The life of a dentist is full of tough decisions, from deciding what to do after graduating dental school to having to fire staff members.
Six dentists recently connected with Becker's to answer, "What is the toughest decision dentists have to make?"
Note: Responses have been lightly edited for length and clarity.
Robert Boff, DMD. Ramsey (N.J.) Family Dental: The toughest decision I've needed to make recently was to drop out of a PPO network. For more than 25 years I had been a premier provider for this particular insurance company and a few years back was unknowingly recategorized into their PPO group.
Out of concern of losing patients and volume, I continued to provide for this insurance company with continuously reduced coverage for procedures and a predatory case review system designed to recover so-called overpayments.
The last straw was when this particular company denied coverage for emergency procedures and enhanced protective equipment during the heart of the COVID-19 crisis.
I dropped out of this PPO/premier hybrid and haven't looked back since. I'm working smarter and not harder. Ridiculous adjustments of over 50 percent are a thing of the past. Most of my patients understood the move and have stayed with our practice, and the majority of those that had left have returned.
A very difficult yet immediately rewarding decision. I wish I had made it 10 years ago.
Louis Cooper, DDS. Greenwich (Conn.) Hospital: The way I see it, the following are three of the toughest decisions dentists have to make:
1. With the increasing activity of DSOs and private equity, dentists face a decision as to whether the advantages of entertaining joining this new wave outweigh giving up their independence.
2. The decision to accept or not accept certain insurances or insurances at all is one that I believe plague many practitioners given the reimbursement for services seems to continually diminish.
3. Constant increases in costs for staffing, supplies and equipment presents doctors with the question of how to balance savings without sacrificing the quality of care.
William Hunt, DDS. William H. Hunt, DDS, PA (Forest City, N.C.): What should I do after graduation from dental school? There are so many options. Grad school? Teaching? Solo practice? Group practice? DSO? All of these are very dependent on the financial factors of the student. Some paths can lead to incurring further debt that can make them seem like an overwhelming impossibility. We must remember that a lot of them already have what seems like an insurmountable debt. The idea of adding to that will send some to areas that are not the choice that they truly desire. We all had to make that decision. Let's remember that and try to do whatever we can to make that easier for the next generation that will represent our great profession.
John Moon, DDS. QC Family Dentistry (Davenport, Iowa): I asked my other doctor and we both agreed that having to fire longstanding staff members is the most painful decision dentists have to make.
Paul Rotunda, DMD. Vice President and Chair of the Department of Dentistry and Oral Maxillofacial Surgery at Jersey City (N.J.) Medical Center: Tough decisions in dentistry are commonplace. One of the first and omnipresent challenges is with respect to patient care. One must decide if the ultimate goal is to provide the best care or to act for financial gain, perhaps compromising quality. This can be distilled down to a life's philosophy of, "Do you put money first or people first?" Each person must decide for themselves. Recognize that the temptation has and will always be there. Altruism can be easy during good financial times but challenging during difficult ones.
Another challenge is when to let an employee go. Statistically, and by their own admission, dentists tend to wait too long. But whatever tough decisions dentists are faced with, if they are viewed as a challenge and dealt with in a positive manner, good results will follow. They are an opportunity for accomplishment and to make a difference. They will be an event to reflect back upon.
Christen Simpson Raynes, DDS. Simpson Dental (Charleston, W.Va.): I would say for me there is so much technology available today, it is so hard to know what and when to invest in it. We are dealing with it in so many aspects of the business, from the office management side to the actual dental treatment. And the minute you invest there is something else that does it better. It can be daunting and frustrating keeping up with all of it.