[mikestew]

Anecdata ahead: I'm about to leave a dentist after 15 years because I feel more and more like a cow with insurance payout for udders. She used to be good, but now seems like she's just making sure there is not a penny of insurance money left at the end of the year. Still got $50 left? Hey, how about some fluoride goo before you go, because "insurance pays for it".

[pixelready]

One thing to consider if there is a shift in this behavior at a small independent practice you use (like dentist or veterinarian offices) is the aggressive acquisition of these firms by private equity over the last few years. Oftentimes the owners / partners get a huge payout and stay on as the face of the practice while taking marching orders from the new owners to maximize profit over quality of care. This acquisition is often invisible to patients / customers except insofar as quality of care declines, people at the office seem more stressed out, and more procedures get ordered that you don’t have the expertise to assess the need for.

[hi-v-rocknroll]

I'm wondering if a similar progression is happening with MDs. OneMedical <-> Amazon (corporate rather than PE), for example. Current provider was solo, then went to OneMedical, and now is an Amazon employee (indirectly).

[hi-v-rocknroll]

Familiarity breeds contempt. 3rd to last DDS drilled a cavity freehand in like 5 minutes without being all that careful. Seemed like it was maximizing the number of procedures while minimizing the amount of care and time spent.