Fees for dentistry

Should auto mechanics earn more than dentists?

I recently paid our auto mechanic, Ian, ninety-five dollars an hour to do some engine work, not counting cost of parts. The total bill came to just over $700. Was this unreasonable? I don’t think so. Ian performed some very skilled diagnostic work and completed the repairs successfully. How does this compare to dentistry?

I’d love to bill hourly and then add materials costs! Mechanics and attorneys do it, so why can’t I? Unfortunately, I think, dentists generally follow the medical model of billing: make a good guess for a fee that sounds good and charge it for a given procedure. The situation has worsened with insurance companies injecting themselves into fee regulation. Most companies try their best to determine what practitioners charge for a given procedure, and over time this has given dentists less and less say in what gets billed for the treatment. In Ontario, dentists have a Fee Guide, created with insurance companies, to set a framework for insurance rebates for dental treatments.
Regardless of fee regulation, dentists have very technical surgical training.  We provide medical and technical expertise to care for the oral and maxillofacial region of the body.  And that training and risk we dentists assume comes at a cost.  Additionally, the staff and specialized equipment of a dentist makes up more than 50% of the overhead costs.
When I opened a brand new practice, I realized that my fees showed little connection to the difficulty and cost of doing a given procedure. Over the years I’ve tried to make corrections in my fees to move closer to the hourly model of billing. I start with what my hourly costs are and work out from there. My rent, staffing, supplies and materials costs come to over $440 every hour of every work day of the year. Yep, that’s before I make a penny. And that’s for “basic” dentistry. Add the complexity of soft tissue or bone surgery, such as a dental implant, and the costs increase.
So next time your dentist diagnoses a molar needing a crown that will cost you more than $1000 remember this: the dental lab gets a quarter, the staff gets another quarter, and the general overhead and materials department gets a quarter. That leaves the Doctor of Dental Surgery the last quarter. Broken down hourly, that’s about $125 an hour. Is that reasonable? You decide.

Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.