Comment

Comment on Why exactly are nursing aids paid so poorly?

Dental work is my most common healthcare experience abroad. I cannot recommend Thailand enough, especially for dental work, nothing but 5 out of 5 dentistry for me so far.

What it all boils down to is: how can you know the work done was good? You can’t. You can know it looks good superficially. You can know the dentist was nice, or that their office was clean, and that the bill was low. You can’t know if the work is actually good. You don’t know if the materials or techniques would be considered substandard in the US. Yes, other countries often have a different “standard of care”. I have seen ABYSMAL work from Asia and the Middle East. I have seen appalling work from Mexico and Central America. Yes I also see bad work done by local US dentists - primarily those who advertise themselves as being some kind of affordable, emergency, or discount office.

Dental tourism scares the hell out of me as a dentist in the US, but I understand why it appeals to people when quality care here is expensive. I have seen abysmal work from every country in the world, including the US, but the trend is you largely get what you pay for.

Why is it often worse? With dental tourism you get no follow-up care. You also have no recourse if they fuck up your mouth.

source

Sort:hotnew top

EndlessNightmare@reddthat.com ⁨4⁩ ⁨days⁩ ago
I agree with much of what you said, particularly:

Why is it often worse? With dental tourism you get no follow-up care. You also have no recourse if they fuck up your mouth.

The reason it may be enticing for many is because of the enormous disparity in cost such that it becomes a risk assessment. Sometimes the alternative to medical tourism may be long-delayed or no treatment at all, though I realize that low-quality treatment is very often worse than no treatment.

source
bitofarambler@crazypeople.online ⁨4⁩ ⁨days⁩ ago

how can you know the work done was good? You can’t.

Fortunately, that’s incorrect and there are plenty of ways to check the efficacy of medical procedures.

You can get x-rays, MRIs and all sorts of after-care examinations done by trusted or a myriad of other doctors and dentists if you are unsure of the quality of care you received.

A very big indicator will be how you feel after the procedure, which is why I include patient surveys in all of my posts about medical care abroad. Very importantly, other than the higher-rated equipment, report accuracy and cost, patient satisfaction regarding medical care in Thailand is rated higher than in the US, for example.

I think I see where you are coming from, it is the most frequent response to high-quality medical care abroad:

Dental tourism scares the hell out of me

This anxiety about the unknown often colors how people react to any situation outside their experience, but there are plenty of ways to ease yourself into receiving higher quality medical care abroad, like translators, medical insurance, or expat meetups so you can get used to an idea you are unfamiliar with.

With dental tourism you get no follow-up care

Incorrect. This applies to most medical care destinations outside of the US; follow-up care is essential abroad and is usually presented in a contract and verbally confirmed with you before any diagnosis even takes place, let alone a procedure.

With Thai dental care an example, my second crown was molded incorrectly, so my dentist sent it back downstairs(in Thailand, their fabs are located in the same building as your dentist) and told me to come back tomorrow for a more perfectly printed gold crown and no extra charge. I returned 18 hours later, they scanned my medical ID card, cemented my new gold crown which fit like a glove, and I was out in 15 minutes free of charge. after again receiving the highest quality of care from a doctor and hospital i trusted and appreciated.

You can purchase as many extra bells and whistles as you want with your chosen care package, but the basic warranty has been more than enough for me; my crowns have lasted more than a decade(knock on wood with me).

source
- rexxit@lemmy.world ⁨4⁩ ⁨days⁩ ago
  With all due respect, you don’t know what you don’t know. In case you missed it, I am a US dentist. I spend every working day dispelling laypeople’s misconceptions about dental work. What work they have, what work they need, benefits and drawbacks, etc. Your post hits on some of the many very common misconceptions.
  
  Fortunately, there are plenty of ways to check the efficacy of medical procedures.
  
  You can get x-rays, MRIs and all sorts of after-care examinations performed by your choice of trusted doctors and dentists if you are unsure of the quality of care you received.
  
  MRI is wildly irrelevant for dental, which is a clue that you don’t understand. Not all work can be evaluated, even with x-rays, as crown materials often hide the most important details. Bacterial ingress and leakage is, for all intents and purposes, invisible. Most docs (in both medicine and dental) are exceptionally reluctant to disparage another’s work.
  
  A strong indicator will be how you feel after the procedure, which is why I include patient surveys in all of my posts about medical care abroad. Very importantly, other than the higher-rated equipment, expertise and report accuracy, patient satisfaction regarding care quality in Thailand is rated higher than in the US, for example.
  
  This could not be further from the truth. Discomfort and success are completely different things. Some extremely high quality treatments will make you feel like shit afterwards. Often, post op symptoms are more closely a matter of chance than they are of quality. Patient satisfaction and surveys are complete worthless bullshit, as evidenced by hospitals, Press Ganey scores, etc. Docs hate chasing patient satisfaction because it is so poorly correlated with actual quality care. See Goodhart’s law. Telling the patient “no, this will have a poor outcome” gets you bad reviews, while doing a slipshod job that looks superficially good gets you patient satisfaction. I see it CONSTANTLY. Smooth-talking, kind-seeming, gentle dentists whose skills and ethics are complete trash. Patients can’t tell the difference.
  
  You have taken your subjective experience and tried to use that to say the work is objectively good. That’s not how any of this works.
  
  Now could that work actually be good? It could be. This is not to say that all foreign dentistry is bad, but SO MUCH OF IT IS. I know because I see it. The fact of the matter is, patients generally don’t know the difference between good and bad work. I see patients all the time who said some absolute basement-tier-garbage work was done by their previous dentist, who they adored.
  
  Incorrect. This applies to most medical care destinations outside of the US; follow-up care is essential abroad and is usually presented in a contract and verbally confirmed with you before any diagnosis even takes place, let alone a procedure. You have access to all the documents and files your hospital abroad does and are also free to share those or ask your hospital to share the documents with other doctors and clinics of your choice.
  
  Ask any orthopedic surgeon what they think of offloading post-op care to an unfamiliar doc in the country the patient is visiting from. This is a huge issue docs discuss in private - patients flying to wherever for cheap, substandard treatment and leaving them to manage the complications. It’s a big issue in places like FL and NY, but also broadly everywhere.
  
  Many treatments, you get essentially one chance to get it right, and fixing it is either impossible or 10x as much difficulty. Getting it right the first time is priceless. You can fuck up a tooth in an instant. Destroyed. Cannot be fixed. Some errors are invisible and don’t hurt right away. Many infections are painless or hard to diagnose from typical x-rays. Many compromised teeth spend a few years feeling normal before they fall apart.
  
  As a practicing professional who spent the majority of my training seeing a high % of international dentistry, it’s hard to watch.
  
  source
  - bitofarambler@crazypeople.online ⁨4⁩ ⁨days⁩ ago
    
    you don’t know what you don’t know
    
    Exactly.
    
    Your post hits on some of the many very common misconceptions.
    
    I’m compelled to dispel misconceptions spread by people(even US dentists) who are promoting misinformation. Transparent fee lists, surgery success, audits, patient numbers, surveys are not “misconceptions”, they are facts by which medical quality may be measured.
    
    Not all work can be evaluated…
    
    All work can be evaluated, some evaluations will be indeterminate regardless of which country the evaluation is performed in. Yes, US dentists will have at least as difficult a time as German doctors definitively identifying the beginning of a dental bacterial infection. That is the nature of diagnosis and has no relative bearing on the quality of German dental infrastructure.
    
    Patient satisfaction and surveys are complete worthless bullshit
    
    Patient surveys are very good supplemental indicators of the professionalism and quality of an institution and their provided medical care.
    
    …your subjective experience and tried to use that to say the work is objectively good.
    
    These are facts, not your feelings. Transparent fee charts, equipment audits, contracts, insurance, warranties, international accreditation, consults, the increase in medical care abroad itself are relevant medical quality data, regardless of how upset those facts make you.
    
    Ask any orthopedic surgeon what they think of foreign procedure mills…
    
    I’ve consulted with dozens of dentists and doctors about many aspects of medical care, both in the US and abroad.
    
    Ask anyone what they think of manipulative healthcare practices in any country…Guess what? They don’t like them. Ask the banned women dying in parking lots in the US, the bounty hunted pregnant women from Texas, US kidney stone sufferers permanently damaged because they are prohibited from entering the ER, US patients denied dentistry or other care because they cannot afford fabricated fee schedules dictated by healthcare monopolies that do not guarantee quality care.
    
    The US healthcare system leans profit-driven, not patient-driven, and that is reflected in the low quality and accessibility of care in the US, regardless of the talent of some US medical professionals. They work in a broken, predatory system.
    
    …one chance…fixing it is either impossible…
    
    Yes, and this has no bearing on the quality of medical care internationally.
    
    Yes, health care is risky everywhere ,and many countries provide the same or better healthcare than the US at a more affordable cost with easier access to care. Yes, health care can be difficult for doctors to perform everywhere, and many countries provide the same or better healthcare than the US at a more affordable cost with easier access to care.
    
    You can fuck up a tooth in an instant. Destroyed. Cannot be fixed.
    
    All the more reason to receive the highest quality medical care as soon as possible at a reasonable cost. The US cannot provide that type of care to most of its citizens. Wait times are harmful or fatal to many US patients. Other countries can provide the highest quality medical care without delay at a reasonable cast to both their citizens and disadvantaged foreigners like US patients. Other healthcare infrastructures functions better and can help more people at a lower cost.
    
    source
    rexxit@lemmy.world ⁨4⁩ ⁨days⁩ ago
    For a layperson, you are unbelievably, stubbornly confident in your incorrectness. I am an expert, and I will continue fixing the problems caused by bad international dentistry for a healthy fee. You don’t need to believe it for it to be true, and your denial does nothing to change my daily reality in practice. Good luck.
    
    source
    -> View More Comments