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978: Unfair Care – Dr. Bryan Laskin

Healthcare isn't broken — it’s rigged against wellness and patient care! In this episode, Kirk Behrendt brings in Dr. Bryan Laskin, author of Unfair Care, to share his “why” behind this book and his mission to empower patients to get the best care possible in dentistry and medicine. To learn how you and your patients can make healthcare work better for you, listen to Episode 978 of The Best Practices Show!

 

Learn More About Dr. Laskin:

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Episode Resources:

Main Takeaways:

  • Even if you have world-class doctors, don't leave your health completely up to them.
  • Be actively involved in your health. It’s the only way to get the best care possible.
  • Healthcare systems are currently optimized for profitability, not for wellness.
  • Our healthcare system is stacked against doctors just as much as patients.
  • Get access to all of your dental and medical records and consolidate it.
  • You have power as a patient. You just need to learn to leverage it.

Quotes:

“Healthcare isn't broken in the United States. Dentistry is not broken — it's rigged. The system is rigged against wellness, and it's rigged against caring for people.” (9:22—9:32) -Dr. Laskin

“The “why” [behind Unfair Care] was really personal. My wife went through a personal healthcare challenge where, at one point, I said to a physician, ‘So, up to now, you've been right zero percent of the time. What are you going to do to be more accurate next time?’ They told me about this test that we scheduled for. But ultimately, what ended up happening was they tried to cancel the test five different times because they said it cost thousands and thousands of dollars — and they wouldn't even tell us how much it cost. Literally a life-or-death test! Then my wife went in, and she was texting me while I'm at work, saying, ‘They're saying it costs thousands. How much can I spend on this life-or-death test?’ I don't know what you would say to your wife. But I'm an idiot. I'm an idiot, so I actually said a number — a high number, but I actually put the number down. Then, as soon as I sent it, I thought, ‘Holy crap! What if it's more than that, you dummy?’ So, let me ask you this. What do you think the test costs? When you're told five times it costs thousands and thousands of dollars, that nobody pays for this test because it's so expensive and we need to cancel it, denied by insurance three times over the weekend . . . I was thinking it was going to cost $50,000. $3,200 is how much the test costs. Then, I found out afterwards the reason why it costs $3,200 — and likely the reason why they tried to cancel it — is that it was denied by insurance. So, there's a law that says if it's denied by insurance, it costs $3,200, if you have health insurance that covers it, the hospital gets paid $8,000. Limited availability for the test, so they only want to have people who have insurance because they get paid more. I think that that's unfair care. So, that motivated me to go, ‘Well, what else is going on here?’ I mean, this isn't about my wife and this one test. This is the way the system works. And I guarantee you, everybody listening has a story like this.” (10:18—12:37) -Dr. Laskin

“I saw it at a private equity group. They had thrown up a slide that said, ‘If we focused on wellness, would healthcare be profitable?’ They don't know, and nobody wants to do the math because they're making so much money the way it is. This isn't random. It's not like people aren't smart that design these systems. These are highly engineered systems that wickedly smart people are optimizing for profitability, not optimizing for wellness. That's the way it is. Good, bad, I don't care. That's pragmatically how it is. So, how do you, as a patient, actually leverage this? Because we have the best healthcare available in the U.S. And this is a global issue, by the way. This isn't a U.S. issue. Every system has issues that, I believe, the only answer — the only answer — is for you to take command of your healthcare. It's like, would you leave such major aspects up to somebody else? I mean, you don't have to know everything. But you have to be in charge. You have to be commanding your care. You have to be the one selecting your providers, asking the right questions, preparing for appointments, because there's only one common denominator in every visit that you have in healthcare, and it's you.” (14:19—15:38) -Dr. Laskin

“It's not that the healthcare professionals aren't caring and wanting to do a good job. They're in a system that's just as stacked against them as it is against patients.” (17:52—18:01) -Dr. Laskin

“I did a presentation at one event about Unfair Care, and a physician walked up to me afterwards and said, ‘You don't know how right you are.’ She treats pancreatic cancer. She said, ‘There's a drug available that could cure a large percentage of my patients that we don't even talk about because it's so expensive.’ She hadn't even really thought about it that way until she heard me talk about the book because they're just in the system going — and we do that in dentistry too, by the way. We're not immune to this; it's just different problems. I think dentistry, one of the things that we've done that we're further ahead — still room for improvement — is on prevention than our medical colleagues. But there are other things that I think we are behind on too. Going back to your story, it seems like you had a rare physician that actually paid attention to what was going on. It's like the crab that's in the pot that's boiling that actually understood that the water was getting hotter. That's not commonplace. But it definitely is that healthcare professionals are boiling in the system, and most of them don't even realize it.” (18:30—19:56) -Dr. Laskin

“Number one, I recommend getting access to all of your information — so, your dental records, your medical records, all of your records — and consolidate them as much as possible. And spoiler alert, our application, Cair, is designed to do that . . . Getting access to your information is number one. Number two is selecting your team of healthcare providers like you did. You didn't just sit around and say, ‘This is a commodity. Let's just roll with whoever I saw.’ You took command. You said, ‘This isn't the level that I expect. I'm going to find somebody that meets my expectations.’ So, I outline in the book what you should look for, what questions you should ask, and what kind of people you could have on your team. Then, the other parts of the book are things like . . . a massive amount of hospital bills that have discrepancies, 80% are in the hospital's favor. So, how do you actually decode that? How do you negotiate, or complain, or how do you bring up the fact to your healthcare providers when you're being overcharged or when there are additional services that you shouldn't have been charged for? Then, even simple things like, what are the questions you should be asking? How do you prepare for an appointment? All of the things that you should know to take command of your healthcare. But it starts off with actually getting all of your information, selecting the right providers, and building your care team.” (21:30—23:22) -Dr. Laskin

“If you're not actively involved in your care, you're not getting the best care you can.” (25:53—25:58) -Dr. Laskin

“If you don't care about your health, fine. Do whatever you want. But if you want to actually be healthy, it's up to you to take command of your health.” (27:12—27:21) -Dr. Laskin

“There are whole sections of the book where I talk about how the complexity [of healthcare] is profitable. So, I don't think that we're going to change the complexity. What we can change is the lack of transparency. There are laws and regulations that aren't being followed that you as a patient have to stand up and say, ‘Hey, I expect this,' or, ‘This is the way the world works, and you're not being compliant. So, it's time for you to give me my information,’ whether it's the cost of a test — which is, blatantly, they have to tell you that. But many don't. You have power as a patient. But you don't have power if you don't understand it and you don't leverage it. So, I think that's the key.” (30:19—31:15) -Dr. Laskin

“We’re not going to be able to change the complexity in the system by just sitting around, throwing our hands in the air, saying, ‘Oh, it's complex. I can't understand it.’ No, it's our job to understand it.” (31:15—31:24) -Dr. Laskin

“As a patient, we have so much more power than most people are leveraging. And I'm not saying we want to be disrespectful. But I believe we have to advocate for our own care. That's the whole shebang. How do you actually do that, though? If you actually want to advocate for yourself, what do you do? I didn't know where to start, so I had to write a book about it.” (32:02—32:27) -Dr. Laskin

“If we look back five years from now and go, ‘What are the big, transformative things that have changed?’ it's going to be deepening the connections between our systems, between ourselves, and between our patients. In dentistry, what is that going to look like? It's going to look much more like medicine from the perspective of, we're going to have to level up our technology and systems to be able to connect with our physicians and refer back and forth seamlessly. Right now, 46% of patients that get referred from a dentist to an endodontist never go. Half the people you're referring to an endodontist never go. That should be horrific to everybody listening right now. So, let's stop that within the next five years. Let's close the loop on referrals. Let's expand it so that we can work as teams, virtually. We have these supercomputers in our pockets that we're not even leveraging at all, both in our practices and for our patients. So, let's change that. Let's get rid of the approximately one-third of dental emergencies that end up in an ER. That's moronic. I think we'll lick that problem in the next five years.” (34:35—35:53) -Dr. Laskin

“I think more and more patients are going to wake up and start taking command of their own care. If that scares you as a healthcare provider, you should probably pay attention because the ship has already left the dock. We have to get to a reality where patients are co-treatment planning with us, they're involved more in their care than ever before, and they're empowered with their own information to make better decisions for themselves. And it is our job to meet them where they are. I think healthcare is going to become much more convenient. But I also think that we're in danger. There are some dangers that we have to circumvent. I think if dentistry becomes part of medicine, it's going to get worse for everybody but insurance companies. So, I think we, as an industry, have to maintain our autonomy while we deepen our connections. It sounds counterintuitive, but it's true.” (36:05—37:03) -Dr. Laskin

“All of this change is really creating the biggest opportunities in dentistry that we've ever had. I think that for those that want to be engaged in the profession, it's better than ever. The flip side is also true. The dentists that just want to coast and not want to think about doing things any differently, I think you're hosed. So, I'll leave you on a controversial point . . . The world is becoming a duality of those who are thriving and those who are going the opposite direction. I think the difference is whether you're adjusting the sail of your practice to what's happening, because it's more important now than ever.” (38:41—39:28) -Dr. Laskin

Snippets:

0:00 Introduction.

1:13 Dr. Laskin’s background.

3:12 Why Dr. Laskin decided to start writing.

6:16 An overview of Dr. Laskin’s three books.

8:57 A sneak peek at Dr. Laskin’s next book.

10:07 The “why” behind Unfair Care.

13:11 Optimized for profitability, not for wellness.

21:00 Bullet points of Unfair Care.

25:59 Be actively involved in your care.

28:16 You have power as a patient.

32:32 The future of the healthcare system.

37:40 More about Dr. Laskin, his books, and how to get in touch.

Dr. Bryan Laskin Bio:

Dr. Bryan Laskin is a Minnesota dentist and tech entrepreneur on a mission to help dental teams and patients break free of the “Dental Disorder” through innovation, education, and standardization.

A practicing dentist and owner of Lake Minnetonka Dental for over 20 years, creator of Upgrade Dental, Digital Nitrous, OperaDDS, and co-founder of Toothapps, as well as author of the Amazon best-selling book, The Patient First Manifesto, and host of “The Patient First Podcast”, Dr. Laskin excels at helping others integrate technology and teamwork into their practices. He serves as CEO and chairman of the board of Dental Standards Institute, which is focused on innovation and patient advocacy, and serves as counsel for the most innovative companies in dentistry.

Dr. Laskin is an advisor and investor to many of the most progressive healthcare companies. He is also a frequent keynote speaker.
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