The Dog’s Bollocks

Truth is like a dog’s bollocks – pretty obvious if you care to look.

Merit pay for dentists!

I received this in an email. I don’t know who wrote this but thought it a worthy read:

My dentist is great! He sends me reminders so I don’t forget checkups. He uses the latest techniques based on research. He never hurts me, and I’ve got all my teeth.

When I ran into him the other day, I was eager to see if he’d heard about the Federal Government’s latest program for improving the dental health of our children by introducing merit pay for dentists.

“Did you hear about the new federal program to measure effectiveness of dentists with their young patients?” I asked.

“No,” he said. He didn’t seem too thrilled. “How will they do that?”

“It’s quite simple,” I answered. “They will just count the number of cavities each patient has at Grades 3, 5, 7, 9, and average that to determine a dentist’s rating. Dentists will be rated as excellent, good, average, below average, and unsatisfactory. That way parents will know which are the best dentists. The plan will also encourage the less effective dentists to get better,” I said. “Poor dentists who don’t improve could lose their licenses to practice.”

“That’s terrible,” he replied.

“What? That’s not a good attitude,” I said. “Don’t you think we should try to improve children’s dental health in this country?”

“Sure I do, but that’s not a fair way to determine who is practising good dentistry.”

“Why not?” I asked. “It makes perfect sense to me.”

“Well, it’s so obvious,” he said. “Don’t you see that dentists don’t all work with the same clientele, and that much depends on things we can’t control? For example, I work in a rural area with a high percentage of patients from deprived homes, while some of my colleagues work in upper middle-class neighbourhoods. Many of the parents I work with don’t bring their children to see me until there is some kind of problem, and I don’t get to do much preventive work. Also, many of the parents I serve let their kids eat way too much sweet food from an early age, unlike more educated parents who understand the relationship between sugar and decay. To top it all off, so many of my clients have tank water which is untreated and has no fluoride in it. Do you have any idea how much difference early use of fluoride can make?”

“It sounds like you’re making excuses. I can’t believe that you would be so defensive. After all, you do a great job, and you needn’t fear a little accountability.”

“I am not being defensive!” he said. “My best patients are as good as anyone’s, my work is as good as anyone’s, but my average cavity count is going to be higher than a lot of other dentists’ because I chose to work where I am needed most.”

“Don’t’ get touchy,” I said.

“Touchy?” he said. His face had turned red, and from the way he was clenching and unclenching his jaws, I was afraid he was going to damage his teeth. “Try furious! In a system like this, I will end up being rated average, below average, or worse. The few educated patients I have who see these ratings may believe this so-called rating is an actual measure of my ability and proficiency as a dentist. They may leave me, and I’ll be left with only the most needy patients. And my cavity average score will get even worse. On top of that, how will I attract good dental hygienists and other excellent dentists to my practice if it is labelled below average?”

“I think you are overreacting,” I said. “‘Complaining, excuse-making and stonewalling won’t improve dental health’… I am quoting from a leading member of the DOC,” I noted.

“What’s the DOC?” he asked.

“It’s the Dental Oversight Committee, a group made up of mostly lay persons to make sure dentistry in this state gets improved.”

“Spare me! I can’t believe this. Reasonable people won’t buy it,” he said hopefully.

The program sounded reasonable to me, so I asked, “How else would you measure good dentistry?”

“Come watch me work,” he said. “Observe my processes.”

“That’s too complicated, expensive and time-consuming,” I said. “Cavities are the bottom line, and you can’t argue with the bottom line. It’s an absolute measure.”

“That’s what I’m afraid my parents and prospective patients will think. This can’t be happening,” he said despairingly.

“Now, now,” I said, “don’t despair. The Federal government will help you some.”

“How?” he asked.

“If you receive a poor rating, they’ll send a dentist who is rated excellent to help straighten you out,” I said brightly.

“You mean,” he said, “they’ll send a dentist with a wealthy clientele to show me how to work on severe juvenile dental problems with which I have probably had much more experience? BIG HELP!”

“There you go again,” I said. “You aren’t acting professionally at all.”

“You don’t get it,” he said. “Doing this would be like grading schools and teachers on an average score made on a test of children’s progress with no regard to influences outside the school, the home, the community served and stuff like that. Why would they do something so unfair to dentists? No one would ever think of doing that to schools.”

I just shook my head sadly, but he had brightened.

“I’m going to write my representatives and senators,” he said. “I’ll use the school analogy. Surely they will see the point.”

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Filed under: Economics, Education, Politics

9 Responses

  1. madmouser says:

    This is a terrible program. The dentist is correct. There are too many outside influences to make it fair.

  2. […] this week has quite some distance to travel, my post of the week so far is this delightful piece on performance pay for dentists by Slim at the Dog’s […]

  3. Michael says:

    Excellent article on dentists stuff

  4. Michael says:

    dentists in doncaster are reasonable in price:)

  5. I agree with madmouser. I don’t really like the idea of this program.

  6. funnyfunny says:

    This dentist program is not real!…It is to relate to the “No Child Left Behind” govt program…it’s supposed to be a joke. Obviously Los Gatos and Madmouser don’t get it. Unless they’re being sarcastic.

  7. Noel Bourke says:

    I wrote this story and posted it on my blogsite on January 6, 2013. My blogsite is called the Font of Knowledge and is located at noelswriting.blogspot.com.au
    I originally wrote it as a simpler story which was published as a letter to the editor of The West Australian newspaper in early 2007.
    Subsequently, and unknown to me, the WA Secondary School Administrators Association submitted the story for publication the the Western Australian Primary Principals Association’s quarterly magazine, WORDS. It was published in July, 2007, but did not cite me as the author.
    I substantially rewrote the story in 2013 and posted it on my blog. It was published in April, 2013 edition of WORDS.
    I would welcome any feedback which may be made through my blogsite comments section or on the blog’s e-mail link

  8. Noel Bourke says:

    Actually my blogsite is called The Font of Noelage ( my daughter thought of it).

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The Dog’s Bollocks

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The Dog's Bollocks: "Bollocks" is one of my favourite words, and this is now one of my favourite blogs and I've only been reading it for five minutes. – John Surname

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