Personal reflection from John after seeing a private dentist:
It would be easy to suspect that the Harley Street dentist was an avaricious rogue, but even I don't believe that matters are that simple. Private medicine and private dentistry have their own dynamic.
At the top end, people will understandably do whatever is technologically possible, regardless of price. If state-of-the-art imaging and treatment reduces the risk of losing a couple of molars from, say, 5% to 3%, they'll do it. Just as understandably, some customers are willing and able to pay a lot for that small advantage.
What gets lost in this dynamic, however, are transparency and proportionality. The Harley Street dentist never explained to me that we were dealing with those sorts of margins in terms of outcome, expenditure, and choice (nor the option of simply having the teeth removed). I had to deduce everything for myself and resist the pressure to aim for "perfect."
As the system becomes pulled along by what the richest can afford rather than what's good enough and affordable for many, more people will be left behind with nothing at all. That's what the NHS was designed to prevent in the first
place.
John Launer,
I always enjoy reading @johnlauner.bsky.social’s writing in the @bmj.com.
Some important reflections on how private medicine (and dentistry) sometimes work.
I too had a recent consultation with an endodontologist. We also agreed to leave well alone!
Link if preferred:
www.bmj.com/content/387/...
