This month, dental professionals spoke with Becker's about staffing shortages, integrated care, insurance and burnout.
Here is what 14 leaders told Becker's in October:
6 dentists' biggest career 'wins'
Clark Stanford, DDS, PhD. Dean and Professor at the University of Iowa College of Dentistry (Iowa City): The opportunity to work with incredibly smart faculty and students, creating learning opportunities with every patient encounter. Dentistry is changing so fast, and I’ve had the ability to see the sense of discovery when a student uses a technology for the first time, encounters a challenging situation and deploys the ability to address the issue(s). Being a part of so many advances in discovery research, clinical innovations and education is the best reward anyone could ever ask for.
What keeps 3 dentists up at night
Huzefa Kapadia, DDS. Kapadia Dental Care (Waterford, Mich.) and Detroit Sterling Dental: When I first started dentistry, I would stress out about every procedure that was a surgical extraction or a root canal. Sometimes even crown preps. Did I over-prep it? I couldn't remove all of the root tips. Now, what's going to happen? With a root canal, is the patient still having postoperative swelling and pain, and why? I would lose sleep over all of these things and more. Does the staff like me, or do they talk about me behind my back? Do they think I'm a good dentist or terrible? Now, after 21 years working as a dentist, what keeps me up at night? Usually, coffee or Diet Coke at 8 p.m. That's a big no-no.
How Dr. Sara Larbi is prioritizing integrated dental-medical care at her practice
Sara Larbi, DDS. The Dentist Lounge (Santa Monica, Calif.): We really do have a responsibility to go out and seek new information. It takes time for that new information to be applied in a clinical setting, so I have personally witnessed resistance to new information that's come out and innovative and progressive ideas that can be implemented in dentistry ... The biggest one is the use of fluoride. We have hydroxyapatite, there's a lot of great research on that to help remineralize dentition. Xylitol is another great ingredient. Also, just moving away from mercury. I'm still seeing some mercury. We have a lot of great biocompatible materials that are friendly to the body. Even for diagnostics as well. Hopefully, at some point, we can make it a standard of care to do a 3D scan on most patients so we can actually catch pathology early on.
'I get to help people': Why 4 professionals pursued a dental career
Kevin Dow, DDS. Chicago Style Smiles: I love fixing things and working with my hands. As a kid I was always breaking things down and building them back up. When I was exposed to different areas of medicine, dentistry really seemed to make sense to me. I get to work with my hands, work with the public and help people, and fix broken things like I did as a kid. What wasn't there to love?
What will 2024 hold for staffing shortages? 6 dentists weigh in
Justin Harlow, DDS. President of Harlow Dental Group (Charlotte, N.C.): We've been fortunate to be at full staffing levels in all departments in our practices, but staff shortages in the industry at large have created a competitive market for employee retention. We've had to get creative in our benefits packages to add to wage compensation, including adding paid holidays, uniform allowances and continuing education to help retain staff. Overall, I do not believe practices will return to the ease of pre-pandemic staffing levels anytime soon and practices will continue to see tightening in the clinical and operational support staff market in 2024.
9 dentists share how burnout is affecting dental practices
Eric Rossow, DDS. Aspen Dental – Private Practice of Cherry Creek (Denver): Dentistry requires a great degree of perfection. If the work is off by a millimeter, it is often no good. And dentists cannot perform this work without a support team. So it takes a supporting workforce that also has attention to detail and believes in perfection to pull it off. With the workforce dwindling in numbers and the remaining workforce having less attention to detail than ever before, I think it will become increasingly more difficult to perform good dental care. That lack of quality support staff is affecting dental practices and has got to be the leading cause of burnout in the industry. It will take a total revamping of the dental workforce model to turn this around. The 10-year time frame the ADA reports it will take to correct the workforce shortage is far too long of a time frame, and have they even calculated for the millennial and Generation Z version of attention to detail?
Why 1 dentist dropped Delta Dental
Brian Fong, DMD. Dental Center of Atherton (Calif.): We recently dropped Delta Dental because our latest fee increase was back in 2011. With the rising cost of labor, utilities, rent and materials, our margins for many of those in-network procedures went to negative where we were providing hygiene appointments at a loss when looking at revenue versus cost.
The interesting thing we discovered is that some employers are providing plans with really competitive out-of-network Delta Dental coverage. Patients would never know this unless they actually saw an out-of-network provider though. So we decided to preauthorize our Delta Dental patients prior to their appointments so we could be as transparent as possible.
The 1 thing that 21 dental leaders would change about the industry
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.
What could hold DSOs back in Q4
Barry Lyon, DDS. Chief Dental Officer for the Division of Orthodontics and Pediatric Dentistry at Dental Care Alliance (Sarasota, Fla.): A major factor holding back DSOs from finishing 2023 strong is a pervasive lack of providers and auxiliaries. While patient demand continues to be strong, meeting that demand continues to pose challenges for DSOs. Driving this is the shortage of providers and auxiliaries. According to data from the Health Resources and Services Administration, the shortage of dentists in the U.S. has increased from 2022 to 2023. With the DSO market valued at $424.59 billion in 2023 and projected to grow to $761.09 billion by 2032, DSOs can expect the competition for hiring providers to continue to be fierce. To make matters even worse, the U.S. Bureau of Labor Statistics projects that job growth for dental assistants will only be about 7% from 2022 to 2032.
Low payer reimbursements hurting dental offices, 3 dentists say
Susan Dunn, DDS. Muskogee (Okla.) Dental and Implants: I built my practice in 1998. I sold it in June 2022, partly due to low reimbursement from third-party payers. We all know that these third-party payers are still paying at 1960s rates. Maximums of $1,000 or even $1,500 per year are so incredibly inadequate. Meanwhile, third-party CEOs are enjoying millions per year in profit. I am seeing DSOs and the next generation of dentists being very "creative" in how they practice in order to live a lifestyle that in the past was not at all difficult to attain. In addition, especially since COVID-19, expenses (due to increased regulations and the general effect from the pandemic) have skyrocketed. Thankfully, I am near the end of my career and have a very limited time remaining to deal with these situations.
Where oral surgery investment is headed next
Brian Hamilton. Managing Director at DuneGlass Capital and Chief Development Officer at Allied OMS (Fort Worth, Texas): Specialty oral care experienced a significant amount of investment over the past five years, with capital deployed across all dental specialties. While 2023 has been challenging across the board, because of the size and profitability of oral surgery practices, many investors are still looking to enter the space. Valuation expectations have been challenging, as noted above, but the valuation gap is decreasing, largely because selling practices now recognize the increased cost of capital, and some platforms adjusted spending in the first half of the year to optimize operations. As a result, we expect oral surgery investments to pick up earlier than the other specialties, primarily because of this higher margin profile and lower exposure to commercial and governmental payers.
'Things are really out of control': How rising costs are affecting dental practices
Pasha Javaheri Saatchi, DMD. Pasha Dental (New York City): Everything is increasing. We thought once the pandemic normalized, it would provide a respite from the increased costs in supply chain issues and inflation, but that hasn't been the case. Payroll has also increased tremendously. The widespread staffing issues that have plagued dental offices instilled a fear in me. I was happy with my staff and with pay transparency becoming much more prevalent. I had to offer very competitive wages to keep them.
Zan Beaver, DMD. Beaver Dental Care (Jacksonville, Fla.): I would like to see an end to the toxic amount of debt new graduates carry from dental school. Well planned and executed career paths are nearly impossible to attain with this atrocious burden. I am 25 years into my career now and would not choose this path if I knew I would graduate without the freedom to choose how I would practice due to crushing amounts of debt.
Businessman, insurance agent or pediatrician: What 5 dentists might have been
Shaun Malek, DDS (Pasadena, Calif.): If I was not a dentist, I would have gotten a business/real estate degree and bought old houses, restored and sold them. This way, I would have stayed away from a hefty student loan and dealing with insurance companies. I could still use my talents in restoring things to their original conditions and make more money.