THE EDITOR'S CORNER

The independent private practice of dentistry and orthodontics is in danger of disappearing as we become more and more dependent on third parties as sales agencies and as fiscal and administrative agencies for the care we perform. Without an accurate understanding of third party programs and mechanisms, many dentists and orthodontists have already fallen into arrangements that are more suited to the needs of the insurance industry than to the needs of health care programs.

We are opposed to orthodontists signing up as Participating Dentists; to closed panels and closed panel advertising, and other mechanisms which interfere with the patient's free choice of dentist and the dentist's free choice of patient; to submission of diagnostic records or other patient records; to paperwork beyond verification that treatment is or has been done; to fee schedules and fee profiles; to the usual, customary and reasonable fee as compared to the table of allowances; to predetermination of fees or benefits by the dentist; to an alternate course of treatment requirement, merely to cut program costs.

All of these mechanisms are in use in third party programs today and they have the potential to destroy the orthodontic specialty and quality orthodontic service.

Two such mechanisms were discussed by Dr. Carr in the April issue of JCO in a short cost-benefit analysis of "predetermination" and "alternate course of treatment". With articles such as this in the future, JCO plans to be a source of specific information to help orthodontists to know what is going on in third party dentistry.