A Mystery Headline In My Inbasket Last Week

“No extenuating circumstances for those who throw mud on the dental profession.”

            - Rome Medical Society Newsletter

Huh? Who was throwing what mud on whom how? I couldn’t resist clicking through. The mudslingers turned out to be . . . real dentists who dishonor the profession by covering for phony ones. This is an old story. Most dentistry in Italy is done privately, not on the National Health Service, which has spawned a whole army of dental imposters – 15,000 or so strong, said to fill a quarter of all the country’s cavities. Usually the pretender is a technician, trained to work on crowns and bridges but dabbling in live teeth on the side, in cahoots with an authentic doc who for a price allows his name to grace the receipts, the prescription forms, and the bronze plaque on the office door. One of my closest friends had a dental technician uncle so she never went to a licensed dentist until she moved to another city at age 35.

The figure of prestanome or name-lender is as deeply rooted in Italian society as that of the Mafia consigliere. Years ago my secretary was inveigled by her first boss into being the official CEO of a shady import-export company, whose shenanigans eventually got her hauled into court. The judge took one look at her neckline and jeans and spat out in disgust, “She’s obviously just a prestanome.”

While name-lender dentists never used to risk more than a slap-on-the-wrist fine, lately the Medical Societies have started upping the ante. Last week’s headline was celebrating the very first time the Rome Medical Society had publically stripped a dentist of his licence, after the courts had found him guilty. This particularly bad actor, charitably left unnamed in the article, had abandoned hand-in-mouth dentistry years earlier in favor of skimming the profits off a chain of quack offices.

But, then, when I was studying medicine in New York it was whispered that patients at my Mount Sinai Hospital had been operated on for years by a neurosurgeon who didn’t have a medical license. As the Italians say, tutto il mondo è paese, everywhere in the world it’s the same village.