The organization that represents Alberta’s 2,600 dentists has found itself in the crosshairs of Health Minister Sarah Hoffman, who demanded Thursday the group “get back to the drawing board” in its efforts to make dental costs more affordable.



Hoffman’s ire was specifically directed at a new dental fee guide — the province’s first such guide in 20 years — released by the Alberta Dental Association and College.



While the association insisted the newly recommended fees would create sufficient “downward pressure” for dentists to reduce their rates, Hoffman said the guide does far too little to help patients who are currently subjected to some of the highest and fastest growing prices in the country.



“I’m making my opinion very clear to (the association and college) of dentists that I’m not satisfied,” she said. “I don’t think Albertans will be satisfied. They deserve better.”



If the association fails to rework the fee guide, Hoffman hinted she could use her power under the Health Professions Act to impose new regulations on dentists. As well, she noted there have been calls for the government to split up the association and college into two separate organizations.



“There are a number of rather extreme measures that are available at my disposal,” she said. “I am examining those. But I expect the professionals of this association to do what Albertans expect, which is to make their lives more affordable.”



The move to publish a new fee guide for the first time since 1997 was one of the outcomes of a government review released last year that confirmed suspicions about high prices in Alberta — including, in some cases, procedures that cost double what is charged in neighbouring provinces.



Hoffman told reporters the newly recommended fees in the guide represent a three per cent reduction from average rates Alberta dentists currently charge for the most common procedures.



“A three per cent reduction across the board doesn’t acknowledge there are some areas where fees are drastically out of line,” she said.



Hoffman was the first to mention the three per cent figure. At a news conference earlier Thursday, association and college president Dr. Mintoo Basahti declined to offer any numbers about how much the new guide would seek to reduce rates.



Asked later why he chose to avoid specifics, Basahti said he was worried about oversimplifying a complex set of changes. He said that while the fee guide calls for a modest reduction in the “average” rates, prices are recommended to drop closer to 20 per cent for dentists charging “above average” rates.



Basahti noted the fee guide is not mandatory, so it is unclear what impact it might have on how dentists set prices. However, he said it is very likely many dentists, along with some of their staff, will see a drop in pay as more patients use the guide to demand better rates.



The experience in other provinces has been a tendency for dentists to “clump close” to the recommended fees because no one wants to be an outlier, he said.



“I think this is going to change reality in dental practices," Basahti said. “There’s an entire generation of dentists that have never had a fee guide. This is a big move in Alberta, so let’s see what this does, but I’m very confident this will pull things down.”



Still, he said it was important for the association to avoid overly “drastic” change that could cause some dental offices to close. He said the association wants more practices to provide discounted services to low-income Albertans, but that won’t happen if they can’t maintain a viable business.



Dr. Doug Pettigrew, an Edmonton periodontist who has been practising for close to 50 years, said he doesn’t believe there is much room for dentists to reduce their rates.



He said the cost of maintaining an office with strict safety standards, hiring highly skilled staff, upgrading equipment and covering other overhead expenses can eat up to 70 per cent or more of the fees dentists collect.



“I think we are doing the best we can with a product that is expensive to deliver safely,” Pettigrew said. “Dentists will take the guide into consideration, but I don’t know it’s going to change things dramatically.”



Hoffman was more skeptical, saying dentists living in expensive parts of B.C. have found a way to make a living with substantially lower fees.



She said she was disappointed the association didn’t provide a copy of the fee guide to her ahead of time, so that controversy could have been avoided.



Basahti said the association collaborated closely with senior staff in Hoffman’s ministry to prepare the fee guide, so it’s unclear why she was surprised by its contents.



He said he has been asking for a face-to-face meeting with Hoffman for four months but her schedule hasn’t allowed it. He said he hopes such a meeting will now be a priority to clear up any miscommunication that may have happened.



kgerein@postmedia.com



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