'The nobility of healthcare is being lost': The toughest decisions facing 4 dentists

Some of the toughest decisions for dentists today can include how to keep up with insurance companies and when it's time to grow or rightsize your team. 

Four dentists recently spoke with Becker's about the toughest decisions they have to make. 

Editor's note: Responses were lightly edited for clarity and length.

Question: What are the toughest decisions you have to make as a dentist?

Bertram Hughes, DMD. Family & Cosmetic Dentistry (Gainesville, Fla.): One of the toughest decisions for dentists today surrounds having to make business decisions about their practice in reaction to policies of insurance companies. When operating in-network, the dental office is oftentimes put in the precarious position of having to choose the viability of the practice versus providing care at the high level they wish to. Accepting plans, especially in today’s environment, comes with a risk of third-party payers using monetary or reimbursement pressure to shape the dental practice. This outside construct can influence the type of patients a practice will attract, as well as the experience the practice will be able to provide. 

With stagnant reimbursement rates or fees that are being reduced by insurers, many dental practices are having to limit their access to patients using dental benefits. We, as dentists, were all trained to treat patients to the best of our abilities. In addition, the entire dental team works diligently to help make our patients healthier. In the current environment, for practices that treat patients with dental plans, dentists are having to focus more on their practice as a business. The nobility of healthcare is being lost due to these aforementioned pressures. Thus, the dentist often feels they are in a decision dilemma while trying to provide the high quality healthcare they expect of themselves. 

Raymond Mascolo, DDS. Mascolo Dental (East Northport, N.Y.): As a practicing dentist for 44 years, the hardest decision is when and how to stop working. I am lucky to have a son and daughter-in-law who are both dentists and two other dentists in my practice who are like family. They wanted to get involved with a DSO and I went along with them. It looks like a good decision. Things still need to be worked out, but we are lucky to have joined Dental Care Alliance which has excellent leadership and seems to be a great way that I can continue working and being involved with the practice when I do not want to actually treat patients.

Michael Perpich, DDS. Northland Smiles (Deerwood and Little Falls, Minn.): The hardest thing has had nothing to do with patient care. It was when I had to lay off my entire staff when the pandemic hit.

Bob Stewart, DDS. Blessed Dental (Texas): As the visionary in a group practice, my toughest decisions have to do with staffing. When do we grow? When and how do we rightsize?

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