Some UAE dentists caught out for grossly over-treating patients
By: Nick Webster | May 12, 2018 | The National
Dubai Health Authority handed out 25 fines for fraud, waste and abuse cases.
From left, Dr Per Rehnberg, chief executive of Snö Dental Clinics, and dentist Dr Nasser Fouda, say dentists can often view their practice as a business rather than as providing healthcare. Pawan Singh / The National
Expensive and pointless dental treatments offered to patients to boost profits have been exposed in a mystery shopping exercise at practices in Abu Dhabi and Dubai.
Fifteen clinics were checked by dentists posing as patients to assess how common over-treatment is in the industry.
One patient was offered unnecessary root canal treatment, crowns and fillings at a total cost of Dh26,200, when all that was required was two fillings and a visit to a hygienist.
The case was just one example highlighted by Scandinavian dentists in Abu Dhabi.
Regulators said they were stepping up inspections, and would only recommend providers based on a positive history of care.
Dr Per Rehnberg, chief executive of Snö Dental Clinics, who has been working in Sweden, Norway and Denmark before running a dentist practice in Abu Dhabi, was shocked at the high level of treatments being offered to patients, with insurers often picking up the costs.
“Root canal treatment is often suggested and is very common here.” he said.
“After my experience, I sent staff out to several other clinics and they found the same thing.
“There was a lack of documentation. Clinics take x-rays but it is very important for patients to get a proper status so they know what is being included in an exam.”
One clinic suggested a patient had a root canal, 3 crowns fitted and 4 fillings amongst other minor treatments costing Dh26,200.Caries – decaying teeth – were removed by another dentist to avoid the need for fillings, root canal work or crown fittings, at a cost of just Dh3,000.
“It is a competitive business, we know that, but none of the mystery shoppers were given any documents and the majority of clinics recommended over treatment,” Dr Rehnberg said.
“The science has gone so far forward. We know there are many alternatives that are cheaper and less invasive than a root canal.
“We earn less money as dentists, as insurance companies do not always pay for these kind of alternative treatments, but they are usually better for the patient.”
Dentists said nine out of ten patients in pain did not need a root canal treatment, yet the procedure was still offered.
“The Hollywood smile is big business; it looks good but many patients I see for follow up work it is clear it has been done in a hurry,” Dr Rehnberg said.
“Cosmetics are very popular, but many dentists are not describing the pros and cons to patients. “There is always risk.”
Veneers at a cost of between Dh2,000 to Dh4,000 per tooth were commonly prescribed, instead of a cheaper option of bleaching.
To achieve the perfect smile, patients can expect to pay anything from Dh12,000 to Dh40,000 for veneers, whereas bleaching can cost just Dh2,000.
Dentists have said proper record keeping is crucial to maintain a transparent industry.
Dr Nasser Fouda has been in the UAE since 1996 and said a common trend is dentists viewing their practice as more of a business than providing healthcare.
“Many dentists call people clients, rather than patients and want to make money – they are more like teeth mechanics, and are happy to drill, screw or carry out a root canal,” he said.
“Patients may go in for a simple filling, and end up with a crown – that’s not always the best option.
“Dentistry teams often want to do everything themselves, rather than call in specialists to maximise their profits. This is not always the best option.
“It’s preferable to preserve natural teeth for as long as possible, as the structure is much better and artificial products will never be as good as enamel and dentine.”
There are clear rules and regulations for dentistry to follow, and clinics must adhere to a strict operating policy imposed by regulators – either the Dubai Health Authority or Department of Health.
DHA has said its regulators inspected 59 clinics in Dubai in 2017, issuing seven warnings and handing out 25 fines for misdemeanors around fraud, waste and abuse.
“At the Health Funding Department we do not directly regulate provider service pricing at this time,” said Ali Lutfi, Head of Insurance Permit at Health Funding at the DHA.
“However, we do conduct inspections across all medical providers in the Emirate from a financial aspect – including hospitals, medical centers, dental clinics and pharmacies. Our inspections mainly look for fraud, waste and abuse (FWA).
“Part of our licensing requirements for insurance companies and third party administrators is for them to provide us with quarterly FWA reports, highlighting any providers with suspected FWA.
“We select providers to inspect based on these reports and feedback from members via our various complaints channels.”
The Department of Health did not respond to a comment request in time for publication.
By Nick Webster
May 12, 2018