Healthcare Savvy

I had to get an old root canal re-roto-rootered recently.

The endodontist prescribed an antibiotic I’d never heard of before called Clindamycin. I can tell you, it’s pretty rough on the digestive tract. I’m usually oblivious to the side effects of medications, but not this time. From what I understand, endodontists prescribe it in spite of its powerful effect on your digestion, in spite of the risk of coming down with colitis. It was prescribed because it can prevent endocarditis.

Stop the presses. That right there, I think, points to a huge gap in the way we are cared for by our doctors, dentists and insurers.

It’s a no-brainer that the mouth is a key part of the human organism. Everything from air, to water, food, germs and more pass through it and into the body. But my Clindamycin prescription story, and revelations in recent years that periodontal disease also can lead to heart disease and more illustrate starkly a big gap in the health care system.

cartoon by Tyler Pike

Why does my primary care physician not know that I had a root canal retreated and was prescribed a hard antibiotic? Read the rest of this entry →

It has always been perplexing to me that pediatricians have  served the MassHealth children  yet dentists avoid serving this indigent population within their generally more affluent communities. These parents have to travel into the city or  a number of towns away to get care and often these children’s oral health is neglected. Given there is data showing oral health care is necessary for good cardiac health that it is vital to start early-not to mention the loss of days at school for pain  I hope Mass dentists will reevaluate their obligations to this population. As a result it appears that in Minnesota market forces are taking over to fill the gap and may occur here eventually. Clay Christensen from the Harvard Business School in his book ” Seeing What’s Next” he states ” A provider level disruptive innovation moves the ability  to the provide competent care down the pyramid, allowing the patient to move into the realm of nurses, nurses to move into the realm of general practitioners, or general practitioners into the realm of specialists.” Thus in order to be more accessible and cost effective, dental health ought to allow what was in the dentist’s realm into the dental hygienist/technician realm. Dental and healthcare costs could bend with this mindset without loosing quality if implemented properly. I call on dentists to provide care for poor children within their own communities. Pediatricians have had to deal with reduced billing revenue from MassHealth for years.

Last week my son Eli pulled the wire out of his braces (or something like that – I’m not exactly sure what happened). The orthodontist put the wire back in place, tightened it, etc. with no extra charge for the visit. Fixing Eli’s braces, even though he likely caused the problem by eating a banned food, was just part of the orthodontia package.

Does this happen anywhere else in health care? If you rip open stitches, have you ever had a doc sew you back up at no charge? If Eli had cracked a cast or ruined one of those boot/braces, I can’t imagine anyone saying, “oh, we’ll fix that, no charge, it’s part of the package.”