Matt writes, "Inability to afford basic dental services is a large problem for many poorer Americans, so naturally when an entrepreneur comes along ready to offer basic dental services at a more affordable price dentists' trade organizations leap into the fray to get the operation shut down. It's proprietor, after all, isn't a dentist and just because it only takes a dental hygienist to do a basic cleaning is no reason you should be able to get a basic cleaning without paying top dollar for a dental school graduate." One of the major problems in health care is the power of the professional guilds. That's true for doctors, surgeons, dentists, orthopedists, etc, etc, etc. Delivery system reform is, as Matt points out, very important, but no one, not the insurers and not the government, feel able to pick a huge fight with these groups, as the public actually likes them. So everyone sort of tiptoes around these issues, because no one really sees a path forward. This is one of the reasons that I support MinuteClinics and other basic care offerings (much to the consternation of some readers) run by nurse practitioners. Not every health problem requires a full doctor, and I'd like to see doctor's office compete and adapt in a world in which patients have the option to bring their low level problems to cheaper, more customer service oriented providers. To give just one example, you walk into a doctor's office and they still put your information on paper in a manila folder. If you walked into a bank and they opened up a giant, dusty book recording transactions, you'd laugh and walk out. But doctors hold all the cards, so you put up with 19th century information practices -- practices which, in a literal way, end up killing people, as prescriptions are misread and crucial information is lost -- and doctors face neither sufficient pressure nor competition to force change. Maybe these clinics can bring some of that competition.
