Alberta’s Dental Fee Guide fiasco
The president of the Alberta Dental Association and College (ADA&C) has announced a Dental Fee Guide in response to the health minister’s challenge to do so. The announcement completely blindsided the government, the members of the ADA&C, and even its elected directors — some of whom had two days or less notice. He explained that the new guide represented a three to five per cent reduction in fees.
The Alberta Health Minister immediately pronounced three to five per cent inadequate and that she might have to resort to “extreme measures.” Dental fees are too high by 20 per cent or more, in the government’s estimation.
Let’s first debunk the connection between physicians’ fees and dentists’ fees. Physicians receive their remuneration directly from the government as the result of contractual negotiations between their association and the government. Treatment facilities, equipment and staff are all provided to physicians — other than the expense they incur to run private diagnostic clinics. Physicians and dentists are different in terms of the present debate.
Dentists are 100 per cent independent small businesses, just like lawyers, accountants, etc. It is thus a slippery slope for the health minister to demand a 20 per cent reduction in fees. Are lawyers and accountants next? I will not repeat here the elements of the 60-70 per cent overhead dentists endure (that is the job of the ADA&C), but suffice it to say if fees are forced down offices will close and new dentists will settle elsewhere. So, what is to be done?
There are several less obtuse ways the health minister could gradually lower dental fees. First, the ADA&C could be encouraged to liberalize its advertising rules. The public know full well that not all dentists are equally experienced and equally qualified, and that many have preferred areas of practice, so let’s put an end to that charade. Second, the ADA&C should be encouraged to insure its regulatory apparatus obeys the spirit of the law, not just the letter of the law. This admittedly will not greatly increase the number of practising dentists, but it would enhance Alberta’s reputation across the country as an inviting place to practise. And third, the Alberta government could fund more seats in the Faculty of Dentistry at the U of Alberta. Given the multimillion-dollar new dental clinic there it’s ridiculous to graduate 35 dentists a year when previously 50 per year were trained in much less auspicious quarters.
Dr. David Balfour