’re really going to regret this Cyrus, you’re really going to regret this.” I literally had to run away from the office to avoid being pressured into getting a dental procedure I had no interest in.

People always have their own unique motivations for what they do, but I left with the distinct feeling that the dentist was pressuring me because she could bill a lot of money for the procedure. While the tort “reform” movement attempts to argue that lawyers and lawsuits increase premiums for medical care (a point rebutted in full by the Center for Justice & Democracy and by Public Citizen), unnecessary procedures obviously do increase the cost of dental insurance for all patients.

While dentists and the dental insurance system are different than medical doctors, and most doctors that most American interact with are not in private practice or in the business of advocating for cosmetic health issues, the point that sometimes dentists or doctors can add to the cost of health related care with unnecessary procedures that are not related to a patient’s actual health, but are instead solely aimed at adding to the billable procedures a dentist can charge your dental insurer should be well taken.

I'm sure that the great majority of doctors do not enageg in this sort of pratice. However, when we look at the costs of medical insurance we’ve got to ask ourselves if doctors, or in this case dentists, have any role in increasing the cost of care because of their own financial interests.

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Posted at 12:08 PM, Jan 11, 2007 in
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