Why pay is no longer enough to recruit staff: Q&A with Dr. Larry Stone

There are several factors contributing to staffing shortages at dental practices across the U.S., and pay is no longer enough to recruit and retain talent, according to one dentist. 

Larry Stone, DDS, of Doylestown (Pa.) Dental Solutions, recently spoke with Becker's about current challenges in the dental industry and which technology is improving services. 

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

Question: What is the biggest challenge facing the dental industry today?

Dr. Larry Stone: The single biggest problem right now is staffing. COVID really just exacerbated some of the problems. But the dental industry is being challenged on so many fronts. Student debt; staffing; the takeover by franchises, corporates and DSOs; the insurance industry. I've never quite seen anything like this. I've been at this for 50 years now. Next year will be my 50th year. And we've seen challenges before, but I don't remember seeing anything quite like this. In addition to the economy and inflation, I've been through it all, but I think it's extremely challenging now.

I don't know what's going to happen. I'm not very good at predicting the future. I see what's happening and some of it's good. Some of it I don't like, much of it I don't like. Of course, the advent of technology and [artificial intelligence] in dentistry is a good thing. Those are certainly a lot of advancements within the profession. But to be able to access that and utilize it, you need money and skills. Dental offices are not like hospitals that are either nonprofits or have fundraisers to help them build a new wing or do something like that. If we need a $50,000 scanner or a $100,000 CBCT or something like that, nobody's having fundraisers for us, we have to go out and buy it ourselves. The average dental student, if they're going to open their own practice, even like I did, they're going to be out of school five years. But when I graduated, there was no debt. The average debt now is about $300,000. And I heard the other day it takes about seven years for a graduate to pay that off. Only 7 percent, I believe, of the dental school graduates are debt free.

Q: What are your thoughts on pay no longer being the driving force behind staffing shortages?

LS: I completely agree with that. I sold my practice just before COVID, about three years ago. The staff I had when I sold the practice, all of them are gone now. It's a completely new staff, but for different reasons. One young lady moved, she took a job closer to an office where they moved to, and she's got three young kids, so family matters. A couple left for cultural reasons, they didn't get along with the new owner. Frankly, he's made some improvements. Sometimes I think he treats the staff better than I did and I joke [that] he makes me look bad. I had an assistant who was with me for 15 years and she left because she hadn't had a raise in five years so she went to an office that's paying her $7 an hour more than she was making with us. 

Q: When do you think challenges with staffing and recruitment will begin to improve for dental practices?

LS: I don't have any predictions, but I think it's going to take a while because, for example, I'm in the greater Philadelphia area. We have a lot of schools here, a lot of residency programs, hygiene schools, all of that. The [local] dental assisting program, they only have, I think, six young ladies who graduated last year or were seniors this year in the dental assisting program. And they get snapped up immediately upon graduation. And the same thing is true with the hygiene programs. With the way some of these DSOs and corporate practices are being run, they get burned out.

Q: What technology do you see improving efficiency and patient care in dentistry?

LS: I think scanners are terrific and they're fairly affordable at different levels. They can do so much more to help educate patients. When I first bought an intraoral camera many years ago, it was about a $10,000 investment. That intraoral camera paid for itself in about a week because I could show people what was going on in their mouths. I could take a photograph and put it up on a screen and show them what was going on. By educating them, they were much more willing to accept treatment. And that's what I see with scanners. And now with artificial intelligence, they have the ability to show people what an orthodontic treatment would look like on the spot.

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