Celebrating 20 years of profession and associate of several foreign
organizations, Miguel Stanley leaves several alerts and speaks of the
benefits of the public service. The government announced that it intends to strengthen health centers with dentists. Is this an important step?
There are several types of dental medicine: emergency, basic care and total reconstruction. The introduction of dental medicine in the SNS (National Public Health Service in Portugal) is very good for the Portuguese. The simplest treatments should be in the SNS. I demand that my taxes be applied to help the Portuguese who are suffering from basic problems.
What are basic care?
Restoration, simple devitalization, tooth whitening, removable dentures. This I believe the SNS can guarantee without great costs. Above this scale, in the case of complex devitalizations, reconstruction of gums, implies equipment and more expensive material stocks.
How much does it cost to set up the dental practice?
To set up a licensed office with all the rules, the cost per cabinet is tremendous. It requires several certifications and equipment for the most basic care and for the most complex treatments. If you take the value of income, decoration and costs with human resources, setting up an office can reach one hundred thousand euros. It can be cheaper without panoramic X-ray or CT, which I consider to be essential for dental implants. The dental practitioner is almost obliged to work the most expensive side in order to have an open clinic. There are more than 5,000 clinics, which have to face the competition and an increasingly aggressive market.
What are the effects of competition?
The business in Portugal is 100% private, which leads to that often the only focus is profit. There may be oversolding of the aesthetic versus basic care. If there are so many dentists and no State support, this can happen. If there is basic care in the SNS, and with this state regulation, it may be good for the business because people no longer come hostage to the basic problems.
But there are regulations that doctors need to follow.
In the business of dentistry can only invest or save on three things: materials, dentist and consultation time. For many the only way to survive is to save on the dentist, on the price of materials - as long as they are recognized by the Infarmed and within validity is acceptable - and at the time of the consultations. There are offices with 16 consultations per day. Managers defile the concept of dental medicine. Quality and excellence come through time. I think the existence of dental medicine in the SNS is fundamental and that the average consultation time is one hour so that the SNS, which is paid with our taxes, can teach the quality of the doctor's act to the people.
What are the risks of less time consuming appointments? Is it a lack of hygiene problem?
This is my new battle. When people ask clinics and clinics what the price of a particular treatment is, they should also ask how much time they will spend on it. The national average time per visit in Portugal is 30 minutes. People get more consultations and then end up losing their teeth. The insurers pay by act and the same value to all. There is no incentive to quality. It is not a problem of lack of hygiene.
How can the NHS change this?
I understand that the NHS will raise the bar of quality over time per consultation. The guidelines say that the average disinfection time between queries should be between eight and ten minutes. I can not say that they do or not, but I hope they do. I have no indication of faults, but it is an alert.
Ana Maia
There are several types of dental medicine: emergency, basic care and total reconstruction. The introduction of dental medicine in the SNS (National Public Health Service in Portugal) is very good for the Portuguese. The simplest treatments should be in the SNS. I demand that my taxes be applied to help the Portuguese who are suffering from basic problems.
What are basic care?
Restoration, simple devitalization, tooth whitening, removable dentures. This I believe the SNS can guarantee without great costs. Above this scale, in the case of complex devitalizations, reconstruction of gums, implies equipment and more expensive material stocks.
How much does it cost to set up the dental practice?
To set up a licensed office with all the rules, the cost per cabinet is tremendous. It requires several certifications and equipment for the most basic care and for the most complex treatments. If you take the value of income, decoration and costs with human resources, setting up an office can reach one hundred thousand euros. It can be cheaper without panoramic X-ray or CT, which I consider to be essential for dental implants. The dental practitioner is almost obliged to work the most expensive side in order to have an open clinic. There are more than 5,000 clinics, which have to face the competition and an increasingly aggressive market.
What are the effects of competition?
The business in Portugal is 100% private, which leads to that often the only focus is profit. There may be oversolding of the aesthetic versus basic care. If there are so many dentists and no State support, this can happen. If there is basic care in the SNS, and with this state regulation, it may be good for the business because people no longer come hostage to the basic problems.
But there are regulations that doctors need to follow.
In the business of dentistry can only invest or save on three things: materials, dentist and consultation time. For many the only way to survive is to save on the dentist, on the price of materials - as long as they are recognized by the Infarmed and within validity is acceptable - and at the time of the consultations. There are offices with 16 consultations per day. Managers defile the concept of dental medicine. Quality and excellence come through time. I think the existence of dental medicine in the SNS is fundamental and that the average consultation time is one hour so that the SNS, which is paid with our taxes, can teach the quality of the doctor's act to the people.
What are the risks of less time consuming appointments? Is it a lack of hygiene problem?
This is my new battle. When people ask clinics and clinics what the price of a particular treatment is, they should also ask how much time they will spend on it. The national average time per visit in Portugal is 30 minutes. People get more consultations and then end up losing their teeth. The insurers pay by act and the same value to all. There is no incentive to quality. It is not a problem of lack of hygiene.
How can the NHS change this?
I understand that the NHS will raise the bar of quality over time per consultation. The guidelines say that the average disinfection time between queries should be between eight and ten minutes. I can not say that they do or not, but I hope they do. I have no indication of faults, but it is an alert.
Ana Maia
