How NYU College of Dentistry is preparing students for private practice

"Dental students, like many dentists, can have a fundamental fear of treating people with disabilities," Charles Bertolami, DDS, told Becker's Dental + DSO Review.

Today, dentistry requires competence, confidence and compassion along with clinical and business skills. Dr. Bertolami, the dean at New York City-based New York University College of Dentistry, understands the importance of teaching students the clinical and business aspects of dentistry.

Below, Dr. Bertolami discusses initiatives at NYU College of Dentistry to get dentists ready for private practice as well as how DSOs have changed the dentistry landscape.

Editor's note: Responses have been lightly edited for clarity and length.

Question: What is NYU Dentistry doing to prepare graduates to operate a dental practice?

Dr. Charles Bertolami: At the NYU College of Dentistry, we are continually innovating to ensure that our graduates are well prepared for the challenges of private practice.

One example is the NYU Dentistry Oral Health Center for People with Disabilities, which opened in February 2019. In addition to addressing a major public health challenge by redefining dental care for disabled individuals, we are offering offer a much-needed training opportunity for our students, who will have the benefit of learning to practice with competence, confidence and compassion in providing quality dental care for this population. Dental students, like many dentists, can have a fundamental fear of treating people with disabilities. By giving our students the skills needed to treat disabled people, we are preparing them to welcome all patients when they enter practice.

Another innovation in the way we educate our students is coming this fall with the opening of a federally qualified health center operated by Metro Community Health Centers. We have built a general medical clinic — to be staffed by physicians from MCHC — within the dental school, which will offer primary and specialty medical care as well as behavioral health services to primarily low-income and underserved patients, including medically and behaviorally complex patients. In addition to expanding access to coordinated healthcare services for patients, it will provide a unique interprofessional education opportunity by making medical care come alive for dental students. This is important for future dentists because the challenge is not how to manage the underlying medical disorder, but rather how dental care must be modified in light of underlying disease.

We are also piloting a new dental education model as the prelude to opening a new patient care facility in Downtown Brooklyn’s City Point in early 2020. Designed to create enhanced educational and patient care learning opportunities for students, as well as to bring high quality, low-cost dental care to residents of Brooklyn and the surrounding area, the program is based on a mentor-protégé model in which a professor-practitioner mentors a very small group of student protégés or associates. The program emphasizes collaborative efforts and synergies among small teams of highly motivated students, faculty and support personnel, which results in increased student learning and productivity. Through the Brooklyn expansion, we are reimagining dental education by giving students even more clinical experience, while also providing them with the opportunity to learn how to run a dental practice in a real-world environment.

Q. How has the rise in DSOs changed how young dentists look at the industry? Do more seek out private practice over DSOs?

CB: As in the past, the majority of young dentists continue to aspire to own their own practice, or to have an equity share in a private dental practice, but most are not in a position financially to achieve this goal for perhaps a dozen years following graduation. Dental service organizations provide a wonderful opportunity for recent graduates to gain experience in practice without having to handle the business aspects of a practice, including financial operations, marketing, information technology, human resources, and office management, among others. As a result, young graduates have a chance to get on their feet financially in an environment that also allows them to learn about practice management. To put it another way, working in a DSO can be a transition to practice ownership. At the same time, DSOs provide opportunities for advancement within the organization for those who decide to pursue them.
Private practice is not disappearing anytime soon, as happened with independent pharmacies. The intimate nature of dental practice allows private practices to compete favorably with DSOs. This could change if many more states pass laws authorizing dental therapists to practice, but currently that is not a threat.

Increasingly, I see a much more social orientation among young dentists than in the past. Instead of going into solo practice, the trend is to practice as part of a group or to have an ownership role in a general practice or a group practice that includes general and specialty care.

Q: If you had to give newly graduating dental students one piece of advice, what would it be and why?

CB: I have always believed that any recent dental graduate can succeed in any environment regardless of the competition by embracing three fundamental qualities: availability, amiability, and ability. Dental graduates are fine technically; they have the ability to provide competent dental care. But success depends on the other critical factors: availability – being accessible to all patients--and amiability—behaving in a caring manner toward patients. It’s a matter of striking the right balance between transactional and relational competence. Many millennials in the digital age can be very adept at transactional interactions that are largely dependent on technology, but they are less adept at relational interactions which are essential for success in a patient-centered profession. To quote the writer Maya Angelou, “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

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