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Breaking free from medical aid rates: empowering dentists to provide high-quality dental services in South Africa

 

 

KC Makhubele

CEO, South African Dental Association

 

 

Dental care is vital to overall health and wellness. There is a myriad of challenges that health practitioners face when dealing with medical schemes/third-party funders. To address some of these challenges, some South African dentists accept medical aid rates for their services, to make their lives, and those of their patients' lives somewhat easier. In this piece, however, we argue that dentists in South Africa should set their own fees rather than rely on medical aid rates.

Initially, the price of dental care varies widely based on the necessary treatment. While calculating their rates, dental practices must account for rent, salaries, equipment, supplies, and other administrative expenses. Accepting medical scheme rates may not correctly reflect the actual cost of providing dental services, resulting in dentists getting less compensation than is necessary to maintain a sustainable practice.

Second, dentists' fees should be based on the value they bring to patients. Dental treatment is not a one-size-fits-all service, and prices should reflect each patient's unique needs. By determining their own fees, dentists can provide individualised treatments and high-quality care without being constrained by medical aid fees and protocols. By setting fees, medical aids are basically eroding the quality of dental care that a patient should otherwise receive.

Thirdly, reliance on medical aid rates may restrict dental care for individuals with the greatest need. The current model of scheme-determined rates flies against all logic -for similar treatment given to different patients, the pricing is based on the medical aid to which the patients belong! The various medical aid schemes have different cost covers for the same/similar treatment. It would make sense that each practitioner sets their own fees.

Fourthly, enabling dentists to set their own fees may stimulate competition and reduce the overall price of dental care. Patients can choose the greatest value for their needs and budget if more dentists offer treatments at various pricing points. This will also motivate dentists to deliver high-quality care at competitive prices to maintain market competitiveness.

As an Association, we have accepted that choosing your own fees can be challenging and occasionally unsettling as a dental professional. You want to give patients high-quality care while ensuring that your practice remains profitable. Fortunately, there are tools available to assist you to make informed judgements regarding your pricing. The SADA DCalc is one such tool that can assist you in determining the correct pricing for your services. This tool has been updated over the years to take into consideration new knowledge, relative value units and for ease of use.

The South African Dental Association (SADA) created the DCalc to equip dentists with an all-inclusive fee calculator. The calculator takes into account several individualis ed variables such as the current income of the practice, the cost of materials, rent, salaries, equipment, supplies, other administrative expenses as well as the relative value units associated with each procedure code, made up of the knowledge, skill, effort and risk involved in performing a procedure and the length of time necessary to perform that procedure. With this tool, dentists can thereby estimate the appropriate fees for their services based on a variety of practice-specific characteristics. The DCalc tool acts as a practice profitability simulator and allows the dentist to also carry out the role of a business owner by determining the practice's estimated profit or loss. By utilising the SADA DCalc, dentists may ensure that their prices accurately reflect the value of their services.

A further advantage of utilising the SADA DCalc is that it ensures patients are charged properly for dental services. Dentists can prevent overcharging people for their services by taking into account the numerous aspects that contribute to the expense of treatment. This is especially significant in South Africa, where patients may not have access to cheap dental care due to a broad range of earnings. Dentists may guarantee that all patients have access to necessary care by setting reasonable fees.

Using the SADA DCalc can also improve dentists' market competitiveness. Dentists can attract and keep patients who seek affordable, high-quality care by establishing fair and competitive fees. This can aid in the expansion of their practice and earnings over time. In a highly competitive sector such as dentistry, the flexibility to determine one's own fees can be a significant advantage.

In conclusion, dental care is essential to overall health and wellness, and every South African should have access to reasonably priced dental care. By allowing dentists to set their own fees, they can provide personalised and high-quality care, enhance access to dental services, and foster competition that can reduce the overall cost of dental care. It is time for dental practitioners in South Africa to break free from the confines of medical aid rates and select their own prices to give better treatment to their patients.