orgtheory.net

dentists & firm boundaries

I asked my dentist: Why haven’t hospitals internalized dental surgeons? Don’t hospitalized patients need care? Inititally, she said that dentists need certain equipment. You can’t do dental work in a hospital bed. But, then, I said, “Can’t the hospital just have a wing for oral surgey?” She then went cultural and claimed that dentists had a strong preference for small group practice. Is that a correct answer?

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Written by fabiorojas

October 20, 2012 at 12:01 am

Posted in fabio, professions

4 Responses

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  1. i bet if you asked paul starr he’d be able to tell you

    andrew

    October 20, 2012 at 1:53 am

  2. I for one am shocked that your dentist couldn’t give you a satisfactory analysis of the structural, financial and cultural constraints and opportunities that has led to the current configuration. Perhaps you should seek care for oral hygiene elsewhere.

    tina

    October 20, 2012 at 12:10 pm

  3. Tina: She prominently displays her Mensa membership certificate. I expected a better answer.

    fabiorojas

    October 20, 2012 at 1:35 pm

  4. Sometimes there are oral surgeons in hospitals (e.g., http://www.massgeneral.org/omfs/). But for many procedures, such as wisdom tooth removal, the facilities of a hospital are just not necessary. It would seem to be much more efficient (and profitable) to have a smaller, leaner operation, unless the procedure is really complex. It likely also has to do with professional turf wars (as in Starr), where dentists were able to carve out a space in the medical sector, independent of physicians.

    So, do orgl surgeons prefer autonomy for cultural reasons? Maybe, but not likely that cultural reasons are the primary driver of independence — I imagine it primarily boils down to $$ and that they don’t really need hospital facilities.

    Also… many other physician specialties have attempted more recently to make such a move towards autonomy (for reasons having to with $$). See http://content.healthaffairs.org/content/24/3/868.full. A critique of this trend is that ambulatory surgery centers allow physicians to skim more profitable cases, leaving more complex (and less profitable) cases for the larger hospitals to take.

    Sean M

    October 20, 2012 at 6:08 pm


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