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Dr. Jeffrey Dorfman's Blog

Archive for February, 2009

Recession Likely to Boost Government Outlays on Health Care

Wednesday, February 25th, 2009

The Center for Special Dentistry in NYC has created a successful unique model for healthcare delivery and education in mid-town Manhattan that is affiliated with both Columbia and NYU dental schools. It provides dental care for those who cannot afford it and trains students for the real world. The program has existed for over ten years and is financially viable. This model could be rolled out to a much larger population for both medicine and dentistry.

The Dental Faculty Practice at The Center for Special Dentistry serves two purposes: 1) To provide dental care for those who cannot afford it, and, 2) To train dental students in a real-world, premium private practice setting.

Top students from Columbia University and NYU dental schools are selected to treat patients of lesser economic means in our mid-town dental practice. Our practice is composed of twelve dentists and specialists who focus on super premium cosmetic reconstruction. It is the only private dental practice in New York State wherein dental students may treat patients for reduced fees with the patient’s informed consent. This dental work is supervised by our Faculty Dentists. Patients do have the option of being treated solely by Faculty Dentists at our regular premium fees. Sometimes more complex cases may be completed by both Faculty and students.

Patients treated by students may typically expect fee reductions starting at 40% off premium fees depending upon the procedure. The procedures available to be performed by students are limited at the discretion of the Faculty Dentists.

This program exists as a public service. It is not associated with any managed care program. This program offers the uninsured an attractive alternative in a quasi-academic environment. A financial dental plan, with prearranged monthly payments, may be available for pre-qualified patients. The number of patients and the type of cases accepted into this program are limited. Patients who do not qualify may be referred to a local New York dental school for treatment.

Our program could serve as a model to address fundamental flaws in American health care education and delivery. It is believed that health care education should be offered to interested students in high school and college and that these students should be on a health professions fast track towards their graduate degree. These students should be offered jobs during high school, college and medical/dental school in which they will be given increasing responsibilities in health care delivery to alleviate labor shortages and to help underserved populations. These students will impress upon their family, friends and neighbors the benefits of preventive health care. This work-study approach would also greatly reduce the debt many students face upon graduation from medical and dental school.

Interested readers may visit NYCdentist.com/faculty for more information.

Read the Wall Street Journal article.

Yahoo to Offer Tools To Match Users, Ads

Tuesday, February 24th, 2009

The “new tools” described in this article are not new. www.NYCdentist.com has been offering ads targeted to users during a certain time of day for about five years – before Google. It has been functional across our 500 worldwide websites with less than one hour of labor.

Winning back advertiser business will require Goodwill. This author believes Yahoo lost it to Google early in the search war with an 800 pound gorilla mentality. Google was sympathetic to new advertisers; Yahoo rewrote the rules as it saw fit. This was similar to the problem faced by print Yellow Page directories in an earlier decade as new competitors emerged and the old guard foolishly ignored circulation drops while increasing pricing.

Yahoo needs an Advisory Board of Category Leading Advertisers. This author likes Google and wants to like Yahoo. Competition is in everyone’s best interest. Yahoo should keep search.

Read the Wall Street Journal article.

Yahoo CEO Set to Install Top-Down Management

Monday, February 23rd, 2009

 

Yahoo should keep its search business but learn how to make it better. Ms. Bartz should compose an Advisory Board of Category Leading Advertisers to learn from their knowledge and experience how to improve Yahoo. Offer members of this Board a substantial chunk of stock options for good results. Some helpful ideas are quite obvious but Yahoo management doesn’t get it.

 

This author has worked with Fortune 500 Chief Web Officers and National Heads of Sales who are clueless about the Internet despite their job titles. Hiring these types won’t help Yahoo. Entrepreneurs who advertise on Yahoo and Google using their own money hold the key to Yahoo’s search future.

 

NYCdentist.com and its family of 500 urls in dentistry have over ten years of Internet data from 200,000 targeted monthly visitors (1dentist.com/about). We have a lot of insight into the Yahoo v. Google search war. I’m sure other Category Leading Advertisers do too. Is Yahoo, its advisors, or its institutional investors interested?

 

Read the Wall Street Journal article.

Aetna’s Earnings Drop 57% Amid Investment Losses

Thursday, February 12th, 2009

Mr. President,

America cannot rely on companies like Aetna to lead it out of a deepening healthcare crisis.  They are part of Wall Street not Main Street.

 

Our country needs to incubate American entrepreneurial ingenuity in healthcare, from the bottom up, similar to current efforts in the auto (X Prize) and green energy industries.  It is the doctors, dentists, nurses, pharmacists, PAs, therapists and others working with their patients each day that might have the next GREAT idea.  $100 million in stock options to healthcare CEOs does not rally the troops.  Listening to them might help.

 

Why not create a “suggestion box” directly between American healthcare workers and the Surgeon General?  Let Americans do what they do best.  Innovate.

Read the Wall Street Journal article.

AMA Joins Suit Against Aetna, Cigna Over Payment Data

Wednesday, February 11th, 2009

Readers of NYCdentist.com first read about this issue in 2000 as reprinted below:

Where Are The Doctors?

by Dr. Jeffrey Dorfman

(Published in Dentist Quarterly – The official publication of the New York County Dental Society – March 2000)

I attended the Bear Stearns 12th Annual Health Care Conference that was scheduled to run from September 15-17, 1999 at the Waldorf-Astoria Hotel in New York City. There were over 1200 registered attendees and over 150 speakers representing all kinds of healthcare companies. I was one of very few doctors who was invited to attend. I was asked to leave.

I was asked to leave because I asked two questions. Will insurance companies like Aetna and Wellpoint respect the request of the American Dental Association and stop using ‘usual, customary and reasonable (ucr)’ terminology in dealing with patients and instead use ‘maximum plan allowance.’ The reason for this request is that there is no such thing as a usual, customary and reasonable fee; there is tremendous variation of reimbursements for a given procedure even within the same insurance company based upon the specific policy purchased and premiums paid. To use such terminology raises distrust in the mind of the patient regarding their doctors fees.

I also asked the management of several publicly traded dental management service organizations if their growth strategies could avoid taking equity positions in dental practices through the legal subterfuge of ‘hard asset buyouts.’ This is because the American Dental Association believes that the welfare of patients is best considered when the ownership and control of dental practices remain with dentists, not investors.

These are legitimate questions that must be answered if doctors are to become involved in the evolution of healthcare delivery in our country. Investment bankers and their investors should not consider doctors merely a variable cost in healthcare and in need of paternalistic employment. We should be considered equal partners and invited to attend these conferences. Healthcare is much more than the pathetic representation of revenues and income growth as shown at this conference.

http://www.nycdentist.com/phpBB2/viewtopic.php?t=97#top

Read the Wall Street Journal article.