The 1 thing that 21 dental leaders would change about the industry

Company expansion, employee retention and preparing for 2024 are three things leaders are looking to complete this year. 

These 21 industry leaders shared the top thing that they would change about dentistry. The executives featured in this article are all speaking at Becker's The Future of Dentistry Roundtable, which will take place Oct. 25-27 at the Swissotel in Chicago.

To learn more about this event, click here.

If you would like to join as a speaker, contact Randi Haseman at rhaseman@beckershealthcare.com.

Question: If you could change one thing about the dental industry, what would it be?

Jason Auerbach, DDS. Founder and President of Riverside Oral Surgery (River Edge, N.J.): If I could change one thing about dentistry today, it would be mindset. The mindset of providers in their willingness to collaborate. Everyone wins when great minds share experience and ideas. The mindset of payers in their approach to reimbursement for optimal care. The least expensive solution to a problem is rarely the best option. The mindset of patients in their understanding that prevention and maintenance is much less costly and far less invasive than reactive care.

Catrise Austin, DDS. Owner of VIP Smiles Cosmetic Dentistry (New York City): If I had the chance to drive change, my primary focus would be on aligning dentistry with modern advancements, particularly harnessing the potential of virtual and mobile patient care. The recent pandemic has highlighted the critical role virtual consultations play in enhancing accessibility and convenience in dental services for our patients. Additionally, I believe there is a significant need for more effective dental health promotion, especially within underserved communities. Furthermore, it's vital to protect our profession and educate consumers about the potential risks associated with seeking dental treatments from non-professionals who are now performing veneers and braces without licensure. These individuals are teaching training courses to other non-licensed individuals and it's getting out of hand. Proper regulation and comprehensive public education are essential to mitigate the dangers of "basement dentistry" and dental tourism, ensuring the preservation of respect for the dental profession.

Brent Barta, DDS. CEO and Chief Dental Officer of West 10th Dental Group (Indianapolis): I would love to see the dental education system make efforts to better align with the rapid changes that are occurring in our industry. COVID dealt a real blow to dental education, and I see the efforts that are being made to rebound. However, graduates need a much greater exposure to the exploding technological advances in the clinical practice of dentistry in addition to the rapid changes in the business models exhibited in the DSO and group practice settings.

Tobi Bosede. Founder and President of DentalFynd (New York City): If I could change one thing about the dental industry, it would be surprise bills. Patients have very little coverage with dental insurance and are often assuming insurance is going to cover their bills, but then are hit with unexpected expenses. Similarly, rates negotiated with dentists by insurance are paltry. Surprise bills wouldn't be an issue if patients simply paid dentists directly for care. So I have in fact changed this by creating DentalFynd, an on demand AI platform where patients shop for care and dentists get fee-for-service patients.

Karandeep Brar, DMD. Founder and CEO of Bright Choice Dental (Havertown, Pa.): One of the pressing issues I would address within the dental industry pertains to the misconceptions surrounding dental practice valuations. Regrettably, these misconceptions have cultivated a scenario where many dental practitioners, who once viewed the sale of their practice as a cornerstone of their retirement strategy, now confront the daunting choices of either walking away from their practice or accepting a substantially reduced sale price. I have observed numerous practices that exhibit significant growth potential; however, suboptimal management and an inadvertent shift from profitability have adversely affected their valuation. In response to these industry needs, we have implemented an innovative financing strategy. By leveraging this approach, dentists are able to optimize the value of their practice through the extensive resources and adept management of our established group.

Bryan Carey. CEO of Benevis (Atlanta): One crucial change needed is ensuring access to quality dental care for all Americans, regardless of their income. Unfortunately, the scarcity of dentists willing to accept Medicaid patients, often citing inadequate reimbursement, exacerbates the issue. Including Benevis, only 18% of dentists in the U.S. treat 100 or more kids covered by Medicaid or CHIP. Additionally, the shortage of dentists and hygienists compounds the challenge, making it increasingly difficult to access excellent dental care. To make matters worse, as many as 15 million Americans are expected to lose Medicaid benefits in 2023 due to the unwinding of public health emergency funds. More than 41 million children in the U.S. are insured through Medicaid or CHIP, and, once dropped, Medicaid beneficiaries often skip necessary preventative care leading to deteriorating oral health, greater complexities, increased school absences and emergency room visits. The importance of oral health cannot be understated, as it impacts overall well-being, with access to healthcare, education and public health policies all playing pivotal roles in children's oral health.

Matt Carlston, DMD. Dentist at Comfort Dental (Lakewood, Colo.): I would change the high cost of becoming a dentist. I speak with many dental students and most have a tremendous amount of debt. This causes students to "settle" for a job instead of building a career. If they make the wrong decision upon graduation, it can delay their career for years to come. They aren't told by the dental schools how to free themselves from debt. Most hiring docs and organizations do not fully understand how much income needs to be earned to pay off their debt and achieve financial freedom.

Jeffrey Carter, MD, DMD. Chief Medical Officer and Oral Surgeon of US Dental Surgery Network (Nashville, Tenn.): The dental industry faces a manpower shortage that is acute in certain specialties. Our medical colleagues have been able to expand access by developing roles for physician extenders and midlevels. Dentistry only has licensed hygienists to support the general practitioner. The time has come for the development, recognition and implementation of midlevels to improve access. Specialties like oral and maxillofacial surgery and dental anesthesiology could dramatically improve access with nurses, nurse practitioners and CRNAs. This will require modification of the CDT coding system to recognize these extenders working in a collaborative practice. The dental insurance industry should replicate the acceptance of these individual's cognitive services in a manner similar to Medicare and Medicaid.

Kristen Cusack. CEO of Phase 1 Equity (Dallas): If I could change one thing about the dental industry, it would be to increase the collaborative opportunities available for doctors. According to a recent ADA report, the anxiety and depression rates for dentists tripled in 2021 compared to 2003 rates. Independent practice can be lonely, and doctors often feel that they have to figure everything out for themselves from the clinical to the day-to-day business operations. That brings a lot of stress and uncertainty that is resulting in depression and anxiety for a growing number of doctors. It's one of the reasons collaborations is a central part of the Phase 1 Equity model. Doctors are connected in a way they have not been before and that provides a forum to share best practices, mitigate concerns and enhance clinical expertise. Because the profession can be so solitary, many doctors do not even know that they are missing this critical element.  Importantly, working with others who understand you and can share ideas and solutions goes a long way toward achieving better mental health, a stronger, more profitable practice and enjoying the work.

Bradley Dykstra, DDS. Founder, CEO and Clinical Director of MI Smiles Dental Group (Hudsonville, Mich.): The number one thing I would change is how dental insurance copays/coupons (not actually insurance at all) work so they are clear to the patients what they really have, and more importantly for the offices to easily get correct information from the insurance companies so we can quickly and correctly determine the patient portion of the services proposed. A very close second is to have a sufficient supply of qualified providers and team members available.

Suzanne Ebert, DMD. Vice President of Dental Professional Career Services at the American Dental Association (Chicago): If I could change one thing about the dental industry, it would be to foster greater awareness among the general public about the critical importance of maintaining their oral health. The undeniable connections between oral health and overall well-being, such as the impact of periodontal disease on birth weight and its association with chronic conditions like Alzheimer's and cardiac disease, highlight the urgency of this issue. In an ideal world, dentists would be recognized as specialists in oral health, and the importance of preventive dental care would be embraced by the public. This proactive approach would help individuals avoid costly and potentially life-threatening problems from compromised oral health. The ultimate outcomes of increased dental care utilization by the public would include a reduction in emergency room visits, a decrease in chronic health conditions, and a positive impact on the overall health of our society. 

Travis Franklin. CFO of Heartland Dental (Effingham, Ill.): If I could change one thing about the dental industry, it would be to address the crisis in access to dental care over the next decade, especially considering the overall growth in demand for dental services. One way to do this is by expanding the availability of dental professionals, both dentists and hygienists. This can be achieved through the expansion of education programs and the implementation of incentives to encourage more individuals to enter the field. By bolstering the workforce, we can ensure that people have better access to essential dental services, ultimately improving overall oral health and well-being within our communities. This proactive approach is essential to address the impending care crisis in the dental industry.

Haim Haviv. Founder and CEO of Hudson Dental (New York City): It would be the power that the insurance companies have over pricing and how unfair it is. They make all the money and pass on next to nothing to the doctors who are providing care. Occasionally they come back with different audits to try to recoup money from providers, and it's not usually based on the work that was done, it is based on the rubric that they set for how they think work should be done.

Richard Huot, DDS. CEO of Beachside Dental Consultants (Vero Beach, Fla.): Going forward, with insurance companies increasingly looking at the bottom line, and trying to solve their budgetary problems by lowering reimbursement even with the inflationary overhead expenses, it's time for dentists to look at the way they provide services going forward. Most professionals including attorneys, builders, engineers and many tradesmen don't have a set "fee" for the level of service they provide, but rather their compensation is based on the degree of difficulty, and the time it takes to complete the project. By working "backwards" and deriving the costs of doing business, an hourly rate can be calculated by the dental office that is required to pay expenses and determine a healthy proportion of profit to be made from these procedures. This will get the dental office away from the "piecework" approach, and more to an hourly type of reimbursement. Once this philosophy is established, a dentist can determine which type of insurance plans he or she will accept that fall into the range of proper compensation.

Abe Jarjoura, DDS. President of Dental Care Team Group (Grand Blanc, Mich.): Having to justify to insurance companies the rationale, and reason for the treatment you recommend and perform. 

Abhishek Nagaraj, DDS. Co-CEO and Full Arch Implant Surgeon of Areo Dental Group (Chicago): I would create strict rules and regulations around the ability of larger dental corporations to dissuade them from paying large sign-on bonuses to new graduate dentists just to entice them into working with them. This creates a sense of false expectation of what dentistry offers and does a huge disservice to the newer doctors who get distracted by shiny objects instead of focusing on becoming great clinicians or working with groups that offer great true clinical mentorship in helping them become great clinicians. Ultimately, this can be really detrimental to the patient experience.

Dipesh Patel, DMD. CEO of Blueprint Smiles Dental Group (Atlanta): I would advocate for a transformation in dental insurance structures to align more closely with general medical insurance plans, addressing the disparity in patient maximums which have stagnated for years despite the rising costs of dental care. The current "coupon" model of dental insurance often misleads patients, leading to underutilization of essential dental services due to financial barriers and misaligned perceptions of what is covered. Aligning dental insurance more closely with medical insurance would involve abolishing annual maximums and ensuring that necessary procedures aren't delayed or avoided due to cost. This alignment could foster a more preventative approach to dental care, align patient perceptions of dental and medical care, and ultimately improve oral and overall health outcomes across populations. Additionally, creating an insurance model that promotes and rewards preventative care could alleviate longer-term healthcare costs and improve oral health outcomes on a wide scale.

Lynda Ricketson. President and CEO of Dental Lifeline Network (Denver): If I could change one thing about the dental industry, it would be to make high-quality dental care more accessible and available for everyone. Dental care in this country is a luxury for so many, especially vulnerable individuals who are disproportionately affected by dental disease. Dental Lifeline Network, through the generosity of volunteer dentists and laboratories, works to ensure those less fortunate are able to eat healthy food and smile again. 

Daniel Romary. Chief Information and Analytics Officer of North American Dental Group (Pittsburgh): The primary thing I would change in the dental Industry is the barrier to patient care. There is a virtually unlimited demand for quality dental care across the U.S., but the limited availability of providers and practices to see new patients has been a challenge. Related, the other area here that I would change is building a bridge between comprehensive healthcare and dental.

Jeffrey Tomcsik. CEO of Grand Dental Group (Aurora, Ill.): If there were one thing I would change about the dental industry today, it would pertain to our relationships with the dental insurance companies. The majority of dental offices and groups have very little leverage over the insurance companies. The past few years have been absolute game changers for the dental industry. Wages have increased 30%. Supplies have been on the rise for the past three years. Equipment pricing has spiked and availability in some cases still remains an issue. All this leads to reduced profitability at a staggering rate, profoundly impacting some of the largest DSOs right down to the smallest individual practice. Despite this being relatively transparent to the insurance industry, the insurance companies remain quiet and steadfast in the position that they will not raise their reimbursements at any significant level. I understand capitalism and the importance of the almighty dollar, but when corporate greed is so demanding that it blinds the board members, management and shareholders from ensuring ethical care and providing a true value to their clients, the patients, something has gone wrong. 

Robert Trager, DDS. Dentist at JFK Airport (New York City): Companies are always advertising their products because they want people to buy them. However, companies should advertise why it's important to see a dentist and why oral health is important. If you educate the public on why they should see the dentist, the dentist would be busier and would order more supplies from the dental supply companies. Labs would have more people getting prosthetics, supply companies would have dentists buying machines and materials and dentists would have more patients, making it a win-win for everyone involved. 

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