Why the 'Walmartization of dentistry' frustrates 1 practice owner

A lack of updates in insurance practices and increased DSO consolidation has created a tough environment for dentists, according to Rajdeep Randhawa, DDS.

Dr. Randhawa is the owner of Innovative Dentistry in Colts Neck, N.J. He recently spoke with Becker's about the most frustrating aspects of the dental industry.

Editor's note: This response was lightly edited for clarity and length.

Question: What frustrates you most as a dentist?

Dr. Rajdeep Randhawa: The amazing thing is that when you love the practice of modern dentistry [and] love interacting with your patients who trust you, nothing frustrates you as you enjoy the practice of dentistry, always striving to provide your patients with the best 21st century dentistry has to offer, including minimally invasive dentistry and other great options to keep their natural teeth healthy in consonance with their increasing lifetimes and their urge to have healthy smiles for life.

The constant decline of the dental profession over the last 70 years or more is definitely much more alarming with the ADA, which represents the majority of the dental profession, willfully surrendering the interests of their member dentists to the all-for-profit insurance industry by writing ADA codes with minimal fee structures that haven't changed much over a long period of time. Intensive ADA codification has led to the ultimate "commoditization of dentistry," where patients shop around for dental procedures like they are shopping for different products on Amazon or other shopping websites like eBay without regard to the skills, education or experience of the dentist.

DSOs throughout the country with the tacit support of private equity and other investors are aggressively moving toward a rapidly organized "Walmartization of dentistry," with the ADA again turning a blind eye.

Outdated ADA codes are used by the insurance industry on a daily basis to exploit hundreds of thousands of in-network providers, dictating them to do outdated maximally invasive dentistry, denying millions of dental claims [and] causing a lot of stress and anxiety for both the providers and patients alike. Very skimpy dental plans with a lot of in-built plan limitations, low yearly maximums now using [artificial intelligence] to reject claims, and paying a lot less than the rapidly increasing cost of doing business in dentistry is a nightmare that all the participating insurance dentists have to face every day.

The high cost of dental education, increasing costs of acquiring and running high-volume, low-profit insurance dental practices makes the business of modern dentistry a lot more complex, expensive and stressful for the newer generation of graduating dentists, demotivating them from working toward having their own independent practices. DSOs know this critical weakness and fervently try to recruit young dentists from dental schools, giving them different incentives as they need more dentists to run their rapidly expanding group dental practices that are also many a times very aggressively competing with each other in highly saturated areas.

As a dental professional who thinks about the greater good of the whole dental profession, it is concerning that the newer generation of dentists that are coming out of dental schools with a high debt burden [and] again have to go through high debt to purchase dental practices, with thousands of them easily giving up the goal of having independent dental practices prematurely and ambivalently start working for DSOs [and] other private dental employers, spending the best part of their working lives working for others creating wealth [and a] constant source of income for third parties or other dental investors.

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