“Oh My God, You’re Going To MEXICO For Medical Care?”
I am not associated with any of the companies mentioned here and I received no compensation for this article. I provide this information as a public service to those seeking to secure affordable dental care for themselves and their loved ones. Thanks to Novocaine, I never got the shot of tequila that I was told was readily available just around the corner.
I traveled to Mexico for dental work, and this is what happened. Spoiler alert, it went better than expected.
In 2016, some 1.4 million Americans went south of the border for medical care, and the market has been growing at a rate of 15% to 25% a year, according to Patients Beyond Borders. And 2016 was a year when the Affordable Care Act was in full swing, so more people had health coverage. We can anticipate those numbers growing exponentially.
I am at the age where I have to start replacing fillings, and sadly, my kindly family dentist sold his practice to become a missionary. I don’t care for his replacement, a real corporate fellow whose recommendations usually involve extracting a tooth, putting in a post, and taking out a second mortgage on my home to pay for it all.
It is never anything like a simple filling — ever. It is always doom and gloom, dire warnings that I am going to have to have a root canal and crown because my tooth is going to shatter “very soon”, but the promised giant crack never materializes. It seems all my teeth have invisible faults the size of the San Andreas that only he can see. In fact, I have gone my entire life without a root canal, I am the rare breed of individual that flosses daily, but my doctor is convinced that I am just six months away from needing major work on every tooth he examines.
I called practices in my area looking for a new doctor and the experience aptly demonstrates one of the more subtle issues I have with American healthcare. They treat you like you are a problem — not a customer — and taking your money is doing you some sort of favor.
The front desk staff, obviously hurried, rapid fired off the first available appointment, as in take-it-or-leave-it. “Your initial consultation will be $150, is that a problem?”
“Oh, I don’t think I mentioned that I just had a cleaning and x-rays,” I said. “I need the doctor to look at one area and tell me if this is something he can address with a laser. If he can, I will gladly have him do the work, but some dentists have said they couldn’t. I am pretty sure this is only going to take 15 minutes of chair time based on other visits I have had.”
If not a free consultation, I was expecting it to be about $50. Silly me.
“Yeah, I got that, but it is still going to be $150 for him to look at it and give you an opinion,” she snapped back. She sounded very annoyed, like this was an objection she heard dozens of times a day, and obviously, the patient’s unwillingness to fork over their demanded ransom was the problem. Like how unreasonable was it for me to object to paying the equivalent of $600 an hour for someone to diagnose a problem that I didn’t even know if they had the proper equipment, much less skill to do?
The sad state of affairs
Let’s just stop here.
I wouldn’t mind paying so much for dental care if the costs were reflected in the technology.
I would gladly pay $150 if the doctor was going to perform some sort of tooth MRI or mouth CAT scan and give me a definitive answer as to the what would solve the problem. But I know his staff will take a $15 x-ray and the dentist will spend 5 minutes sticking my gum with a pointy metal probe until he draws blood and then will make an educated guess which will be the most profitable procedure for his practice. Those guesses have cost me visits to five specialists, two crowns, about $8,000 and the problem has never been fixed. No one is willing to guarantee their work, either.
Short of flagrant malpractice, the consumer has no recourse for ineffective treatment when it comes to healthcare.
The appointment was wasn’t going to result in any laboratory tests or treatment, $150 was for 15 minutes of the dentist’s time. The average doctor doesn’t earn that kind of money.
American dentists are still doing most things pretty much the same way they did 20 years ago. The equipment has not changed. The techniques are the same. Why have costs increased so much?
According to an article in The Huffington Post, steep increases are the result of compensation that have resulted in dentists earning more money on average than many physicians.
I blame the “corporatization” of dentistry, franchised Managed Service Organizations or Dental Service Organizations owned or backed by venture capital or equity firms which have sought to maximize profits. It’s like the mortgage industry and insurance lobby formed an unholy alliance and the resulting offspring was Dr. Gordon “Greed is Good” Gekko in a white lab coat.
“Um, $150 is what I just paid for a cleaning and x-rays,” I said, shocked that they weren’t trying to entice me into the office for what would be at least $700 in work, and I am assuming that would be on top of his consultation fee.
And let’s face it, “consultation” in the US usually is a euphemism for a hard sell that would make a used car salesman seem like they were giving free puppies to orphans. For every uninsured American adult, an estimated three will not have dental insurance, according to the Kaiser Family Foundation and perhaps this is because ultimately they can’t afford the treatment even with the scanty coverage offered by most providers.
“Do you want the appointment or not?” Her customer service skills were amazing.
I have friends who have family in Mexico and they sing the praises of dentists south of the border as being more professional, better trained and a lot less expensive. They wait for trips back home to have any work done.
I decided to give it a shot.
Mexico? For Medical Care?
There is this idea that everything south of the border is third world. To many Americans, the idea of Mexican dental work evokes pictures of a sweaty guy in a lean-to with a hammer and chisel.
More than ten years ago, I had eye surgery in Mexico. Nothing as mundane as laser surgery, but cutting edge implants by the best cornea surgeon in the world who saved my vision — using a procedure that was at that time not only unapproved in the US by the FDA, but also unheard of by my American physician who was also the chair at a prestigious teaching university. Every American doctor I saw, including specialists, were unaware of treatment options abroad. There are advancements in healthcare that are unknown in America and unless patients do their own research, they likely will receive whatever is considered standard in the US which is often times sorely lagging behind the rest of the world.
I was impressed by the advanced technology, level of care I received in Mexico and the way the doctor seemed so relaxed and. . . well. . . kind. Perhaps this can be attributed to the culture, or maybe it is a different way of training doctors, but I have noticed a stark difference in attitude south of the border.
The big issue blocking me from returning for healthcare was the idea of driving my vehicle there and crossing the border alone.
I signed up with Coyote Dental, a service that arranges your appointment with Arizona Dental and then drives you from Tucson to Nogales, Mexico, and escorts you across the border. The company is owned and operated by a semi-retired American dentist, Dr. Mark McMahon, which seemed like another unstated recommendation to me.
What was most important about Coyote Dental’s service is they make sure you get back across the border and then return you to Tucson regardless of how long your appointment takes. The company is also expanding into the metro Phoenix area as well. This was a big issue for me being a female traveling alone. I also wouldn’t have to wait months for an opening and I could get an appointment in a week.
Having an escort is key if you don’t know the extent of the work you need done and whether you will need pain medication following a procedure. And if you don’t have extensive work, you can get tacos around the corner. The fee I paid for transportation was $50 and even though I had only one filling replaced on my first visit, all in it was still about half the cost of the so-called American consultation. Plus, they suggested a new treatment they felt would permanently solve my nagging gum problem.
While I felt it was a reasonable price for a round trip to Nogales, and I saved a ton of money, I must point out that the fee does not include shot of tequila and I intend to discuss this with the company on my next trip.
How It Works
When my appointment day arrived, I gathered my driver’s license and birth certificate and met the van at a restaurant in Tucson. From there, I enjoyed a leisurely drive to the border with two other passengers.
The clinics are located right across the border to Mexico, so even those with limited mobility won’t find the trip particularly arduous. Everything was wheelchair accessible.
The clinic was more upscale than any clinic I have visited in the US — marble, cherry wood, the kind of expensive details you would find in a cosmetic dental practice. The staff was friendly, unhurried, dressed professionally and everyone spoke English. I have to tell you, everyone looked like they were wearing brand new scrubs.
The place was spotlessly clean, including the restrooms. That is something about my American dental office I didn’t like. When the new doctor took over, I noticed there was dirt in the corners of the rooms, the bathrooms were not clean and it made me wonder if they approached sterilizing their equipment in the same slipshod manner. *Shivers*
In Mexico, no one treated me like I was an inconvenience. There were no lectures, no disapproving looks, no exasperated sighs. I did not wait more than a few minutes to be taken in the back. It didn’t feel like the appointments were overbooked, either.
My first stop was a small room where a panoramic x-ray was taken. Rather than jamming sharp pieces of film into my mouth, I was instructed to bite down on a small piece of plastic between my front teeth. It was fast and hassle free and we ended up with a complete image of my smile.
I was led to an examining room and a dentist entered immediately. The x-ray was on a large video screen in front of me. The doctor did a thorough exam, offered his suggestions, and then patiently explained all my options. “We can try a filling, but you should be prepared that I could get in there and discover you need a root canal.” I didn’t. When does that happen in the US?
I was told the price for each procedure up front, then my doctor wrote it down for me along with my treatment plan spanning the next two years. He also told me how long I could wait to have the work done and in what order I should do it. There were no hysterical warnings of imminent structural failure. And then they replaced my filling and I was done.
The cost was about 1/3 what I would have paid in the States. For comparison, my former dentist charges $150 for a filling and in Mexico, it was just $45. There was no up sell, no trying to get me to agree to “smile brightening” treatments, no telling me I should replace my bridge work.
A Lab on the Premises
The other benefit of going south of the border is that they make all porcelain crowns on site so you don’t have to wait weeks while walking around in a temporary. You can actually watch your crown being produced in the office. They use a computerized system so no impressions with a gloppy mold to make you gag — everything is the finest state-of-the-art equipment.
I found the equipment interesting and I asked to see their on-site lab. My American dentist could not use his laser because he misplaced some part to it and couldn’t be bothered to get a replacement.
Now, I want you to imagine what you think a dental lab in the US must look like before we move on to our tour. I was so impressed, I took photos.
The lab in Mexico was nothing like anything I have ever seen. First, there was a staff of about eight people working in various areas, like a clean room and a computer lab. They were busy, but it was neat and orderly. They had technicians that looked like dental graphics designers creating prosthetics on a computer monitor. They had a big 3D printer that made models of skulls and teeth. There was enclosed equipment churning out partials, another for veneers, and people were quietly working. Management was on hand directing the staff and overseeing the work.
I learned everyone is highly trained, and well compensated, so there is no worry that you are encouraging a “slave labor” industry. Honestly, the staff seemed far happier than in any health clinic in America. The practice pays for continuing education, so the workers have a promising, life long career.
After paying with a credit card, we all gathered a few hours later and crossed the border together. I showed my driver’s license, chatted with the border guards long enough to prove I was an American and we drove home. I did not have to show my birth certificate.
Would I do it again? You bet, I have several fillings that need replacing and I plan on returning.
But next time, I am getting the tequila.