Why 1 dentist expects a rise in boutique dentistry

As DSO consolidation increases in the industry, solo practitioners may opt for boutique dentistry to remain economically stable, one dentist predicts. 

Angelina Franklin, DDS, is a dentist at Signature Family Dentistry in Angier and Holly Springs, N.C. She recently spoke with Becker's about challenges and her predictions for the future of dentistry.

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

Question: What are the biggest challenges facing the industry?

Dr. Angelina Franklin:

- There is very little space between offering dental insurance to help our patients and keeping the lights on and payroll met, especially in the last few years as costs of goods and services have skyrocketed and contracted fees have not kept up and in some cases have actually decreased. 

- Continuing to remove standards to apply, enter, graduate and practice dentistry along with government subsidies will mean that more applicants apply for dental school than spots available, which will continue to drive up the cost of dental school. 

- The cost of dental school will drive dental students toward DSOs, which traditionally are worried about production and not good-quality dentistry or technique. 

- It is becoming increasingly difficult to hire and this is a macro problem, not just in dentistry.

- Assistants range of pay is not commensurate with their abilities for the high level assistant. There is no active push to create a new classification of "veteran assistant" that can prove they have exceptional skills and are therefore deserving of the associated increase in pay. This will continue to deter talent away from this career. 

- Hygienists are asking for massive increases in pay, greater flexibility, diminished patient loads and work hours without any additional skills or productive procedures they perform. 

- Dentist burnout as expectations from patients and staff continue to rise while compensation has largely remained stagnant. 

Q: How do you see your company/the industry evolving in the next three to five years?

AF: There will be a mass consolidation of dental offices under large DSOs as private practitioners attempt to control costs and realize benefits of economies of scale. The remaining solo practitioners will drop insurance and fill the cottage/boutique niche while downsizing staff to control overhead and increase the bottom line. Dentists may provide all the services including hygiene instead of overpaying for labor. The labor shortage almost makes this necessary anyway. As the baby boomers retire, we will lose a tremendous amount of knowledge and experience in the industry.

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