Staffing and scheduling challenges have led hygiene services to be less profitable for dental practices, according to Edward Feins, DMD.
Dr. Feins, of River Vale, N.J., recently spoke with Becker's to discuss the challenges facing dental practices in 2024 and what practices can do to evolve.
Note: This response was lightly edited for clarity and length.
Question: How do you think the dental industry will evolve in 2024? What changes do you hope to see?
Dr. Edward Feins: I've been practicing for 33 years and the dental industry, in my opinion, is going to need to start evolving in a number of ways. The most difficult thing at the moment is staffing. The big area right now in my office is hygiene. Hygienists are in shorter supply, at least here in New Jersey. They want to be paid more. Many do not want to work the traditional longer hours we did prior to Covid. In addition, our appointment length increased after Covid for safety reasons, and it appears the appointments generally will not be made shorter now, as nobody wants to go back to that. So what does this mean? It's a struggle to staff a busy practice that may want to offer later or Saturday hours. While it is true more people work from home now and are available during the day, many generally still prefer some later or Saturday appointments. Hygiene is no longer as profitable as it once was for a practice. Simply put, higher pay, less availability and fewer patients are now evolving as a loss leader for dental practices.
The struggle continues because, for those of us who participate in PPOs, we have limited pricing power to increase our fees. In general, without recall visits, we have fewer opportunities to examine and diagnose dental disease. One can say to themselves, "Drop the PPOs," but it is not necessarily good for the patients or the practice. How we evolve from this is going to be by operating a more efficient hygiene schedule leveraging technology to have command of the schedule and limit dead time. In addition, I think the practices that evolve [to have] better human resources policies for hygienists will attract the talent. Finally, doctors are going to need to be better diagnosticians and educators to their patients so that these relatively unprofitable recall visits are more profitable on the treatment side. In other words, make the loss up by diagnosing diseases better.
On the administrative side, it's increasingly difficult to find employees who are well-versed in insurance and accounts receivable management. I do believe we are going to need to evolve to outsource more of our insurance claims, billing and collection. Technology is starting to make that easier, but I don't think we are quite there yet, not until we have more standardized software across insurance platforms. This would ideally get incorporated into the practice management software of an office. That would make things so much easier to manage upfront.