Online Dentistry: Health Care Takes to the Net

Even as Internet romances become commonplace, sweet nothings won't be in "Bibbihart's" or "dentist schmerzfrei's" ears should the two who found each other at an online auction site meet. In fact, it will be the whizzing of a dentist's drill that commands their attention.

Unsure that she was getting a fair price from his dentist, "Bibbihart" decided to get a second opinion, but instead of turning to the yellow pages she looked to the Internet and may end up saving nearly 3,000 euros ($3,860) if she accepts "dentist schmerzfrei's" bid of 1,050 euros for crowning and bridging her teeth.

Dental work has become more expensive for many Germans since the public health-care system cut coverage for a number of dental treatments. Now patients who need dental work are looking for ways to save on what insurance policies used to pay for, according to Claudius Schikora of arzt-preisvergleich.de, which translates to "doctors price comparison."

"Transparency is missing from the German health system on the price and service levels," he said. "We make it possible for patients to find the doctor with their idea of the best price/performance ratio."

Auctions leave doctors and patients with no obligations

Schikora's Web site -- and others like it, including 2te-zahnarztmeinung.de (second dentist's opinion) and CareDental.de -- require people looking for dental work, or in some cases physical therapy and cosmetic surgery, to register anonymously and post their current doctor's treatment plans, how much the treatment is estimated to cost and how far they would be willing to travel.

Then, other doctors, whose credentials are apparently checked before they can use the sites, read the plans and make their own offers in an auction for the treatment. At the end of the auctions, which typically run for about a week, patients receive a list of the top offers and can contact the doctors. They aren't forced to receive treatment from the lowest bidder.

"Patients have to realize that dentists are businesspeople, and that there are economic interests behind every medical service," said Holger Lehmann of 2te-zahnarztmeinung.de.

After they are treated, patients can rate their experiences on the sites. The sites do not release the patients' or doctors' real names or addresses to protect their privacy.

Calculating the difference in the lab

The prices for similar treatments differ as a result of varying laboratory costs, whether the dentist plans to create implants or bridges, which are estimated to account for two-thirds of the final price tag, and are also partially dependent on how much profit the dentists calculate in, according to German consumer magazine Stiftung Warentest.

While supporting people in their search for a second opinion, dentists need to have actually seen inside the patient's mouth to make an accurate assessment of what needs to be done, said Reiner Kern, a representative of a German dentists' association.

"Auction sites give the impression that medical services are as good as any other, but you cannot buy health like a new piece of furniture," he said. "The doctor only gets an anonymous treatment and cost plan via the Internet, he does not know if any necessary preliminary treatments took place."

The auction sites could lead to dentists lowering their prices so drastically that they could only afford to continue practicing by taking on more patients than they could handle, which could eventually lead to patients receiving substandard care, Kern added.

All of the sites, however, point out that doctors are not obligated to fulfill their initial bids if a subsequent exam proves more work needs to be done than originally planned.

"The contract is only finished when the doctor has personally advised and examined the patient," Schikora said.

The Internet auctions, of which some 1,400 are running, are limited to mainly dentistry, some types of physical therapy and cosmetic surgery, as most other branches of German health care set their rates according to agreements between doctors and insurers.