Military dentistry

The civilian and military sectors have different approaches to dentistry.

To the military clinics on Fort Hood, the highest priority is getting soldiers deployable ("Class 1"). If you haven't gotten a checkup in the past year, that makes you "Amber," (Class 2). You're non-deployable, so they'll schedule you in, no problem.

Second priority is the easy work -- the cavities that have to be filled, etc. Oddly, if you walk in because you think you have a cavity, they won't see you unless you say you're in pain. (I know because that's what I did last year; false alarm.)

The last priority is the "Class 3" group. These are people who have serious dental issues. Unfortunately, they're pushed to the back of the line; the time spent getting the guy in this situation deployable could be spent getting -- say -- three others ready. The decision makes sense for organizations that are focused on numbers rather than profitability, but it stinks for the Class 3 people.

I have a soldier in this position. He's gone several times to the clinic and been given statements saying they don't have time to see him. I told him to ask for a referral to a civilian doctor, but they said no -- they told time to come in every day at 7:30am until he gets seen. I guess the only remedy for his situation is to hope somebody cancels their appointment so they can squeeze him in.

The primary cause of this situation is overcrowding -- one of the four or so dental clinics here on Fort Hood is closed for renovation. Obviously, that's going to have an impact, so I can understand the problem, even if I can't think of any way around it.

It's very interesting to see systems that aren't driven by the same priorities as in the private sector. When concepts like "customer satisfaction-driven profitability" become irrelevant, different -- and often unpredictable -- incentives come to the fore.

I hope that the folks working on health care reform understand this.