I have done my best to keep healthy and stay away from the doctors, most of my life. My last family doctor retired from his profession about 17 years ago. He had done my last preventive medical examination: Checking blood for cholesterol, urine, heart and so on. My health passed with no warnings. Unfortunately, I never had any other urgency to seek a further medical examination. Family and friends always remind me of necessity to have regular checkups. My wife has occasionally visited the walked-in clinic, just to treat her cold. I always like to put off unpleasant things and; therefore, there were always higher priority tasks on my list. Few months ago, I walked in into a family medical office close to my home. The immediate impression of the office was not exactly very cheerful! I enquired about being accepted as a new patient. A receptionist who must have been hired for the job because of her lack of smile handed me a new patients’ application form. She asked me if I feel sick and if I have any urgency to see a doctor. I replied no. She said that my application would be reviewed by a doctor. They accept some new patients and the office will phone me to set up an appointment. The promised phone call never came. I assume that my reasons for seeing a doctor were not deemed important. Therefore, they just do not want me as a new patient. Many medical clinics in Toronto just do not accept new patients, and the signs are clearly posted on the door. If I can find a time and courage, I will try another medical office.
Although I do not like doctors, I do not fear dentists, and we do have a family dentist. He is our second family practitioner since the retirement of our first one. My wife has more frequent reasons for her visits, but I stick to about once a year. Unlike my wife, I do not have a dental insurance and each visit usually empties my wallet. Dental offices have adopted marketing and know how to compensate taking money by making the visit more pleasant than it was in the past. There is a big difference between now and just twenty years ago. Their offices used to be located in places with low or economy level of rent, but never in prime retail locations. The second floors of the malls were littered with these professional offices. Doctor’s names were always on the signs and the doors. There were no dental trade names in use yet. My first experience was with an old school dentist on Bloor Street West near Jane and Bloor subway station in Toronto. It was a second floor of a low-rise building at the major intersection on Bloor Danforth Subway line. It was a one-man office him serving patients and handling the phone calls. Sometimes his wife showed up to help with his administration. I think she prepared the patients statements on old Olivetti electric typewriter and mailed them to patients for payments or to the insurance companies. Credit cards were just not accepted at their offices, yet. Our bill to pay never exceeded $100.00. The dentist alone provided cleaning, but I recall asking for it. It seems that cleaning was not a standard procedure yet, the way it is emphasized today. I never heard about whitening. The only exception was his recommendation to see a periodontist who was located in a similar simple looking office few buildings away. I felt no pain from his actions, but have to acknowledge that the environment in his office increased my level of nervousness, while sitting in his waiting room. The place just had a stigma of place where the pain is inflicted. He retired number of years ago and his office was closed for good. There was no family member to carry the professional office under the same name. Advertising at the time was non-existent, not allowed by the governing dental college. Only exception was to mail the flyers in the neighborhood at the time of office opening.
We have visited new one, the same dentist for past 17 years or so. It is all a brand-new experience. His dental clinic is located on the store-front of a large plaza, next to a brand-name restaurant. Prime and expensive retail location. The office makes an impression of overseas spa-resort, rather than a place for personal discomfort. Use of the latest technology is visible. Patient’s education programs are available on a large screen tv in the waiting room. There seems to be so many people working there. Assistants, hygienists, an office manager. The office makes an impression that it is clearly overstaffed. The doctor alone seems to have a lower status than his office’s brand-name. It is how they do the business these days, since there are always so many new associates willing to work for established clinic. They also seem to come and go. One dentist I know has recently completed a post-graduate business program at the local university. All these bells and whistles have their price for the patients. If you do not have a dental insurance coverage than receiving a bill can be shocking news. It has been said that people dislike dentists, but I would add that it must be because of those high bills that many can’t afford. My recent cleaning with two sessions came to over $400, and the hygienist recommended visits every 5 months. Cleaning done by the previous family dentist cost me just about $40.00. I will allow for the inflation factor, but clearly new prices are just reflections of new costs and new ways of carrying the profession. Their marketing and advertising are also part of the costs, but there are no economies of scale to keep the prices down. I can clearly see how dental offices are always compelled to advertise for new patients. Their advertising flyers are always in my mailbox. Lately, Internet is another preferred media to recruit new patients.
Which the medical profession is more financially rewarding in Toronto, and anywhere in Canada is a subject to a lengthy debate. Last time a dentist confided to me that he should have been a different type of doctor, not a dental one. Apparently the financial stresses of running a business can be overbearing. He told me in private that since his sold his professional office, he works for well-known clinic now, and he is more than happy. His net pay is about the same as before, but he has more free time for family and mainly less stress. The success in the profession is not defined how good you are to your patients, but by those visible luxuries you can accumulate from the business side. The dream of every dentist is to own as many clinics as they can and employ other professionals to take care of clinic’s patients. It might be sad to admit, but new dentists do not dream of becoming great doctors, but great business people. Very few of them succeed with their goals. To start with, they have to operate in several clinics in the same time. For business reasons and for branding, the dentist’s name becomes less important and it is seldom ever used today. Most of time, the professionals will come up with their brand names that are related to their locations. There are many ambitious business dentists. With their work, they rotate among two, three or more office locations per week. It must be personally very tiring to drive distances over the city, if you have one clinic in Scarborough, second in Mississauga and third somewhere in Toronto. They have to be available there during posted hours. It is what many motivated clinics’ owners in Toronto GTA do these days.
Would there be something positive that medical and dental offices could learn from each other? Each profession is run by different sets of objectives. Dental is primarily profit oriented profession run like a business should be. It can be said that many people would rather not see them as profit oriented businesses, but more as affordable medical service. Medical clinics, family doctors or walk-in clinics are free of payment from patients. The government run OHIP insurance pays the bills, but services provided do not seem to have the same luster. Medical and non-emergency services seem to be rationed, and there is no demand for new patients to make money. On the other hand, patients are free from worrying about financial consequences, if somebody is stricken by an illness or accident. Highest dental fees are paid for optional cosmetic procedures. On the other hand, in places south of our border illnesses with no private insurance can mean some financial ruins.
Midtown Torontohas cosmetic dentists with long experience near subway stations.