By Carrie Mauterer, D.D.S., CDA Editor
From the Autumn 2023 Journal of the Colorado Dental Association
Dr. Carrie Mauterer
A recent article released Aug. 8 by the Health Policy Institute (HPI) gave me heart palpitations. The HPI reported that “The annual average net income of general dentists in private practice declined 7% in 2022, due in part to increasing practice expenses.” When I read this, my tummy hurt a little.
I read the report with my cautious skepticism and wondered how they came to that conclusion. I wondered if their sample size was big enough or if they were somehow jumping to conclusions too early. Then I read, “Data sourced from ADA HP1 survey of Dental Practice and Bureau of Labor Statistics…results are weighted to compensate for oversampling and nonresponse bias.” Dang.
OK so the HPI is pretty good at doing scientific research and stuff.
Over the last 10 years, the HPI reports that the revenue increase in these practices is 2.2% while the expense of delivering care to our patients is rising at 7.7%. This is an alarming 10-year trend. To continue these trends over the next few decades will not serve the dental industry or our patients well. While this is not a reason to panic, it may be a good indication that early adoption of changes in the way we deliver dental care may be warranted.
Next, I read that the percent of dentists is at an all-time high who indicated that they are “too busy to treat all people … or provided care to all… but were overworked.” My right armpit started to sweat a little on that one. My colleagues are showing signs of losing the joy and happiness that comes with restoring our patients to their best health. I’m hopeful that some changes to dentistry can help our colleagues feel less burnout and more joy.
It gets better … but first it gets worse. Apply a second round of antiperspirant, take a Tums and stay with me a second. The HPI then reported that “on average, GP dentists worked 4.5% more hours in 2022 than the average hours from 2000-2019.” So, GP dentists are making 7% less and working 4.5% more. Someone get me some lavender moon milk and a gong bath because this girl is needing a timeout.
The article offered some good news when it spoke about patient demand. Patients are being booked out (significantly!) longer when they call to make an appointment with their dentist and hygienist than ever before. I am not saying it is good news that patients have to wait to get into the office, but rather the good news is that patient demand for dentistry holds strong. So, the economics of dentistry is not being affected by patient demand … rather capacity issues and rising costs seem to be the top factors.
That is not just good news, that is great news! If patient demand for dentistry were dropping off, that would be a much harder problem to fix than controlling rising expenses and addressing capacity issues. The latter two are problems we can fix with a little creative ingenuity. And, our colleagues are already on it. Here are three ways to take back control of your expenses and capacity limitations so that our dental practices can stay healthy.
Adaptation technique #1
Automation (using software rather than people to get the task done) and Outsourcing (using a subscription service to get the job done):
Sometimes the right combination of outsourcing and automation can reduce costs in your operations. This is potentially a huge cost savings. The AI potential in the operations realm is currently undertapped and underutilized in the dental profession.
Adaptation technique #2
Consolidation:
Many dentists are opting to work within a larger group to take advantage of the efficiencies that a larger group can offer. A single marketing person or small team of insurance coordinators can support many practices, helping to lower payroll costs. A larger bulk order of a product can produce supply cost savings. A bigger group of dentists taking the same CE course can lower tuition costs. Another benefit of the larger group practice is the sharing of ideas that help everyday efficiencies like what works well when scheduling patients, ideas for team retention and appreciation, and special ways to wow your patients.
Adaptation technique #3
Delivery Model:
Perhaps the most controversial pivot in the dental sector is the delegation of dental services to an auxiliary team member who is trained well and works within the boundaries of the Dental Practice Act. An example of this is assisted hygiene where the dental assistant performs duties like taking radiographs, performing a prophy polish, placing fluoride, updating medical and dental history, and charting existing dentistry. The duties that currently require licensure like administering local anesthesia and scaling teeth remain in the hands of the licensed hygienist. There is much debate at every dental strategic planning table regarding needed changes in our current delivery model and whether changing the scope of practice or introducing a new type of provider will move the needle on margin compression and/or access to care.
All three of these evolutions of dentistry can be implemented in a way that keeps our patient care as the center of our focus. There are many doctors who have already shifted many aspects of their practices to accommodate more patients and maintain the highest standards of care. If we are to keep the field of dentistry a sustainable field, we can no longer be afraid to try to implement adaptation techniques like the ones mentioned above.
We should also take the time to compliment our colleagues who are not afraid to try.
No one is perfect when implementing change, but I would argue that a little encouragement from our colleagues could make a good adaptation into a great one. Let’s support and learn from our early adopters when it comes to ingenuity within our industry!
Watching our industry trends is so important for maintaining our high level of care for our patients. Doing the same thing for another decade clearly will not work out well for any of us. Not for our dental association, not for our team, not for our doctors, and most importantly not for our patients.
So, here is what I have to say. Go hug a dentist who is not afraid to shake things up. They may be creating a pathway for us all to have sustainable joyful thriving practices. All they need is open minds and open hearts to understand the intention behind what they are trying to do. Ultimately, we all want to find sustainable solutions to delivering the best patient care possible.
If you want me to send you a “Hug a Dentist” sticker, let me know. I am currently printing them and would love to send you one. I am only half kidding. By the time this article goes to print, I may be launching a full-blown sticker campaign. I may even make them scented stickers – available in three scents: IRM, formocresol and for a serious throwback…polysulfide impression material. Mmmm. Delicious.
Be good to each other and as always, thanks for reading.