The COVID-19 pandemic, staffing challenges, rising costs and low reimbursement rates are leading to a bleak outlook on independent dentistry, but some are still eyeing a promising future.
Here, six dentists shared with Becker's what they foresee for independent dentists:
Note: Responses were lightly edited.
Barry Kaimakis, DDS. Dentist in Seattle: Dark. As inflation spirals out of control, and we are unable to raise fees, I feel the profession is doomed. I am unable to understand how a graduate with over $400,000 in debt and wants to buy a practice for another $500,000 could ever make enough money to own his own home. As long as insurers dictate fees, I see the profession getting worse, not better.
Bridgett Jorgensen, DMD. North Gwinnett Dental Care (Sugar Hill, Ga.): Bright!There will always be a market for cheaper, less personalized dental care and dental service organizations, but many dentists want to practice in a private, non-corporate office. The shift away from low-paying, in-network dental insurance plans has arrived. More dentists want to be in control of what plans are taken and have the freedom to [provide] comprehensive dentistry without worrying that a corporate entity will restrict that freedom.
Huzefa Kapadia, DDS. Kapadia Dental Care (Waterford, Mich.): I think the future is dark for independent dentists. I've been working for 20 years in private practice running two dental offices. The costs of running a dental practice have shot up significantly. Wages, dental supplies, lab expenses are just a few examples making it difficult for a small business owner to stay afloat. We simply do not have the bargaining power DSOs have.
It's been extremely stressful trying to run a practice during the last few years. Trying to hire and retain qualified and skilled staff has been extremely difficult. Is dentistry following medicine and pharmacy? Yes, it most definitely is. In 20 years the landscape of dentistry will look more similar to both pharmacy and medicine. Solo practitioners will be an unsustainable business model for most dental practices. In the past, I was in denial about dental transforming into DSOs. Now I'm much more certain.
Robert Trager, DDS. Dentist at JFK International and LaGuardia airports (New York City): The future will be a win-win for both the solo and group practitioner and the DSO groups. Those dentists who want to retire or don't want the headache of managing a private practice will welcome a buyout. The solo and independent practitioners will gain and keep patients who want and are used to a personal relationship. Some or many patients may or will leave a DSO because of long wait times between appointments, possible copayments that a solo provider can reduce or eliminate. Others may not like a commercial atmosphere and want the same dentist every visit. There will always be a need for both types of services.
Cyrus Javadi, DDS. Sandcreek Dental (Tillamook, Ore.): The future is bright for independent dentists, but it's not without some challenges. As a general dentist who works in a small, rural community, I can report the practice of dentistry is very rewarding. Patients want long-term relationships with their dentists, and the value of that relationship is one of the main reasons why the future is bright for practices like our own. However, workforce shortages, insurance reimbursement and rising expenses are challenges facing small, independent dental offices.
Rising expenses, regulations and workforce shortages are burdening dentists and taking their time and attention away from caring for their patients. Operating expenses over the last two years have doubled and tripled in many cases without a similar increase in fees. New and changing regulations from the CDC, federal and state [Occupational Safety and Health Administration], dental boards and other agencies require dentists to spend hours trying to search for and understand their responsibilities for patients, employees and more. And, a shortfall of available people looking for jobs as dental staff, assistants and hygienists juxtaposed against an increasing number of graduating dentists means many offices don’t have the personnel they need to be fully functional.
Yet, despite those challenges, I believe the niche for independent dentists is well-established, well-protected, in high demand and offers a bright and rewarding future for the doctors who choose that mode of practice. As a dental office, our success is measured by how well we meet our patients' needs. With the tools and technology available to dental teams today, we can offer solutions to meet almost any need, and we can connect with patients better than at any time in our profession's history. Looking forward, I believe these resources and capabilities will continue to enhance how independent dental offices offer value to their patients.
Rajdeep Randhawa, DDS. Innovative Dentistry (Rahway, N.J.): The current COVID-19 situation is going to heavily influence patient behavior, provider options and insurance companies' attitude in a manner that is going to create a lot of unpredictability and uncertainty for the future. The independent dentists who are really independent from the insurance industry and depend on fee-for-service cosmetic dentistry and other services will definitely see an uptick in post-pandemic demand with patients asking for services like laser dentistry, Invisalign, laser teeth whitening, veneers and other exclusive services.
The main turf war between dentists and DSOs is going to be where both independent dental providers and DSOs are going to be targeting the same group of patients and create oversupply and oversaturated markets. There are areas where DSOs don't want to venture and independent dentists are trusted by local communities. These are the areas where current and future dentists are going to prosper, and have a very bright future. In areas where independent dentists are catering to a different demographic than what the DSOs are targeting, they can both flourish in the same environment.
Another factor that is going to influence the future is the COVID burnout rate for dentists, dental hygienists, dental assistants and other important staff members needed to run independent dental offices, DSOs and DSO-supported offices. If there are staffing shortages, everybody is going to suffer, including the DSOs, as they are staff-heavy and tend to provide services to a high volume of patients every day. Independent dentists with good management systems, very high staff loyalty and a low staff turnover are going to thrive and prosper in the future. Independent dentists who run high-stress, high-volume, high-overhead offices with a revolving door for patients and staff are going to feel the heat and stress.
I work as a totally independent dentist with no influence from insurance companies, other local insurance-based independent and DSO dental providers, and enjoy providing my patients that trust me the best that 21st-century dentistry has to offer!
It gives me immense professional satisfaction, an amazing sense of fulfillment to enjoy and celebrate my independence everyday, and I am looking forward to a very bright future.