Amerika

Wandering the darkened halls of conservative social media, one encounters interesting people. Some of them stand out as having a certain quality of leadership to their thinking, and one of these in my experience is someone we shall call Anonymous Dentist.

His expression of basic conservative values which are leaning toward extreme realism struck me as fascinating, so I asked him to sit down for an interview with us which is reproduced below.

When did you know you were going to be a dentist?

Honestly, when I graduated. It wasn’t something I was “called” to do. My best friend’s dad growing up was a dentist and I had zero interest in it. But doors opened up… I made the right friends… and next thing you know I’m in as an alternate. Then I had to drag myself through over four years of it, wondering if I’d get across the finish line.

Was it hard to get through all the schooling?

Insanely hard. There’s a common notion that dental school is actually more difficult than med school because you’re basically cramming four years of education along with two years of residency into four years overall. The hardest part wasn’t so much the didactic work; it was having to swallow lots of bullshit you knew didn’t matter and be able to regurgitate it on a test. There’s a ton of antiquated stuff taught in dental school especially.

How did you afford this, and how long did it take to pay off any loans?

Loans baby, lots and lots of loans. Our school was pretty awesome in that we had a student loan expert who could always come through for you, but that was a problem also. I definitely took out more than I needed to in order to pay for stupid shit. Some others took out way more for stupid shit (like five thousand extra to go on a vacation). I made the conscious decision going into school that I’d focus on it and live off of loans because I wouldn’t have the time to work. I worked like crazy through undergrad and made good money doing it but I’m glad I didn’t continue that going into dental school.

How long did it take to pay off the loans? About ten years. Couple interesting asides about that. I graduated in 2006 and was a couple months late. My cohorts who graduated on time and consolidated quickly paid around 3% interest over a 25 year schedule I think. Since I was a little late and rates had climbed, I ended up consolidating at just under 6%. Huge difference. Early after practicing a few years I decided this wouldn’t be a life long career (I wanted to coach football instead believe it or not) so I started working hard to pay off the debt. But still for years it was a huge amount and I was making only minimal progress. I started listening to Dave Ramsey and reminded myself that I could easily live below where I’m at. So in one year I sold a second vehicle (for only like $2,500), sold a condo I had in a city two hours away (again, not much… like under 30K), sold some stocks, and threw a lot of cash I had saved at it. I went from a balance of over 100K to zero in one year because of that and saved myself a ton of interest of course.

What, in your view, are the signs that a dentist knows what he is doing?

This is really hard. I can identify it myself in half a second but for a patient to is almost impossible. Someone who knows what they’re doing is going to have a process — a system — for everything from simple exams to large complex procedures. Always beware the jack-of-all-trades studs in this business are so busy doing restorative work they don’t have time to do specialist work (root canals… extractions… complex perio procedures) and they farm it all out (it’s what I do). Best way for a layperson to know: ask local specialists. They’re the ones who work hand in hand with them all day, and they’re the ones who have to clean up the messes sometimes. A great dentist will never give you promises they can’t deliver. They don’t say things like “never” or “forever” or “always,” at least not generally. A great dentist will also plan things to the hilt before jumping in. Not necessarily small things like a simple filling (though I’m doing that as I’m getting ready to work on it). But big things like multiple crowns or restructuring someone’s entire arch; there’s a ton of legwork that needs to be done first if it’s going to go smoothly.

How has healthcare reform changed your practice?

The beautiful thing about dentistry is we’re somewhat insulated from a lot of the medicine-based reforms. The biggest impact that it has had is the cost of health insurance for employees. When the ACA came out our old plan was no longer acceptable, so we had to migrate to a plan that pretty much tripled our premiums. I had to become much more astute and aware of the health of a potential new hire, and health insurance became a bargaining chip more so than an automatic benefit. The only other big changes (and it’s pretty big) has been the insurance industry’s constant inroads into monopolizing the market and then manipulating it to their benefit.

Right now insurance companies in the dental industry are trying to integrate everything from the top down. They want to be both the payer, and the provider. Corporate outfits are making the provider side of that equation more difficult everyday as well. Delta has tried to eliminate top tier plans in many states, forcing providers instead to accept lower reimbursement rates or risk losing all their Delta patients because of hoops Delta makes people jump through if they’re not in network. If it weren’t for McCarran-Ferguson, most of the insco (insurance company) executives would be in prison. Delta trying to eliminate premier level plans would pretty much destroy my practice and bankrupt me, and it’s one of the factors in my decision to get out.

Are there better policy choices we could make in the healthcare arena?

Absolutely. I think one of the biggest things is to get out of this habit of inscos paying preventative care at a high rate, but treatment at a lower rate. This seeds an entitlement mindset in people where they think everything will be covered because preventative is. Instead people should be asked to cover the preventative costs, and insurance can cover the larger case costs. Problem with that is it disincentives preventative care.

The biggest challenges to our healthcare system though are more cultural than problems with the systems themselves. Entitled people make terrible patients and the quality of care someone gets is directly a result of their cooperation and ability to be a good patient. Personal responsibility is a big part of why some people have very few health issues and some are constantly beset by them. I personally think we have a huge problem with both Munchhausen and Munchhausen-by-proxy issues. We have a huge mental health problem that’s mostly the result of parenting and society filing people’s heads with nonsense. All that stress and anxiety magnify other health issues big time. I actually think we need to regulate insurance companies more, because right now they’re able to basically defraud people by selling what people think is reasonable insurance that ends up not covering dick. The out-of-network versus within-network issue is huge too. There just shouldn’t be any networks in my opinion. Or if there are, there shouldn’t be different tiers of benefits covered for one or the other.

What are the unnecessary expenses in your business that are getting passed along to consumers?

I’m an overhead shark. I keep any unnecessary expenses pretty low. I quit renewing my DEA license so I don’t need to pass that on anymore (but before it was like $750 / three years). Malpractice insurance is reasonable. I’d say the biggest example is insurance companies inventing new ways they’ll refuse to pay for things, and the costs then get passed to the patient. Case in point: Guardian insurance doesn’t want to pay for multiple surface fillings on front teeth. Therefore they downgrade them to a single surface, and only pay for a single surface. Since I’m not going to accept that and take a pay cut because of it, the patient ends up paying more out of pocket for the service than they did just a year ago.

How has your perspective as a dentist influenced your political views?

When I was in school I was pretty liberally minded. I bought into the notion that everyone is essentially good, and if they’re not able to live that it’s because of the ills of society and society is keeping them down. I carried that mentality out to California with me and worked my first job in a public health clinic. That mentality was all but gone after two months.

What I saw — over and over and over and over — was that these people were in the position they chose to be in. People would complain about getting cavities all the time and tooth problems and such, yet sit a 32oz mini jug of Mountain Dew on the counter when they came in for visits. I started to probe a little more and started asking patients about their experiences and why they were in the shape they were in. I’d say I ran into a 9:1 ratio of people that blamed others versus took responsibility for it. It opened my eyes pretty quickly.

Then to add to that, I started observing those who were really good at what they did and were very successful and noticed the exact opposite trend. I realized that for most of the people I was “helping,” they cause their own problems and now they expected me to give them top-notch world class care while someone else was paying for it. It honestly led me to believe that the public health care system in this country is terrible and probably seeds more problems than it addresses.

It also opened my eyes to what wimps and crybabies people are today. I see the trend worse in kids. About a year ago I needed my last two third molars removed, so I asked the oral surgeon I work with to do it for me. I thought “hey, this will be good for me to be on the other side of things and remember what it’s like to be a patient.” I have very little tolerance for drama in the chair, and I thought this might humble me a little bit. I kid you not it was one of the easiest things I’ve ever done. I went in expecting to have more tolerance for drama after I was done, and I ended up having even less tolerance for it. Life is hard and you’re going to get some cuts and bruises along the way. You can cry like a child about it, or suck it up and push on. Being a dentist showed me that unfortunately, most Americans choose the first path in that conundrum.

What do you think of Donald Trump and the issues on which he campaigned?

Anyone who knows me even halfway well knows I’m an ardent supporter of the President. I don’t always agree with all of his political stances. I very much disliked the bump stock ban and the way it was gone about. But the thing is he’s the kind of leader we just need right now. I wasn’t on his train initially — I pulled for Ben Carson hard — but once I realized Carson wouldn’t make it, Trump was the only one left who made sense. He’s a direct counter, both metaphorically and literally, to the sissified nanny crybaby culture we live in today. He stands as an affront to that and his election was basically drawing a line in the sand saying “no more.” The number one issue facing our country wasn’t ISIS or the economy or any of that; it was the cultural direction we were headed. Trump’s election thwarted that advance and started a retreat back to sanity. That’s why you see the intense reaction you’ve seen, because the crybabies knew “oh crap, the game is up… I can’t get my way by throwing a temper tantrum anymore.” Which, ironically, caused them to throw more and bigger temper tantrums. There’s always going to be more of a mess initially when you’re cleaning up an already big mess.

If you could “fix” America, how would you do it, assuming that you had Emperor Commodus style powers?

I would work to re-instill a culture of self-reliance, hardiness, and toughness. We need to make being tough cool again. Today a person’s social clout or status is determined by how much of a victim they are. That needs to change if we’re going to make our country and our culture great again. We need to get back to the place where whining is met with deaf ears or a turned back, where victors and winners are championed, and being a winner is cool again. How we do that is a mystery to me, so I just try to live my truth everyday and confront victimhood culture head on when I meet it.

Thanks for taking the time to be with us today, and happy… uh… drilling.

Tags: dentistry, healthcare, interview, medicine